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Guest editor: Tina Keeler, MSN, RN, Western Michigan University, Bronson School of Nursing in Kalamazoo, Mich.

Not so long ago, healthcare was primarily rendered in the home. Mothers and midwives attended the sick, and physicians were only called for emergencies. People came to hospitals with life-threatening illnesses, but the rest was taken care of at the kitchen sink.

As modern medicine advanced, hospitals began to emerge as a place of health and care instead of death and dying. Today, people seek out hospitals for a multitude of reasons: to celebrate a birth, to grieve a death, to replace a joint, to fix a gut, to repair damage done, or to prevent future injury.

Patients will have some sort of an experience when they come to the hospital. The question we need to ask ourselves is: What can we do to ensure their experience is a positive one?

Patient experiences are based on interactions with nurses and other staff that patients encounter while in the hospital. For example, Betty came to the ED with abdominal pain and is now having blood drawn. The nurse gives the scripted greeting, but is mechanical and minimally interactive. Even though the nurse has a professional manner and flawless technique, Betty perceives the experience as negative. Why? Her perception was that the nurse's demeanor was cold and uncaring. In reality, the nurse was focused on trying to follow protocol and not break sterile technique or contaminate the specimen. Although the service rendered was adequate, it didn't exceed the patient's expectations. What could the nurse have done better to create a positive patient experience?

First impressions are key, so smile and make a connection. Try starting a friendly conversation: "Oh, I see your name is Betty. My mother's name is Betty. She was named after her favorite aunt. Does yours have a special meaning?" While preparing to draw the blood specimen, the patient is probably secretly sizing up the nurse, who appears young. "Have you done this before?" the patient nervously asks. The nurse smiles once again and explains that she's done this many times before. She then compliments the patient on her lovely veins. "I wish more of my patients had vessels like yours. That would surely make my job easier," she says. The patient nervously adds, "But I've been told my veins roll and I'm a difficult stick." Once again, the nurse smiles and says, "Oh, then I have a special way to hold your arm to help prevent that from happening." Then she demonstrates the technique. The patient is put at ease and her experience is markedly better.

We, as nurses, need to expand the dialogue on patient experiences beyond rendering excellent clinical care. How can we engage patients and families to build positive healthcare experiences? By focusing on creating connections, starting with a smile!