The view from a hospital bed can be intimidating. Doctors and nurses coming in and out of the room—the tests, the IVs, the beeping machines, the unfamiliar space, and many faces. It’s easy to feel overwhelmed and uncomfortable.
But what happens when a doctor or nurse takes a few moments to stop, to sit, and to simply talk?
“It’s heart-to-heart communication,” Carlos Galindo said. Galindo is Manager of the Patient Experience Office at The University of New Mexico Hospital. “It’s more impactful and the patient remembers the interaction.”
“Commit to Sit” is the nationally recognized evidence-based practice that puts this heart-to-heart communication consistently into practice. UNM Hospital has been piloting Commit to Sit in three units of the hospital since January. The idea is for doctors and nurses to be intentional about making time to sit down with their patients to check in, to hear their concerns or fears and to listen. “It’s having that one-on-one undivided attention on the patient, letting them know, ‘I'm here for you. I'm listening; let me know what's going on,” Galindo said.
When I sit with my patients, I find out so much more about them. My connection feels stronger in terms of how much I trust them, how much they trust me, and their understanding of their medical situation.
Nationally, the data shows 81% of patients surveyed rated the importance of their physician sitting with them as 8 out of 10 or higher. The sitting posture is also associated with greater compassion and makes patients feel more comfortable asking questions.
Jessica Kelly is the Director of Patient Relations at UNM Hospital. “Everything driving where we're going is based on feedback directly from the patients about whether they felt like their caregiver explained information in a way that they understood, listened to them, exhibited respect and empathy,” Kelly said.
“When I sit with my patients, I find out so much more about them,” Cassie Shaw, MD, said. “My connection feels stronger in terms of how much I trust them, how much they trust me, and their understanding of their medical situation.”
Shaw is an Assistant Professor of Internal Medicine at UNM and the Medical Director of 4 West, the general inpatient medicine unit at UNM Hospital. She’s no stranger to sitting with her patients. In fact, it’s become a point of emphasis for her.
“I used to carry a little stool with me,” she said. “I still do to some of the places in the hospital, especially the ER where there are a lot of beds set up in the hall. I’ve had patients remember who I was on the care team because I’m the doctor with the stool.”
Shaw says she first learned the importance of sitting with patients in medical school. “It’s something I’ve tried to do for a long time. But as we get in a hurry, and we’re coming out of this pandemic, and the hospital is really busy, I think it’s something that has fallen to the wayside for many of us.”
A key goal of “Commit to Sit” is making sure patients recognize and remember connecting with their clinician or nurse. “You’re being deliberate about something you know that you like to do and that you know is important. It takes no extra time, and it gives back so much more than it would ever take effort wise,” Shaw said.
“When I go into a room, I identify the chair in the room. Sometimes I have to ask if I can move the patient’s belongings and I have a seat. I say, ‘Hi, I’m Dr. Shaw. I’m here to chat with you about your care. Do you mind if I sit for a little bit and chat with you?’”
Shaw says she’s noticed patients do ask more questions when she sits with them and open up about their care, their symptoms and how they are feeling. Patients who have gotten used to Shaw sitting with them will sometimes even invite her to sit. “They’ll say ‘Oh, why don’t you have a seat. Are you in a hurry today?’”
As a new nurse at UNM Hospital, Ashley Martinez, RN, says “Commit to Sit” has really helped her develop communication skills with her patients. “I can see the difference by just getting down to their level and letting them be heard. They’re often so frustrated and they just they need time to let it out,” she said.
Martinez works with high-risk OB GYN patients who are often feeling stressed. “I can see it on their faces that they are scared. I try to reassure them that we’re doing the best for them and for baby and tell them ‘You’re in a safe place and we’re working really hard for you.’”
Units piloting Commit to Sit at UNM Hospital will participate for at least two quarters. Then Kelly says the hope is leaders will be able to develop an approach that fits their specific unit.
“We’ll have a conversation with each leader to say what does this look like moving forward for you, and how do we create a system that’s part of the culture and a part of the units’ fabric,” she said.
“We are working to create a culture of effective communication at UNM Hospital that’s as normative as our hand hygiene practices. That it's something you just do. But to create this culture change it will take time,” Kelly said.
Data collected so far reveals that patients are responding favorably to the “Commit to Sit” pilot. With patient experience scores trending upward in the pilot units. It’s likely the program will expand hospital-wide and across UNM Health clinics that want to participate.
For Shaw, the timing of the pilot is perfect. “I know that so many of us in the hospital have been missing that connection since COVID,” she said. “We forget that that time spent really connecting with our patient seems to fill my cup and I know it fills the nurses’ cups and that brings us back to why we wanted to take care of people in in the first place.”