Take Your Coat Off, Doc, Sit a Spell
have a confession to make: I suffer from White Coat Syndrome. My brow sweats, my
heart pounds and my blood pressure spikes with each doctor’s office visit. Some
call it White
I finally have a doctor who understands this, after seeing another who insisted
on prescribing blood pressure medication for me instead of hearing me out. We even joke
about it, my good doc and his nurse and me; but only after the
readings on my wrist monitor taken before and after a few visits proved my blood
pressure is completely normal outside his office.
addition to never wearing a white coat, something that helps a lot is that my
doc is very quick-witted and always up for a chat about most anything, which is
usually what I have to offer, i.e., something I’d been thinking of mentioning to
him that has nothing at all to do with my general health and well-being let
alone the reason for my visit (diversionary tactics).
visit, when I was telling him all about a friend who used e-cigarettes to quit smoking.
She found that what she was really addicted to was drawing the smoke into her
mouth, and the inhaling and the exhaling. So she just bought the non-nicotine
cartridges instead and satiated her oral fixation with the vapor. Two months
later and she still doesn’t miss the nicotine. [Check out one of the features
"Nixing Nicotine" in our Lifestyle
for Nurses section sponsored by Dansko for more tips on quitting
But I digress (an effective diversionary tactic,
One of the other things my doc does to put me at ease is when he
comes in to the room he sits down in a chair. Although to be honest, I did not even realize this was
making me feel better until I
happened upon a study about sitting docs having happier patients by
researchers at The University of Kansas Hospital Spinal Cord Injury Center in
Kansas City, Kan.
Among the many fascinating things they discovered was if a
doctor sat down during an office visit they were perceived as spending 40% more
time with their patients, whose satisfaction scores increased accordingly. Many patients said they felt their doctor had been in the room
for at least five minutes when in reality it had not been much longer than a
And it can work for nurses, too, experts say, many noting that
the simple act of sitting down in a chair near the head of the bed instead of
standing at the foot of it makes a patient feel as though the caregiver is taking greater interest in them and actively listening to their story.
Some call it "Therapeutic Presence" while others
refer to it as "Caring Presence." If the latter sounds familiar it may be
because a feature article by that title may have appeared in one of your recent
issues of ADVANCE. Written by holistic nursing expert, Veda
Andrus, EdD, MSN, RN, HN-BC, the article delves deeper into the meaning patients
put into simple gestures made by clinicians and offers ideas for how you can
incorporate being present into your nursing practice.
And as Andrus
points out, being a caring presence for patients is a notion that is especially
timely as the health reform law is implemented.
“Today, with the implementation
of the Affordable Care Act (ACA), value-based purchasing, the Hospital Consumer
Assessment of Healthcare Providers and Systems (HCAHPS), and a focus on the
patient experience, the stakes are even higher for nurses to provide sustainable
quality outcomes for their patients,” Andrus writes. “With a new focus on
reimbursement from CMS, nurses are now called upon to have an understanding of
and direct relationship with the business side of healthcare.”
Caring Presence article in its entirety here.]
I’m certain there are many of you who could tell us a story or two about making a
difference in a patient or family member’s life simply by being present and
listening when it mattered most. Or maybe you can share some tips for how to
spot the symptoms of White Coat Syndrome and prevent a patient like me from
being misdiagnosed with something more sinister.
way, we’d love to hear what you have to say by commenting on this blog [also don’t miss the ADVANCE blog The Politics
of Healthcare]. Or, share your experiences anytime via our interactive feature “Tell Us Your Nursing
Story” also in our special Lifestyle
for Nurses section.