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Patient Satisfaction

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Chapter 1

Patient satisfaction is a very important aspect of healthcare. It is a key determinant of the overall quality of care provided in a hospital and is usually part of a hospital’s performance metric. Patient satisfaction is the generalized perception of patients on the realities of the care provided. Patient satisfaction has been given greater emphasis over the years through numerous studies that have assessed its implications on healthcare facilities, caregivers, and patients themselves. Positive patient satisfaction is essential in avoiding instances of malpractice claims, and patient retention.  As nurses continue to take on new tasks in their workplace, they become even more crucial in ensuring patient satisfaction.

Nurses as the primary caregivers play a major role in ensuring that patients are satisfied. The role of nurses has been evolving over time and present-day nurses play a significant role in the wellbeing of patients in medical facilities. The evolution of the nursing role entails an expansion of the duties and tasks handled by a nurse. Bodenheimer and Bauer (2016) indicate that over the years, the shortage in the number of primary care physicians has been on the rise. This creates a gap in medical service provision that needs to be filled. On the other hand, the number of nurse practitioners has been on the rise. The demand for healthcare services along with a shortage of physicians has meant that nurses have had to take on more duties (Bodenheimer and Bauer, 2017).

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As the roles of nurses increase and they begin to complement that of physicians. As nurse practitioners adopt more duties, physicians will be left to focus on complicated medical cases. Another case for the use of nurses in primary care comes from cost. The cost of services provided by nurse practitioners tends to be lower than that of physicians. Bodenheimer and Bauer (2016) estimate that the costs that are up to 29 percent lower for patients who see nurse practitioners than those who see physicians. The adoption of duties by nurses is likely to grow further in future because of the low number of nurse practitioners and physician assistants who choose to venture into primary care. As nurse practitioners take on more duties that were previously undertaken by physicians, registered nurses are taking on new roles like the management of patients who have chronic diseases. Bodenheimer and Bauer (2017) indicate that registered nurses also coordinate care provision between healthcare services providers and primary care homes and they also lead management teams to cut down the cost of care and to improve service provision.

Smolowitz et al. (2014) identify nine general functions of registered nurses that match with the modern day expectations of nurses expanded roles. These duties include telephone triage, hospital transition management, care for episodic illness, health coaching, assessing and recording patient health information, supervision, reconciling medication, episodic illness management, chronic illness case management, and quality improvement. These duties can be generalized to three main groups. They include practice operations, chronic disease management, and preventative and episodic care.

According to Smolowitz et al. (2014), some of the tasks undertaken by nurses under chronic disease management include early interventions when the symptoms of chronic illnesses appear and establishing new treatment regiments when symptoms change. Preventative and episodic care includes reconciling medication, health and wellness coaching, and health management using set standards and procedures. Practice operations include the handling and management of telephone triage as well as the prioritization of patient appointments. These three main categories of duties undertaken by nurses indicate a shift from a basic caregiver to active involvement in the planning and administration of care. Registered nurses find themselves in a very strategic position to provide team-based and patient-oriented care. Such a position also gives nurses a significant role in ensuring patients receive the care they require in the manner that is required using preset guidelines.

Chapter 2

Multiple studies show that registered nurses have the requisite skills to take on enhanced roles. A study by Denver et al. (2003) shows that patients with high blood pressure and diabetes were handled by registered nurse care managers. The researchers indicate that patients who received care from registered nurses fared better than those who were handled by physicians alone. Moreover, in some states, the registered nurses are allowed to change the medication doses, albeit using standardized approaches (Bodenheimer and Bauer, 2016).   In some studies, nurses have been shown to provide services that are at par with those offered by physicians (Guzik, 2009). At the same time, the level of satisfaction that patients obtain from being handles by physicians and nurse practitioners is shown to be no different. Similar findings are indicated by Guzik et al. (2009) who examined the two in professions in an occupational health setting. The scholars also indicate that both nurse practitioners and physicians had high scores with regards to patient satisfaction. Such findings add weight to the role of nurse practitioners in occupational health settings as providers of primary care. Nonetheless, the findings by Guzik et al. (2009) may not be wholly applicable because of its narrow focus. Physicians and nurses assume a wide range of roles in occupational health settings. Despite the adoption of new roles by nurse practitioners, they are still seen as being inferior to physicians even when they handle the same tasks (Donelan et al., 2013). The disparity arises because physicians feel that their specialization makes them superior to nurses. Such perceptions mean that even though nurse practitioners may be trained in the same primary care techniques as physicians, they do not get the same recognitions. Also, while their roles are expanding, they are still limited in what they can do without the supervision of a physician. However, the need for supervision may not be misplaced. Ammouri et al. (2015) make use of a cross-sectional and descriptive study to assess patient safety culture among nurses at four public hospitals in Oman. The findings of the research show that when nurses perceive that they have a strict supervisor who has very high expectations of performance and minimal errors, they tend to have high standards for patient safety. However, for patient safety culture to be well ingrained, communication and teamwork have to be well established. Healthcare is a multidisciplinary process that requires coordinated input from multiple healthcare practitioners.  High safety standards for patients are crucial for patient satisfaction. After all, patients go to the hospital to get treated. If the outcomes are negative then patient satisfaction drops. As nurse practitioners take up more roles, their importance in ensuring patient satisfaction grows commensurately. The role of nurses has grown significantly over the years driven by demand for versatile personnel to take on new roles which fill the gap left by physicians.

