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ADVANCE Perspective: Nurses

Take Your Coat Off, Doc, Sit a Spell

Published October 9, 2013 11:39 AM by Chuck Holt

I 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 Coat Hypertension

Fortunately, 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.

In 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). 

Like last 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 smoking.] 

But I digress (an effective diversionary tactic, no?).

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 one-minute visit. 

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.” 

[Read the Caring Presence article in its entirety here.]

Meanwhile, 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.

Either 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.


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