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Listening to patients’ concerns and taking them seriously are key factors for nurses to gain patients’ trust and increase their sense of security. That, in turn, will prevent harm and reduce risks in hospitals. 

Patricia Groves, an associate professor in the College of Nursing at the University of Iowa, offered that message in her lecture “Hospital Safety Communication: Working Together to Create Patient Safety and Sense of Security” in the University Student Union’s Volstorff Ballroom. Grove presented this year’s Helen K. Grace and Nursing Deans’ Distinguished Lecture on April 18 for the South Dakota State University College of Nursing, preceding its 2024 Sigma Theta Tau induction ceremony. 

Her lecture provided insights into the importance of patient safety and was geared toward nursing students, practicing nurses and the public. Groves combines her experience and research with other nursing literature to provide insights into patient safety. 

As a safety scholar, Groves has focused her career on the intersections of safety culture, bedside nursing practice, patient safety engagement and patient safety outcomes. 

Her experience as a clinical nurse led to questions on the differences in health care provided from unit to unit and hospital to hospital. Her sparked interest in leadership and patient safety took her back to school to earn her Ph.D. and conduct research on the topic. 

“My passion is really illuminating the critical role nurses play in keeping patients safe and how, in particular, nurses, patients and family co-create patient safety in hospitals,” Groves said. 

She completed the Veterans Affairs Quality Scholars program as a post-doctorate fellow. Groves’ research has been funded by the Agency for Healthcare Research and Quality, the National Institute on Minority Health and Health Disparities and the American Nurses Foundation. 

“Harm is not inevitable,” Groves explained to lecture attendees. “We can actually do a lot to prevent it. I personally view safety as something that is continuously built and maintained by health care personnel, patients and their families, and it requires both actions of individual people like you and me and the support of the organizational parts that make it easier to do the right things.” 

Groves said nurses are the professional health care team members most frequently at the bedside, so they have the first opportunity to react to safety concerns conveyed by patients or their family members. 

“Nurses also play an important role in overall organizational safety by reporting safety incidents and concerns through the organization’s incident reporting system, and that allows the organization to learn from the events, act on the events and hopefully prevent future events,” she said. 

“There’s a good chance that a patient will identify or report potential problems, feeling unsafe or actually being harmed in ways that nurses and others just didn’t see. Patients are the only ones who are there throughout their entire stay. … If we don’t have those patient perspectives, how are we supposed to respond to those problems? How do we learn from them? How do we prevent them from happening to anybody else?” 

But Groves said vulnerable patients can be reluctant to express safety concerns, even to nurses, among the most trustworthy of professions. They might not want to bother busy staff, think their concern is minor, or not want to challenge authority. Others may worry about being labeled difficult or not being taken seriously, or that their care will suffer if they speak up. 

Types of patient concerns include staff competence or knowledge, communication and coordination, potential treatment errors, and the care environment. 

That’s why nurses’ attitudes and encouragement toward patients with safety concerns are especially important. One nurse’s response can set patient expectations for any responses in the future, and patients have to rely on their nurse’s judgement on whether their concern is valid and should be acted on and reported to the organization. 

“One of the most powerful things a nurse can do is sit down by the patient and give them their undivided attention,” Groves said. 

“I can’t say this enough times. It is really critical to think about how you respond to someone who brings a safety concern to you, that you really do have to respond in such a trustworthy way that people feel they can bring their concerns to you again in the future, and that involves being respectful and paying attention and listening.” 

Nurses also have to create a plan and follow up on how to address the safety concern, such as verifying the events underlying the concern, evaluating and determining the likelihood of harm to prioritize response, and deciding whether an incident report is needed. That can result in a process or system change to prevent similar problems in the future. 

Moving forward, nurses should strive to be present, responsive and make a personal connection with their patients, demonstrate competence, communicate effectively and provide emotional support. 

“Safety isn’t something that just happens because of policy or protocol. It is not all about adding more rules and resources to the system. It’s interpersonal, it’s cognitive, it’s something that nurses constantly work often and unconsciously to maintain, and we should work to eliminate risk wherever possible. But since we can never eliminate all risk, nurses and others have to manage those dynamic threats,” Groves said.