S07 E06: Promoting a new nurse to patients in your practice

In this episode of TeamUP!, Morgan and Sarah discuss promoting a new nurse to patients in your practice.

Our hosts discuss the integration of nurses into primary care teams and highlight the importance of effective communication with patients regarding team-based care transitions. The conversation includes examples and scenarios for promoting new nursing staff within clinics, individual patient engagement strategies, and addressing patient concerns about seeing new team members. The episode also emphasizes understanding patient apprehensions and providing tangible benefits and personal introductions as a way to build trust and comfort.

Special Thanks

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Throughout this season you’ll hear from several amazing nurses:

• Angela Wignall is a Registered Nurse who has worked in perinatal health and public health. Since recording this episode Angela has been promoted to the CEO of the Nurses and Nurse Practitioners of BC from her position as Senior Executive Director. Angela is also a board member at the Canadian Nurses Association.
• Diana Boateng is a Registered Nurse and is working on her dual master’s degree in nursing and health informatics. In her Masters, she is a co-op student working with the Innovation Support Unit. Her background is mostly in acute care but she has been interested in exploring what it means to be a nurse in primary care.
• Hannah Roy works as a Registered Nurse in primary care and urgent primary care. She has certified practice in STI management and is completing her Masters degree to be a nurse practitioner.
• Jamie Duteil is a Registered Nurse and the Health System Improvement Director at Health Quality BC. She has managed urgent primary care centres and acute care centres.
• Kacey Wall is a Registered Nurse and a diabetes educator, she has worked in primary care networks and is a team member of the Innovation Support Unit.
• Nikki Kafal is a Registered Nurse and has spent her career working in emergency and critical care settings. She is completing a dual master degree in nursing and health informatics and joins the Innovation Support Unit as a co-op student.

Links and Resources

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The Communication to Patient Checklist aims to equip your clinic with easy to follow, and categorized, ideas of when and how you can bring up team-based care to your patients. https://teambasedcarebc.ca/resources/tbc-communication-to-patient-checklist/#details

What is Team Up! Team-based primary and community care in action?

A podcast that brings together primary care providers, healthcare planners, patients, innovators and others to talk about the changes that are happening in primary care in British Columbia.

Sarah: Are you excited about
everything we're learning about nurses?

Are you thinking about how to
best communicate this to the

team and to your patients?

Yeah, me too.

Morgan, there are many practices in
BC and across Canada that are bringing

nurses into primary care teams.

Morgan: Yeah, and Sarah, that means
lots to change for how people work

together.

Sarah: And I think, you know, it can
be confusing or unsettling for patients

who don't know why all of a sudden they
might be seeing a nurse if, they don't

know that this transition is happening.

And we learned a lot about this last
year in our patient communication

around team based care learning cycle.

I think some of the key things we
learned, we really realized that

although this transition was being
communicated relatively well to

providers, very little was happening,
in terms of communication to patients.

Morgan: Patients might not even know
that they're part of a new team and

patients do want to understand what's
happening and although they might be

very grateful for the care they're
getting, if they don't understand it,

they're going to be unsure and concerned.

Sarah: That's right.

So they want to know how teams are
working, who's on their team, how they're

communicating, how their health needs
and concerns get shared across the team.

And we did create a really great
patient communication checklist here.

We'll link to this
resource in the show notes.

And Morgan, I know you've been
working as part of a team for years.

How is the team communicated
to patients in your practice?

Morgan: So, Sarah, we've worked together
as a team for years before I joined

the practice, which was years ago now.

And honestly, I haven't had to
worry so much about promoting team

based care to our patients because
it's so much of how we work.

and people see it from the pharmacy
in the waiting room through to The

counselors, the social workers,
the nurses, the doctors, all

of us working across the team.

It's, just part of how we do things.

So I feel like we don't have
to explain it as much as a

new team.

Sarah: Well, and I think there are
teams like yours that are quite unique

and already sort of working as these
teams, but we really do have a lot

of teams that are just starting out
now with new nurses in practice.

