The Caring Science

The Caring Science
Engaging the experts: Maureen Fagan, DNP, MHA (front row, center), and members of BWH's Patient and Family Advisory Council meet bi-monthly to discuss opportunities for improving patient and family experiences.

Nearly 20 years ago, long-time Brigham and Women’s Hospital trustee Robert Bretholtz envisioned a special environment where patients’ families could unwind, while staying connected to their loved ones in other areas of the hospital. When Bretholtz passed away in 1999 after battling cancer, his wife Ronnie and sons Jared and Joshua gave BWH a generous gift to create the Bretholtz Center for Patient and Families. Opening just a year later, the center is a tribute to the Bretholtz family’s decades of philanthropy and volunteerism at BWH.

Now in its 14th year, the Bretholtz Center serves tens of thousands of visitors annually, and is a model for patient- and family-centered programs in other top hospitals around the nation. Inside the Bretholtz Center, the buzzing energy of the main lobby dissipates into a quiet, restful atmosphere where families can seek comfort and reflection. With private nooks, computer stations, and a help desk where staffers track patient status in real time, this is not a typical waiting room.

“The Center provides its own type of medicine,” says Maureen Fagan, DNP, MHA, executive director for the Bretholtz Center. “We’re treating the whole family by putting this haven around them and encouraging them through often difficult times.” 

Nurses: the most trusted professionals

It is no coincidence that the Bretholtz Center’s leader is a doctorally-educated nurse. Demonstrating constant awareness of comfort and safety in a frenetic environment where even the smallest missed detail could spell disaster, nursing is a career that demands sophisticated judgment and extensive knowledge—but that’s only the beginning.

“When the nurse comes with a caring intention and is fully present, and is there to listen and uncover what is truly important to the patient, that is what we call the caring science,” says Jackie Somerville, PhD, RN chief nursing officer at BWH.

As our healthcare system changes, nurses are poised to make critical breakthroughs through nursing science, Nurses are the only members of the health care system who practice in close proximity to the patients around the clock. While experience is a leading factor in cultivating skills, recent reports, including the Institute of Medicine Report on the Future of Nursing, emphasize that higher education within the nursing workforce will advance the health of the nation. To that end, Somerville says BWH is committed to bringing the amount of nurses with bachelor degrees or higher up to 80 percent by 2020.

“If we are going to transform healthcare, we need to invest in nursing education. The knowledge nurses gain through academic investment improves patient outcomes,” says Somerville. “Clinical nurses propose the best research questions, because they are constantly intersecting with the patient and family’s experience. A nurse may notice patterns with her patients over time, and yet not find anything about it in the literature. When that happens, having doctoral nurses on staff helps nurses craft research studies, and gives them protected time and resources to investigate these trends.”

Family- and patient-centered care

executive director Maureen FaganAs the eyes and ears of the care team, nurses synthesize a tremendous amount of data on a daily basis.

“People often think of nurses as just doing tasks that are delegated to them, but they also have deep scientific knowledge of anatomy, physiology, chemistry, and biology,” says Somerville. “What is equally important though is this caring science, because what patients really want is for a caring person to help them heal while honoring their human experience.”

In addition to forming relationships with patients, nurses constantly interface with family and friends who accompany their loved one to the hospital. BWH recommends that patients bring a trusted person to facilitate communication with healthcare providers and help with decision making.

“As nurses, we may be experts on the patient’s condition, but we are not necessarily expert on the individual patient. That’s where their family and loved ones come in,” says Fagan.

To improve the hospital experience for everyone, BWH established Patient and Family Advisory Councils (PFACs) in 2008, gathering passionate members of the patient community.  Patient and family advisors regularly meet in the Bretholtz Center with Fagan and other senior leaders to discuss priority topics.

At last year’s Psychological Care Nursing Conference, two BWH patient advisors were invited to take part in a panel on caring for patients with delirium. The advisors’ insights were so well received that they returned to speak at the next conference.

“Our patient advisors contribute so much of their time, some 30-40 hours a week, to teach us how to keep improving our care,” says Fagan. “It’s been wonderful to have their voices welcomed across different departments and service lines inside the hospital, and beyond.”

In the Bretholtz Center, Fagan’s team of staff and volunteers are devoted to working with physicians, nurses, and other hospital personnel to create a community of support for the tens of thousands of patients and families who visit BWH each year.

“We always think about how we want people to remember their time here,” Fagan says. “One of our senior patient advisors says it best: we can’t always control the outcome, but we can always control the experience.”