Goals: To facilitate knowing the patient and personalizing care; to elicit patient/family priorities for the shift; to discuss/update the current plan of care with the patient; to demonstrate caring about the patient as a person.
Expectation: Nurses will spend Five Minutes every shift (as appropriate) sitting in a chair and talking with each of the patients they are caring for.
- Carry out the Five Minute conversations as early as possible in the shift.
- Sit in a chair and position yourself so that you and the patient/family are at eye level if at all possible (these evidence-based steps are important in order to communicate that you have time to talk and that you and the patient are talking on an equal basis).
- If patients are sleeping, the process may be deferred, but night nurses are encouraged to sit with wakeful patients.
- For pediatric and other patients unable to converse, sitting with families/significant others should be substituted.
- Alert patients should be asked in advance if they wish families/significant others to be included (when they are present).
- High priority should be given to accomplishing the Five Minutes but if it is truly impossible due to patient acuity, then make a point of telling patients that you will be unable to sit this shift and asking: "What is the most important thing I can do for you this shift?". It is appropriate to ask for CTL assistance in covering your patients to enable the Five Minutes.
- If it becomes clear that the patient concerns are going to be a prolonged conversation, it is appropriate to tell them that you will find time to talk more later in the shift.
- Salient points from the Five Minutes should be documented and communicated to other nurses caring for the patient.
The following material suggests what to say to patients and families about Primary Nursing. This content does not need to be memorized or used verbatim, but can and should be adapted to reflect the nurse's personal style as well as individualized to patients/families.
Initial explanation of the Five Minutes process to patients/families:
"One of the ways that we will keep in touch with you is to spend a few minutes a couple of times a day sitting down with you talking about how things are going and the plan for the shift. You can tell us about any needs or concerns then but you should feel free to talk to your nurse at any time."
Introduction of the Five Minutes:
"If it's OK with you, I'm going to spend a few minutes with you now talking about how you are doing and what to expect during the next day or so."
Key questions to use as appropriate:
- "How are things going for you?"
- "Do you have any particular needs or concerns I can help you with?"
- "What is the most important thing I can do for you this shift?"
Information to give during the conversation:
For next 8-24 hours (as known): Expected diagnostic tests, therapies & procedures, trips off-unit, consults, patient teaching, potential discharge date.
"Thank you. Even though we were able to sit and talk just now, please let me know at any time if you have any new needs or concerns."