The emergency department is the toughest healthcare environment
in which to achieve high patient satisfaction. Complaints about the
speed of service and operational processes are common. In such a
stressful environment, it may make all the difference to patients
simply whether staff members are nice to them. Is this
basic expectation being met?
Data from Gallup's 2001-2003 healthcare databases include
thousands of patient ratings of the "caring and compassion" of both
ER doctors and nurses. Despite the much-publicized operational
challenges America's emergency departments have been dealing with
over the past few years, and the subsequent obstacles ER doctors
and nurses face, satisfaction with the care and compassion of both
doctors and nurses remained stable between 2001 and 2003. In each
of the three years, nurses received higher mean scores than doctors
on the caring and compassion question. In 2003, nurses received a
score of 3.42 (on a 1-to-4 scale) for care and compassion, while
doctors scored 3.32.
Mean scores are a good indication of general satisfaction
levels. But Gallup research has shown that the most predictive gaps
(namely, those that best determine those who will return to the
hospital from those who won't) are between patients who give
ratings of "very satisfied" and all other patients (those giving
ratings of "satisfied," "somewhat dissatisfied," and "very
dissatisfied"). Therefore it is helpful to examine the percentage
of patients giving "very satisfied" ratings to the care and
compassion of nurses and doctors.
Regarding both nurses and doctors, about half of patients say
they are very satisfied with the care and compassion shown. As with
the mean scores, nurses outscore doctors, but only slightly (by 51%
to 48% in 2003).
What do these findings tell us? First, regardless of how the
data are examined, patients see ER nurses as more caring and
compassionate than ER doctors. Second, doctors don't lag far behind
nurses in the percentage of patients who are "very satisfied."
Rather, doctors are more likely than nurses to receive
dissatisfied ratings on the care and compassion
question.
Why Are Nurses Viewed as More
Compassionate?
It's no surprise that nurses outscore doctors on care and
compassion. On Gallup's annual honesty and ethics poll, Americans
routinely rate nurses as the profession with the highest level of
honesty and ethics. Doctors also score very highly on the honesty
and ethics poll, but significantly below nurses (see "Nurses Top
List in Honesty and Ethics Poll" in Related Items). Also, nurses
are frequently portrayed in the media as short-staffed, overworked,
and underpaid. Before they even enter the emergency room, most
patients probably have a more favorable and sympathetic impression
of nurses than they do doctors.
Sexual stereotyping may also come into play. Women are
traditionally viewed as the more caring and compassionate sex. And
even in the 21st century, nurses are frequently
stereotyped as female and doctors are stereotyped as male.
The ER environment itself is another possible contributor to the
perception that nurses are more caring than doctors. Time is of the
essence, and Gallup has found the No. 1 complaint among ER patients
is that it took too long to see the doctor. In many cases, doctors
may have to choose between taking extra time to interact socially
with each patient, or dispatching with small talk in the name of
efficiency. Doctors who choose the first option may see fewer
patients and increase wait times; doctors who choose the second
option run the risk of being seen as uncaring.
Doctors with poor ratings in the "care and compassion"
department may simply not realize the power of a few simple
guidelines for patient interactions:
- Address each patient by name.
- Fully enter the treatment area and sit down while talking to
the patient.
- Ask patients if they understand and have them repeat back
critical information.
- Always finish by asking if the patient has any questions.
- Smile.
