While rounding in the hospital and hoping for a place to sit while speaking with patients, I am often reminded of a classic joke made somewhat famous by Eddie Murphy in the movie Coming to America:
A man goes into a restaurant and sits down. He is having a bowl of soup and he says to the waiter:“Waiter, come taste the soup.”
Waiter: “Is something wrong with the soup?”
Man: “Taste the soup.”
Waiter: “Is there something wrong with the soup? Is the soup too hot?”
Man: “Will you taste the soup?”
Waiter: “What's wrong, is the soup too cold?”
Man: “Will you just taste the soup?!”
Waiter: “Allright, I'll taste the soup - where's the spoon??”
Man: “Aha...Aha!”
The problem, of course, is that there is no spoon. Similarly, in hospital rooms across the country, there is simply no place for providers to sit.
For years, patient satisfaction experts have rightly touted the benefits of providers taking a seat while communicating with hospitalized patients. Personally, I don’t have to be told twice to sit down. At 6’6”, I feel a mile away from my bed-bound patients and welcome the opportunity to make it a conversation rather than a shouting contest.
And for die-hard, data-driven practitioners, there is powerful evidence supporting this intervention. A 2010 study from The University of Kansas Medical Center showed that when doctors are seated during hospital encounters, patients perceive them as spending 40% more time at the bedside than if they were standing. Most importantly, patients of seated doctors are more satisfied with their care and report a better understanding of their condition. In fact, when doctors sit down, 95% of patients' post-visit comments are positive. When doctors stand, that number drops to 61%.
Last December, the New England Journal of Medicine published a piece called “Seeing Eye to Eye,” by Daniel R. Wolpaw, MD, a member of the faculty at The Case Western Reserve School of Medicine. He wrote about his desire to improve communication with patients by “leveling the topography” and sitting down when talking with them. But he comments on a situation that is largely universal:
“...there’s a logistic problem: Where to sit? Many health care professionals consider it inappropriate to perch on the edge of the bed — it is the patient’s space, and you never really know what you might be sitting on. Any chairs in the room are generally not well positioned for face-to-face conversation and are frequently occupied by clothing, equipment, or visitors.”
Dr. Wolpaw’s solution came in the form of a portable stool that an intern had witnessed a chaplain using. The next day, armed with a folding canvas camping stool, Dr. Wolpaw began using it on teaching rounds. He comments on the “transformation” of rounds as he witnessed his housestaff communicate in comfortable and engaging ways that were clearly the result of being seated and at eye-level with the patients. He ultimately calls for portable stools to be supplied to all medical ward teams for the benefit of both the patient and learner experience.
Nurses, physicians and other clinical providers should committ to improving the patient experience by sitting down with their patients at every opportunity. But hospitals must provide designated chairs or stools in patient rooms. If you support sitting with patients as a critical ingredient in the creation of an optimal patient experience, you may need to “taste the soup” at your hospital and make sure something's not missing.
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