And I'm wondering what are some
specific ways that nurses have

suggested that clinics can help
patients become more comfortable or

excited, when they think about seeing
a nurse from your conversations?

Morgan: yeah, so, you know, I asked our
nursing colleagues about this as well,

and they're pretty consistent about, what
they wanted and what would be helpful.

So I think a few things I'd love to talk
about today, How do you let the whole

practice know who the new nurse is, and
why there's a nurse joining the team?

And then second, what do you do to
support individual patients who now

might be connecting with a nurse?

And lastly, I'd like to share some tips
or tricks, to help patients who might be

a little bit unsure about seeing a nurse
and what you can do to engage patients

so they can, meet their new team member.

Sarah: And I love those three ideas.

So let's go through these.

so the first idea, you know,
promoting across the whole practice.

Tell me what you learned about this.

What's the right place to start?

Morgan: So this is definitely
the place to start.

And I would start promoting a
nurse joining the team before

the nurse actually starts.

Jamie.

The director at HQBC, who's a
registered nurse, responds to this

with a personal request to a practice
if she was going to join one.

Jamie: it would be important for me
to know that they are introducing me

to the clinic as part of the care team
and not as somebody that can do some

of the tasks that you don't want to do.

think it's important to highlight the
value add that including a nurse into

practice can be for the team and for the
patient and why it's important and that

they, that you recognize my abilities.

Morgan: So tell everybody before you start
why the nurse is joining the practice.

Let them know the benefits for the
practice, but specifically what the

tangible benefits are for the patients
so they see value in why there's

a change.

Sarah: Right, and this is something
we heard from patients as well

about teams, like, let them know
why is team based care good for me,

Morgan: and then I think also along
those lines, not just That there's

a benefit for me, but also something
personal, like let them know who

the nurse is, that's joining.

And I think it is okay to be a little

bit

personal.

Sarah: within reason, right?

Morgan: Oh yeah, of course.

I mean, don't over disclose.

I think a good rule of thumb is
don't share anything that you

wouldn't share with all patients

but , a little bit of information
really makes , getting to know somebody

much easier when you have a little
bit of a hint about who they are.

Angela, the senior executive director
for nursing programs at NNPBC, Also

suggests celebrating the new team member,
which I think is a great frame for this.

Angela: the best thing
you can do is celebrate.

So when you hire a nurse, Let
everyone know, announce it on social

media, put a poster up on the door.

Talk to folks when they're
coming to check in with your MOA.

Hey, we have a new nurse, have some
resources available, like a little one

pager or a write up about what the nurse.

is there to do what your hopes are for
the nursing role featured the picture

of the nurse that you've hired and a
little bio of who they are really let

folks know in a celebratory positive
way that you have a new addition to your

team and that new addition is a nurse.

You can also introduce them to patients.

During visits, so there may be a period of
time when you're orienting and onboarding

a nurse into your practice where their
work is dedicated to shadowing other

roles within a clinic so that they can
understand how the clinic functions.

And so they can start to have those
small side conversations with your

MOA and the thick of the work to
say, Oh yeah, that's a kind of

thing that you could send my way.

Sarah: So I guess, how
can practices do this?

Morgan: Well, I think keep it simple.

and it depends a little bit
on what you already have.

So if you already have a
newsletter, obviously just use that.

Start to share out.

If you have a website, use that.

if those things aren't familiar
to you, it might be hard to start

them as part of this process.

So do what works in your office.

Put up posters.

Be physical about it, put up posters in
the waiting room and all the exam rooms.

and on those posters include a
picture or two the new team member.

Those are easy

things

to get started with.

Sarah: And I think as soon as
you see a picture of someone,

the way you think about them
changes, ? Because they have a face.

Makes such a huge difference.

So Your second idea, I think, was
promoting, the nurse to specific

patients or patient populations.

if you want to think about how you're
talking to individual patients, if

I'm a patient in your practice, how
would you promote a nurse to me?

Morgan: Well, I would first highlight
what the value would be for you.

