By Alene Nitzky, Ph.D. RN OCN
I’m not sure who said it originally, but it’s been said that we have two ears, but just one mouth, for a reason.
Listening is what we do when we take the time to build a relationship with the patient.
When we meet with a patient, they are coming to us for a service, to get help for some problem for which they are not qualified to remedy themselves, just as we go to an auto mechanic when our car breaks down. Untrained in auto mechanics, we might understand the inner workings of the electronic circuits in our car as much as a patient without healthcare training understands their disease process.
We’re providing a service, not a product, however, we are still expected to produce good outcomes and improve health, and that only ends well when we build a relationship.
We need to establish trust by building the patient’s confidence in our skills, training, and experience that we bring to the relationship, so they will be as engaged as possible and get the most from their time with us.
We as healthcare providers must be engaged, fully focused on the patient during the time they are with us. We need to listen for important information, but not necessarily just for what goes into the EHR. That includes remembering their name and family members who are present, details about their own unique lives, their goals for their quality of life and health outcomes. Eye contact, nonverbal expressions and body language are as important as conversation. Staring into a computer as a patient talks to us does not build trust or create engagement.
When we are educating the patient and we have important information for them, we need to do as much listening as talking. We must ensure they received the message we intended, and understand it the way we intended. This means we take the time to listen to their own version of what they heard us say. When a visit or patient encounter is rushed, there might not be time to ensure that all the information is given and received as intended.
It’s important to remember that we are a team, we work together, and the patient steers the decision-making. The patient will make the ultimate decision, through informed choices. That’s why we need to be very attentive in listening to their questions. Are they truly understanding the risks and benefits of each option? If we suspect that they don’t understand or are not fully informed, then we need to listen to how they respond to us, including their nonverbal communication, and clarify in ways that will inform them.
Today our work is driven by data, typing things into the EHR, checking boxes, and other requirements that place an administrative burden on healthcare providers like never before. We still need to listen, and even more carefully, over the many distractions of technology.
When we spend too much time paying attention to data and productivity and forget about the real reason why we went into healthcare, we are not listening. Getting the message across takes time, often more time than we are allotted.
We must always remember that it is our job to support them in becoming informed so that they can make decisions in their own best interest. They are not here for a quick purchase, or for us to persuade them to do what we would do for ourselves. We need to understand their priorities, lifestyle, goals, and values, and help them make decisions that will serve their own lives well.
Everyone in healthcare needs to use two ears to guide one mouth, if we want to serve patients’ needs, as well as our own professional goals of providing safe, quality patient care, well.
Alene Nitzky, Ph.D. RN OCN is CEO/Founder of Cancer Harbors, an educational and support service that extends beyond rehabilitation and survivorship care plans, for both cancer survivors and caregivers to improve and restore function and quality of life after treatment.