Emotional intelligence is necessary for patient satisfaction. Celik (2017) examines the implication of nurses’ emotional intelligence on patient satisfaction. The researcher makes use of a sample size of 113 patients and 79 nurses. The findings of the researchers indicate that nurses with high levels of emotional intelligence also have corresponding levels of patient satisfaction.

Emotional intelligence is important because it enables nurses to recognize the various patient emotions. Emotional intelligence is also associated with kindness on the part of nurses. The ability of nurses to recognize a patients feelings is important because it helps caregivers to react appropriately. An appropriate reaction involves raising the patient’s mood and averting negativity. All patients are different and all of them require different types of care. By being emotionally intelligent, a nurse can adapt to the diverse and dynamic situations that arise during their work process.

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Celik (2017) indicates that skills like empathy and mercy increase patient satisfaction and are important elements of emotional intelligence. A patient has no medical metric to assess the quality of care that he/she is being given due to a lack of medical knowledge or background. Thus, patients tend to apply a subjective metric based on their perceptions. A caregiver’s emotional intelligence is an important aspect of the subjective metric that is used to determine a patient’s satisfaction levels.

Emotional intelligence is not only beneficial for patient satisfaction but also the potential success levels of nurses. Nurses who have high levels of emotional intelligence are more likely to excel in their duties than those who have low levels of emotional intelligence. Nursing cannot be successful if it is done in a one-sided way. Communication is essential for nurses and patients. Emotional intelligence is key to establishing successful and effective communication. When a nurse can communicate with patients in an effective way, they find their work to be satisfying. Thus, emotional intelligence is important in the creation of rapport between nurses and patients, which in turn, helps caregivers to excel in their duties.

Evidence-based practices are important in ensuring patient satisfaction because they provide caregivers with tried and tested approaches that will work. Evidence-based practice usually entails a life-long learning approach that is geared to solving issues using techniques from well-designed studies. Melnyk, Gallagher-Ford, and Fineout-Overholt (2014) provide a potential guideline that can be used for the implementation of evidence-based approaches in the nursing practice to guarantee patient satisfaction. First off, the nurse leaders need to incorporate evidence-based practice to various aspects of the nursing practice such as orientations and performance reviews. Second, medical organizations need to have policies that require and encourage the use of evidence-based approaches. Third, evidence-based methods need to be included in the operations of hospitals and they should be well funded.


Patient satisfaction is a very important aspect of healthcare and is usually part of a hospital’s performance metric. The demand for healthcare services along with a shortage of physicians has meant that nurses have had to take on more duties. As the roles of nurses increase and they begin to complement that of physicians. The increase in roles means that nurses are increasingly crucial in ensuring that patients are satisfied. The success of nurses in ensuring that patients are successful in their role is influenced by their emotional intelligence. The inclusion of evidence-based methods eliminates the need for trial and error and ensures patient satisfaction..

1. Ammouri, A., Tailakh, A., Muliira, J., Geethakrishnan, R., Phil, M., & Kindi, A. (2015). Patient safety culture among nurses. International nursing review, 62.

2. Bodenheimer, T., & Bauer, L. (2016). Rethinking the primary care workforce — an expanded role for nurses, The New England Journal of Medicine, 2016(375). DOI: 10.1056/NEJMp1606869

3. Celik, G. (2017). The relationship between patient satisfaction and emotional intelligence skills of nurses working in surgical clinics. Patient Preference and Adherence, Volume 11, 1363-1368. doi:10.2147/ppa.s136185

4. Denver, E., Banard, M., Woolfson, R., & Earle, K. (2003). Management of uncontrolled hypertension in a nurse-led clinic compared with conventional care for patients with type 2 diabetes.

5. Donelan, K., DesRoches, C., Dittus, R., Beurhaus, P. (2013). Perspectives of physicians and nurse practitioners on primary care practice. The New England Journal of Medicine, 2013(368). DOI: 10.1056/NEJMsa1212938.

6. Guzik, A., Menzel, N. N., Fitzpatrick, J., & McNulty, R. (2009). Patient Satisfaction with Nurse Practitioner and Physician Services in the Occupational Health Setting. AAOHN Journal, 57(5), 191-197. doi:10.3928/08910162-20090428-06

7. Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt, E. (2014). The Establishment of Evidence-Based Practice Competencies for Practicing Registered Nurses and Advanced Practice Nurses in Real-World Clinical Settings: Proficiencies to Improve Healthcare Quality, Reliability, Patient Outcomes, and Costs. Worldviews on Evidence-Based Nursing, 11(1), 5-15. doi:10.1111/wvn.12021

8. Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E., Ulrich, S., Hayes, C., & Wood, L. (2015). Role of the registered nurse in primary health care: Meeting health care needs in the 21st century. Nursing Outlook, 63(2), 130-136. doi:10.1016/j.outlook.2014.08.004


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