Patient-Centered Communication: Where Does the Time Go?

Nurse Practitioners (NP) diagnose, prescribe, treat and manage the care of patients with aims to provide high quality, timely, patient centered, evidence informed care. Increased demands for managing more patients, providing more care, in less amounts of time, are placed upon NPs by the marketplace and payers. This confluence of market demands on time spent with patients and nursing art and science aimed towards patient centered care, has challenged the allowance of time for conversation between patient and provider. This confluence may render less encounter engagement in which concerns ought be expressed. Less than optimal communication pattern manifests in either/or provider-to-patient and/or patient-to-provider communications. Time constraints placed on time allowance between NPs and patients, with less engagement opportunity for patient centered communication, can lead to patient and provider encounter dissatisfaction. Ultimately encounters with time constraints may lead to increased demands for follow up care and increasing expenses for care. Further, when presented with the suffering patient, complaints and laments can ensue, optimally requiring proficient conservation and judicious use of time. If effective communication skills are not implemented, both the patient and provider may view encounters as less than optimal. Use of time and patient centered communication is of especially great import with consideration to populations of global migration where there may be language barriers and need for identification of needs unique to the diverse patient. The bundle of time management, diverse needs in communication, compassion and culturally appropriate care can be introduced on all levels of nursing education, as well as in the return to graduate school for the NP programs of study. The OPEN framework supports optimal communication in patient encounters, lending to expanded impressions of time, engaging patients in health care thereby enhancing patient outcomes. The CAMPS framework supports conversation where the patient is offered the opportunity to identify meaning and purpose in life, rendering the global migrant populations moments to express unique beliefs and needs. The literature provides reasonable support for exploration of outcomes where the OPEN framework and CAMPS framework are integrated into NP education. The OPEN and CAMPS frameworks provide new NPs with new communication frameworks to rely upon. Likewise, the same frameworks can be utilized by experienced NPs. Organized continuing education, institutional support and Quality Assurance indicators of best practice can assist NPs to continue development of patient centered communication skill sets across time. NPs continued capacity for patient centered communication supports sustaining patient centered care and encounter management, while ensuring evidence informed care, therapeutic communication, compassionate care and patient follow through with care plans.