Napa Day 3-thinking about communicating

“If you don’t sit at the table-you’ll probably be on the menu.” This sage advice came from one of my fellow PhD students at TWU and it has always resonated with me. If you think about it-this is all about communication and being willing to have the conversation. If you don’t participate-you may not like the outcome. Communication is so simple in some ways and so complex in others-yet there is so much room for misunderstanding and assumptions.

Words are very powerful. It is amazing to think what they can do. They can motivate or devastate, persuade or dissuade, show emotion or authority. Careers, marriages, negotiations & contracts have been build or destroyed with words.  Words can represent a range of things…from promises & compliments to slander & abuse. This is why we need to use them carefully and deliberately.

Enter the healthcare profession. Communication is crucial to what we all do every day-but how many of us really have been trained how to do this effectively, clearly and without any confusion?  Most of us would think that our communication is fine but if there is a chance for more than one interpretation-someone usually will take another meaning than what was intended.

I am reminded of a time I was pulled into another unit one night and was helping with a new patient being admitted from from the OR. My nurse colleague Frank was a very free spirit and one of the most laid back people I had ever met. (He had long brown hair, brown eyes and a beard. I will explain why this is important in a bit.) We proceeded to get the patient admitted and connected to all of the monitors. At some point, Frank started talking to the patient. “Mr. Smith-you can wake up now. It’s all over.” “Mr. Smith” opened his eyes. He seemed OK at first-but then looked at Frank, got a terrified look on his face and started screaming. We were both startled and couldn’t imagine what was wrong- until he yelled “AAAAH! I see Jesus! I see Jesus! AHHH!”.  The patient actually thought he was dead and Frank had come to call him home. Once we got “Mr. Smith” calmed down and reoriented, I realized that Frank did bear a striking resemblance to the most common portraits of Jesus. His choice of words telling the patient “it’s all over” contributed to his patient’s assumption that he was in heaven. As humorous as this is to look at now-I feel for the guy. I can only imagine how terrified he was. There was obviously room to interpret what was said the wrong way.

Communication is one of the most important skills that we will use throughout our lifetime. It is something that needs to be practiced and polished. It is our duty as healthcare providers to make sure that we are clearly understood so we do not endanger our patients & that the information that comes across is accurate. This can be between providers or between providers and families. I keep thinking of the poor communication around Michael Skolnick’s consent and need for surgery….or the poor communication between Lewis’s providers…….I cannot imagine the guilt that providers feel when there are gaps in communication that lead to bad outcomes…even worse, I can’t imagine the devastation that a family feels when there is a communication issue that causes a preventable error. So much to think about….