Unfortunately, the push for instant gratification and a consumer-centric marketplace in retail and e-commerce now means people have unrealistic expectations in many areas of their lives — including health care.

As a result, many patients and their families fail to understand that a patient’s treatment and recovery often extend well past his or her hospital stay. Not only that, they may overestimate how well the patient will respond to treatment and assume a patient will “bounce back” from an illness or injury more quickly than he or she actually will.

Since nurses have the most direct patient contact, managing patient expectations often falls on their shoulders. Here’s how nurses can work with patients and their families to set realistic expectations about what happens after they leave the hospital.

Identifying an Expectation Gap

Simply put, an expectation gap is the difference between what a patient expects to happen and what the care team anticipates will occur.

The patient and his or her family may not realize the true extent of how the patient’s physical, cognitive and emotional health will be impacted and how the injury or illness will affect the patient’s ability to resume normal activity. In fact, depending on the seriousness of the condition, the patient may never be able to return to his or her regular daily routine. If these details are not discussed, the patient may have expectations about his or her recovery that don’t match what his or her actual state of health will allow.

To prevent expectation gaps, nurses must have open and honest communication with the patient and his or her family early in the patient’s stay. Nurses should ask the patient and his or her family where the patient will be staying after leaving the hospital, who will be involved in the patient’s post-discharge recovery and treatment plans, which activities of daily living (ADL) the patient will need to accomplish and how the patient intends to perform these ADLs.

The nurse must then compare patient expectations to the care team’s assessment of the patient’s condition and abilities. If a discrepancy exists between the patient and his or her family’s perceptions and what the care team deems realistic, it must be addressed immediately.

Addressing an Expectation Gap

If an expectation gap exists, the nurse must help the patient and his or her family understand realistic treatment plans and recovery timelines based on the patient’s specific illness or injury. The nurse must communicate how the patient’s current clinical status and seriousness of the condition will impact the patient’s life both in and outside the hospital.

Nurses and the rest of the care team must educate the patient and his or her family on the following:

• Scope of the patient’s condition
• Plans for post-discharge care
• Responsibilities of the patient and his or her family in the patient’s treatment and recovery
• Treatment and recovery time frames

Nurses should also work with the patient and his or her family to develop care plans that are best suited to address the patient’s needs. By involving the patient and his or her family, nurses can ensure everyone is in agreement as well as shape expectations and perceptions to match what is reasonable and attainable. Research shows that empowering patients to make decisions about their health and helping them set realistic goals gives the patient a greater sense of ownership of their treatment, which can lead to increased compliance and better outcomes.

Patients and their families often enter a hospital with preconceived notions about the patient’s own abilities, which makes managing patient expectations one of the most difficult challenges nurses face. In addition to having open lines of communication with the patient and his or her family, don’t be afraid to consult your colleagues — they likely have their fair share of expertise in this area and can help guide you.

A patient-centered care approach can help make it easier to set realistic patient expectations. Download our free guide, How Nurses Can Increase Satisfaction through Patient-Centered Care, to learn helpful tips about implementing patient-centered care.