, explain the expertise of the nurse
and how that helps you specifically.

We heard this from
everybody that I spoke with.

Here's Jamie again.

Jamie: So am I going to be able
to provide, some education and

some resources or wound care or
something that's within my expertise?

it's, it's, recognizing the nurse and
their abilities and their competence

to support the patient's needs

Sarah: right, so really part
of this is telling the patient

sort of what's in it for them.

Morgan: Yeah.

And I think you can be personal here too.

I think sharing your
trust is really important.

So.

I want you to meet Jamie.

Jamie's a fantastic nurse.

I'm really lucky to be working
with her and I think you're

going to really like her.

And then talk about why you think
there'll be a good fit for the person

and how they fit well with the nurse.

Again, here's Jamie.

Jamie: I think a lot of patients place
so much trust in their physicians

and their, practitioners, their
NPs, that when maybe being seen by

somebody other than, they have this
sense of fear and, well, why not me?

Why am I not seeing the physician?

Am I not sick enough?

So I would like the physician to
introduce me as part of the team and

that, you know, this is why I'm here.

we've expanded our practice.

Sarah: Right, so you're getting
more expertise, more care, and

more time with this addition.

Morgan: Yeah.

and then something about perhaps
nursing as a whole or the nurse again

that you're working with specifically.

And they're an expert with wound care,
and I really want to get their opinion on

how I can help and how we can help with
your feet, or they're great with kids.

Casey, who's one of the ISU nurses,
who's also been a diabetes educator and

has worked in primary care networks,
had an example of how, in one clinic,

they used her background and knowledge
in diabetes care as a way to introduce

patients at the front staff of the office.

Kacey: what we started doing was the,
medical office assistants at the front,

when they booked those appointments,
they were very clear to say you're going

to meet with Casey, she's a registered
nurse and she's a certified diabetes

educator, and you're meeting her for this.

So if it was, you know, in relations
to diabetes or which condition,

They were made aware of it up front.

So that was a big thing.

And I think that really helped.

Sarah: And I think so much of that kind
of additional expertise that people

can bring into their roles is really
highlighted in this diabetes example.

But really, you won me over, Morgan,
when you said there might be a

nurse who's really good with kids.

Morgan: right?

And if it isn't kids, then, play to
the strengths that fit the patient.

Sarah: And I feel like that personal touch
from the other team members, you know, my

doctor, my MOA, anything that involves a
kind of warm handover just wins me over.

And, you know, I think this really
ties into our third topic, winning

over more hesitant patients towards
this idea of team based care.

What if, you know, I wasn't
sure if I really wanted a new

person involved in my care.

I really like my doctor.

I really trust my doctor.

That's the last topic.

What if the patient doesn't
want to see the nurse?

Morgan: Yeah.

So first and foremost, if you
don't want to see the nurse,

you don't have to see the nurse.

I think that, especially at the
beginning, that's absolutely fair.

It's completely fine.

You don't need to see the nurse right now.

But then over time, helping patients
understand where there's clear value.

that's where you start
to bridge that connection

over time.

Sarah: So do you have
examples or stories here?

Morgan: Sure do.

first off, talk about things
like, a nurse might have more

time to dig into the problems and
dig into your care and help out.

Particularly when a nurse is new
in practice, that's very true.

Where the visits are longer
and potentially can be

extended because of capacity.

He can talk about the
different perspective.

Like we talked about a couple episodes
ago and say, you know, this is an

expertise, they're going to, they're
going to look at things in a new way.

That's really going to help.

Hannah doesn't run as late as I do.

So that's a huge benefit.

You don't have to hang out in
the waiting room for two hours.

so you get better access with urgent
appointments, particularly if you've

got a registered nurse who's doing some
triage, that's a way to get access sooner.

And then you can talk about efficiency.

So.

Perhaps you're going to be able
to do more of a one stop shop at

the clinic if you see both of us.

So Hannah, a primary care nurse
at Kool Aid, who I get to work

with every Thursday, has a
great example of a time saver.

