Helping to Navigate the Nurse-Patient Relationship

One Chicago-based entrepreneur shares her insight and experiences that have led her to a unique collaboration with nurses to create a positive patient experience.

With a father who worked as a physician, Jessica Schwarz grew up learning how to care for people. Learning how to be an advocate. Learning how to be compassionate and how to interact appropriately with patients. Yet nothing could prepare her for the inherent stressors that accompanied her own nearly one-month hospital stay as a twenty-something. It was 2005, and Schwarz, who today serves as chief executive officer of Chicago-based Health Navigation 360O LLC, an organization that provides personal guidance, concierge services, and non-medical support to hospital patients, had been admitted for a procedure that ultimately resulted in life-saving care but was not without negative experiences and bureaucratic challenges that led to what she describes as poor care planning.

“My father had to really advocate for me and had to work his way up through the hospital administration in order to get me the appropriate care,” she related. “He understood the hospital system very well, and knew who to talk to in order to get what I needed. And it all worked out, but had he not been there then I might not be here today.”

Bridging the Gap to create a positive patient experience

Through her work with Health Navigation, a company that she founded and launched in 2016, her “here today” has had a resounding impact on those individuals who employ her to serve as a health navigator during their medical visits, whether they be within the hospital setting or physician offices. One of a growing workforce that accompanies patients as they “navigate” the healthcare continuum, Schwarz also sees her work as an opportunity to collaborate with nurses and other healthcare providers to create positive patient care experiences with the goal of relieving frustration, anxiety and stress while fostering effective communication and interaction.

“When patients go into a hospital, it’s a strange place and their lives are in the hands of strangers,” Schwarz said. “And many times they are totally dependent on these people, who are medical professionals, but strangers at the same time. And that can be very scary for people.”

To help alleviate those concerns, Schwarz said she maintains relationships that bridge the numerous members within the healthcare spectrum: the patients; the hospitals and providers (with whom she also enters into contracts); the caregivers; and the researchers and other parties aiming for improved patient satisfaction who can benefit from both qualitative and quantitative real-time patient experience data that is collected.
“Patient satisfaction is a huge market right now, and patients are self-reporting their experiences through the hospitals themselves,” she said. “And I’m in a position to be able to access that type of data from third parties and provide perspective through the lens of the patients I work with, because a lot of the self-reporting done in hospitals is flawed.”

According to a 2015 report by the Hastings Center, a nonpartisan research center that addresses fundamental ethical and social issues in healthcare, science, and technology, patient satisfaction surveys used by the Centers for Medicare & Medicaid Services to assess hospitals are not valid due to their propensity to “lead health professionals and institutions to practice bad medicine by honoring patient requests for unnecessary and even harmful treatments.”

In her role, Schwarz said she’s empowered to help reverse this trend by helping patients to have realistic expectations and by encouraging providers to meet those expectations as best as possible. “We humanize the hospital experience while monitoring for medical errors, now the third leading cause of death in the United States,” she said. “We all know that we’re going to have to go to the hospital at some point. So if there’s a way to go without being alone and feel more comfortable, I can provide that.”

Sharing an example of easing expectations

As a fairly innocent example, Schwarz shared an approach she takes when a hospital patient has a simple request for a glass of water: “If the nurse says ‘I’ll be back with that in five minutes,’ the patient is going to expect that and may become disappointed if they don’t get that, and that could tarnish the whole patient-nurse experience depending on the patient’s mood and the nurse’s response,” she said.

“But I’m also there to ease expectations as well as set them. And in that situation, I may tell the patient to give the nurse more time, because the nurse may get interrupted or an emergency could arise. If the nurse ultimately does not return with the water [in a timely manner] I will approach them to expedite that. Or I may go to triage. Or perhaps I’ll suggest that the nurse step inside the room quickly to let the patient know that the water is coming.”

Though this scenario may sound trite, Schwarz stresses that it is indicative of how relationships with patients can become fractured if not appropriately massaged at all times. It can also be an example of cases that have led to errors onsite, if perhaps a patient’s doctor orders called for no water at the time. “Nurses know how to be advocates already, so what it really comes down to is having a heightened state of awareness,” Schwarz said.

Trusting the caregivers

A non-medical professional, Schwarz believes she’s become successful in this industry and as a collaborator with nurses in part due to her standard to not go beyond the scope of her knowledge. “I do not make medical decisions or legal decisions,” she said. “I am not a doctor. I am not a lawyer. I do not research treatment options — that would be going above the head of the doctor.

Part of my role is also not interfering with the (medical staff) relationship because patients need to trust their caregivers. And if I’m seen as a ‘troublemaker’ there’s not going to be trust for the staff or for me. That would be a disturbance for everyone involved. The patient is my client, but I have an obligation to be a team member. I don’t just ‘side’ with the patient. It is important for nurses to understand that.”

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