There is a plethora of evidence that confirms that an increasing number of patients are spending more and more time in waiting rooms across a variety of health care settings (Willis, Ozturk & Chandra, 2015). However, there is a gap in the literature regarding what patients are doing while they are waiting for care providers to meet their needs. Many nurses view these wait times as frustrating, unacceptable and an additional stressor that patients should not have to manage. Recently, I have been reflecting upon this issue and potential strategies that rural nurses, in particular, can implement to transform wait times into opportunities for patient education.

Implementing a Multi-Pronged Approach to Patient Education

The nature of rural healthcare settings makes it implausible to propose a one-size-fits all solution to the problem of wait-times. Therefore, the following suggestions offer a variety of strategies that nurse educators may implement to turn the perceived barriers that wait times pose into opportunities to enhance patient education and health literacy.

In many of our rural hospitals, patient volunteers provide a valuable foundational resource. Volunteers are often assigned to serve in a variety of roles including as patient greeters, information officers, and gift-shop staff. However, I would like to suggest that these same volunteers may also serve as source of peer support and education for patients struggling with acute and chronic illnesses.

The Benefits of Peer-Peer Support

The implementation of a peer to peer support network is not a new concept. Wilson & Pratt (1987) described the benefits of peer to peer education for elder clients attending diabetes education programs and the likelihood of participants making positive behavioural changes in their lifestyle when prompted by a peer. The researchers found that a group of Type II diabetics had an overall reduction in weight and glycosylated hemoglobin (GHb) when they were actively engaged with peers who were also living with Type II diabetes. A recent study conducted with United States college students living with Type I diabetes. demonstrates that young adults with T1DM who participated in a university-based diabetes student organisation experience health benefits, including less isolation and fewer depressive and anxiety symptoms. Participants were also less likely to encounter low blood glucose and DKA episodes while in college compared with peers with T1DM who did not participate. The results are aligned evidence-based literature on the shielding effects of an active peer-peer support network (Saylor, Lee, Ness; et. al 2018). Therefore, since the benefits of peer to peer support are widely known, let’s consider utilising patient wait times as opportunities for creating a network of peer to peer support that will enhance patient education in rural settings.

Step One: Creating a Peer to Peer Network of Support

I encourage you to contact the Director of Community Support/Volunteerism in your health care facility and request permission to survey your volunteer staff. Are there volunteers who are living with chronic illnesses such as Type II Diabetes, heart disease, hypertension or arthritis. Are any of the current volunteer staff active in a support group network? Would they be interested in participating in a training to be a peer-mentor? Once you have accurately assessed your current staff of volunteers, you may choose to expand your survey to paid staff who may also be interested in becoming involved in a peer to peer network.

Step Two: Create an Educational Training Program that will Educate and Motivate Volunteers

It is essential that your peer mentors understand their role is to support fellow patients who may be anxious and frustrated while waiting for medical appointments, procedures, and laboratory tests. Their role as peer mentors is to provide support and basic information regarding how to navigate the hospital setting and provide information regarding community resources to enhance their support. Once the peer mentors have completed their training, they should be recognised for this achievement and assigned to the outpatient clinic or emergent setting where they can provide support, information and comfort to patients who are often feeling powerless and frustrated while they await vitally needed care. A volunteer who is willing to give 1-2 hours of their time during peak outpatient clinic hours, may prove to be an invaluable resource to clinic staff who are struggling to meet the care needs of an increasingly fragile population of patients.

Step Three: Utilising Available Technology to Monitor and Enhance Peer to Peer Support

Pamphlets and brochures can serve as vehicles for patient education. These written materials may be shared with family members who are not able to be present for every medical appointment. In addition, the use of smart-devices such as tablets or smart-phones that are preloaded with evidence-based information may be invaluable for patients who are subjected to prolonged wait times and may not always have access to peer mentors. Finally, I encourage you to seek out bilingual staff or volunteers who would be willing to translate patient education in order to maximise teaching opportunities for patients who are anxiously waiting for care and information from medical providers.

Step Four: Create a Mechanism for Ongoing Evaluation and Monitoring of Peer Mentors

A mechanism for ongoing evaluation of peer mentors is essential in order to reinforce and modify this unique resource within your health setting. The process should include quarterly, anonymous surveys to the health care professionals, the peer mentors and the patients who are engaged in this program. This can be accomplished with an online survey tool and focus groups that provide real-time feedback and vital information.

Summary

Patient wait-times have been a reality since the first health-care settings opened their doors centuries ago. The aim of this post is not to minimise the deleterious effects that wait times may have on our patient populations but rather to propose viewing this reality as an opportunity to provide a vehicle for education, support and sharing for those who are patiently waiting for to fill their half-empty glass with support, education and care.

References

Beckwith, N., Jean-Baptiste, M.-L., & Katz, A. (2016). Waiting Room Education in a Community Health System: Provider Perceptions and Suggestions. Journal of Community Health, 41(6), 1196–1203. https://doi.org/10.1007/s10900-016-0201-y
Saylor, J., Lee, S., Ness, M., Ambrosino, J. M., Ike, E., Ziegler, M., … Calamaro, C. (2018). Positive Health Benefits of Peer Support and Connections for College Students With Type 1 Diabetes Mellitus. The Diabetes Educator, 44(4), 340–347. https://doi.org/1177/0145721718765947
Stribling, J. C., & Richardson, J. E. (2016). Placing wireless tablets in clinical settings for patient education. Journal of the Medical Library Association, 104(2), 159–164. https://doi.org/10.3163/1536-5050.104.2.013
Wahl, C., Hultquist, B. T., Struwe, L. & Moore, J. (2018). Implementing a peer support network to promote compassion without fatigue. JONA: The Journal of Nursing Administration, 48(12), 615–621. doi: 10.1097/NNA.0000000000000691.
Willis, W. K., Ozturk, A. “Ozzie,” & Chandra, A. (2015). The Impact of Patient-to-Patient Interaction in Health Facility Waiting Rooms on Their Perception of Health Professionals. Hospital Topics, 93(1), 13–18. https://doi.org/10.1080/00185868.2014.969607

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