The Significance of Small Gestures at the Patient Bedside

Caring for sick patients often sheds light on what matters most in life. Textbooks rightly emphasize the importance of diagnostic and treatment skills, but we also believe it’s vital not to lose sight of the big impact that small gestures can have. For example, providing a dying patient’s family member with a tissue during a pivotal moment shows empathy and understanding. Knocking before entering a room demonstrates respect for a patient’s privacy. Keeping a patient properly covered during a physical exam protects their dignity. If you’ve spent time at the patient bedside, you know that these details matter.

We’re glad to see this attention to detail exists within our own Stanford community, but we’ve also observed it in outside organizations. Below, we examine a few of the ways hospitals, physicians and caregivers near and far go the extra mile to bring comfort and healing to their patients.

·      At the onset of the pandemic, Stanford Medicine researcher Cati Brown-Johnson, PhD, who has studied the role of compassion in medicine, believed it was important to make medicine feel personal again. “The circumstance [was] scary, and we [wanted] to shift the mindset towards warmth and caring and healing," Brown-Johnson told Scope. The solution? Brown-Johnson and her team turned portraits of health care workers into stickers that could adhere to PPE, giving a personal touch to the sterile equipment. Staff reported that the photos enhanced their interactions with patients. According to Anna Chico, RN, the images allowed patients to see her as a whole person, rather than a suit of PPE. “It's so important to establish that human connection, especially in these times of social distancing and isolation,” she says.

·      Stanford Medicine Children’s Health recognized the healing power of a wet nose and wagging tail. Through the Packard Paws Facility Dog program, canine friends bring comfort to kids and their families. Sheri Fox, the mother of pediatric patient Katelyn Fox, said “it was like magic” when Donatella the Labrador Retriever calmed her daughter by resting her head on her chest. “I feel like Donatella absorbed all of Katelyn’s fears, and the stress melted away,” she told blog author Wendy Healy. “There’s no other explanation. It was extremely therapeutic. Seeing her anxiety go away—and not need medications to calm down—was huge.”

·      In a perspective piece for the Journal of Medical Imaging and Radiation Sciences, Nova Scotia Cancer Center’s Natasha McMaster, RT(T), and Jennifer DeGiobbi, RT(T), describe how a mask decorating program has had a huge impact on their radiation therapy patients. “Customizing the mask gives them something to look forward to when they come for treatment. It takes their mind off what they are going through and gives them a small sense of control over their treatment process,” McMaster and DeGiobbi write. “The overall feedback has been that this small gesture has appeared to have helped in reducing anxiety and stress related to treatment for patients and, in some cases, their families as well.”

·      Researchers at The Ohio State University examined what patients need to feel at ease during their time in the hospital. They found that privacy, accessibility and comfort were key factors that could aid in recovery. “When we’re sick and feeling vulnerable, it’s especially important to feel in control of our surroundings – privacy, room temperature, lighting, window blinds and having our things within reach,” explains Ohio State’s Emily Patterson. This feedback ultimately shaped the institution’s hospital room designs, but also shed light on simple improvements that could be implemented anywhere. “Some of the findings are inexpensive and possible to incorporate, even without changing architectural design,” Patterson says. For example, the research prioritized changes that facilitated human connection, like by providing chairs for loved ones to sit close to patients and connect with them at eye level. Giving patients easy access to their phones was also key. “Each change can improve the patient and family experience by reducing unnecessary stress and anxiety and enhancing the healing process,” says Patterson.

We know from experience that from patient care to record management, physicians have a lot on their plates. But we hope that even in the midst of these whirlwind days, you will embrace the moments that allow you to remind patients of their humanity.