Liaison Nurse Easing Patient Stress in the ED

The Emergency Department (ED) can be a scary place for patients and their families. It can be even more frightening when a patient doesn’t understand their condition or treatment plan, or caregivers don’t speak the patient’s language.

In an effort to enhance communication between caregivers and patients and their families and improve the overall ED patient experience, in July 2016, nurse leaders at Cleveland Clinic Abu Dhabi implemented a Patient Liaison Nurse (PLN) role. This role is different from a traditional patient liaison role because the liaison is an actual nurse – someone who can understand the patients’ conditions from a clinical perspective and relay it in common terms to patients and their families.

Nurse Manager Colin Fleming, MSc, BSc, RN, and Assistant Nurse Manager Ailbhe Kelly, MSc, BSc, RN, introduced the role to improve patient experience scores in multiple themes, including information about delays in care, discussion of the care plan and communication with family. As a result, experience scores have improved and concerns have decreased in the Cleveland Clinic Abu Dhabi ED.

“I truly believe that this role has been invaluable for our patients over the last year,” Kelly says. “It is our hope as a leadership team to be able to expand and develop the PLN role so that we can offer services to ED patients at all times.”

Currently, two nurses – Mayada El Chidiac, BSN, RN and Mosab Eyadat, BSc, RN – are assigned to this role. They work during high volume hours – weekdays from midday until late evening. They divide PLN time equally with clinical time. When they are on duty as PLNs, they are dedicated to rounding on patients with complex issues and patients waiting to be seen. Their duties include:

• Communicating with patients on why they are waiting and what the process is in the ED
• Ensuring that patients understand why they are in the ED
• Making sure patients understand their diagnoses and treatment they receive
• In patients with complex discharges, helping to schedule follow-up appointments and understand discharge instructions
• Ensuring patients’ family members are involved

Along with being experienced ED nurses, having an Arabic background was an important reason Chidiac and Eyadat were chosen. About 70 percent of patients being treated in the ED need an interpreter. Ultimately, patients and families may be more at ease when nurses are able to speak the language, as Chidiac and Eyadat do.

Training involved spending time with Service Excellence caregivers to learn about dealing with service issues, service recovery and de-escalation of situations. Nurses also spent time with case managers to gain insight into the different phases of care.

“I have witnessed our PLNs alleviate worry and concern as soon as patients walk into the ED. The PLNs calm patients, explain procedures and other activities and discuss how nurses will help,” Kelly says. “I have also witnessed them de-escalate stressful situations and facilitate collegial patient/nurse collaborations to ensure that everyone is has the same understanding of expectations and are satisfied with expected outcomes.”

Chidiac won The Daisy Award for compassionate care earlier this year for the kindness and compassion she showed to the family of a patient who had died suddenly, and both she and Eyadat received Team Excellence awards for Cleveland Clinic Abu Dhabi in late 2016 for their contribution to the department.