That could get the door open for
some people to see the nurse.

Hannah: from my experience working
in primary care, I can do things

that really benefit clients.

So like, doing their blood work so
they don't have to go to a phlebotomy

lab and save them a lot of time.

Sarah: And tangible things like
that, I think, could be a huge win.

I'd really appreciate
the, time saving there

Morgan: absolutely.

And then the other thing is to
understand the patient's concerns.

Why they're

hesitant.

Hannah: I think the first
thing is figuring out why,

why are you apprehensive?

if they feel vulnerable.

Maybe they don't want extra
people in their care or they don't

want to share their story again.

Morgan: So then, once you know what's
a concern, then you can reassure the

patient and address those concerns.

And then you can work together to say,
well, you know, how about if Hannah just

draws your blood today and nothing else?

Wouldn't that be helpful?

And you can kind of build from there
and, the relationship gets to be built

very gently and slowly, but, There's
value happening there for the person

at the same time.

Sarah: And I think that makes so
much sense and makes it all kind

of a little bit more natural when
you think about growing a team.

Morgan: The other one of my favorite
tricks is to flip things around.

Sarah: What do you mean?

Morgan: Well, instead of, you
know, having a visit and then

saying, I'd like you to see the
nurse, start the visit together.

Meet the patient together as a team.

Again, particularly when you're
starting to work with a nurse and

the nurse has a bit more capacity.

It can be easier to do that and say, Oh,
Hannah, come, come with me right now.

let's say hello to Mrs.

Jones.

Sarah: And I guess this doesn't have to
be a hundred percent shared visit either.

you could just bring the nurse
in for the beginning, more of

kind of a meet and greet, and
then they could go on their way.

Morgan: Absolutely.

It could just be, even in the hallway, it
doesn't even have to be in the exam room.

You can just say, Oh, I,
I want you to see Hannah.

This is, the new nurse
that's joined our practice.

She's really great.

And that just opens up.

That connection and reduces the anxiety
for the next time and then you can carry

on with your one on one visit if it
makes sense or you and the nurse can meet

the patient together for a few minutes.

Sarah: Oh, and I think that's just,
those little changes can go such a

long way in making people comfortable
and building out those relationships.

So I think that's good for today.

Those are our three things.

Let's wrap up today.

What can a practice do that has just hired
a nurse, but the nurse hasn't started yet?

Morgan: So I've got two ideas
if they haven't started yet.

The first one is the
poster with the picture.

I think sharing that before
the nurse joins the team.

Use it in an email if you have a
newsletter and then put it up in all the

exam rooms and the waiting room so people
get a chance to see who the person is.

That's a great way to get started.

And then secondly, plan
some shared visits.

Start by working together as a team.

Letting patients see
how you work together.

really try to integrate at the beginning
is a way that just, builds that

confidence and that umbrella of trust.

Anything from your

perspective, Sarah?

Sarah: I really like the hallway
or waiting room, hello, nice and

personal, great for families and
actually from a kid's perspective,

I think stickers, to give away go a
really long way in winning people over.

Can't stress that enough.

Those little things can,
can really help with pulling

people kind of into a new team.

Morgan: Yeah, absolutely.

Sarah: And that seems like
a great place to wrap up.

We'll see you next time on Team Up.

The Innovation Support Unit is a
distributed multidisciplinary team.

We work mostly remotely from communities
across the Lower Mainland and

Vancouver Island in British Columbia.

Morgan: Sarah and I are both recording
from our offices in the territories

of the Lekwungen speaking peoples, the
Songhees and Esquimalt First Nations.

Sarah: And recognizing the colonial
history and the ongoing impacts of

colonization and healthcare systems
and in Indigenous communities in

Canada and around the world, as we
move through the season, we'll work

to bring an equity lens to this work.

And we really encourage you, our
listener, to reflect on your past,

present, and future participation.

On the indigenous lands
where you are situated.

Morgan: we'll see you in
the next episode of team up.