Here's how you can compassionately communicate with emotionally distressed patients.

Listening is one of the most important skills one can have. But part of that skill is letting the other person know that you are listening. This means sitting down if the pay is sitting, so that you are eye level. It means putting down screens and having a calm voice. And lastly, open ended questions are really important. When we truly listen, we learn, and we strengthen the relationship.

Compassionate communication begins with creating psychological safety for your patient. You can do that by listening and affirming their emotions - ANY - emotion that they may experience or express. Many patients and parents (if in pediatrics) may automatically assume you are smarter or more qualified to talk about their child. It is our job to demonstrate to them that they are the expert in their child. We bring specialized knowledge to them, so they can make the best decisions.

It is important to listen. Actually listen to what your patient is concerned about. often as physicians we think very scientifically and clinically but that might not be what's bothering your patient. Patients are more than their health problems and they are a part of a whole life experience. Knowing and working within the parameters of what is acceptable to your patient ultimately ensures you provide good clinical care. Make time. Be aware of potential distractions and try to minimise them. Be prepared to answer questions and explain certain aspects of care which are obvious to you and most importantly remember that this is a normal day of work for you but for your patient it might be one of their worst days. don't forget to be kind!

Essential elements of an effective, compassionate communication with distressed and other patients needing support and help: 1. Active and patient listening with allowed moments of silence 2. Showing respect and good contacts 3. Giving empathetic responses and appropriate and focused questions on most important issues 4. Enabling self-understanding and acceptance of own situation(s) 5. Attention to the present moment and emotions, and mindful to your body responses 6. Guiding to look into things from different angles, by reviewing the values, thoughts and emotions in a few challenging experiences 7. Facilitating to clarify and reestablish values and goals, and move to positive and compassionate ways of self-care and caregiving

From my experience it follows this sequence and this order: 1. It starts by the practitioner really and truly wanting to help. 2. Then listen to what the patient says and wants. 3. Then contemplate deeply what the patient truly needs in order to get better. 4. Then soul search how to communicate to the patient what they need versus what they want, which may or not align. 5. Finally, the will to help overcomes the desire for empathy if they dont align. Truly communicating with compassion means that helping the patient comes above everything else. If there is unease in my heart as a practitioner, and I am only partially committed to the patient (i.e. I also have other things to worry about) then this is not compassionate communication.

An empathetic response is one that is framed through the lens of safety and trust by acknowledging and being responsive to the needs of the other person.

Empathy is a natural human response. It connects their emotion and condition to the prognosis and treatment plan. A facial expression, raising eyebrows, using our bodies to express the empathy while not distracting the patient with a lot of words is a good way I've found. Verbalizing at the high points. Builds confidence in both the provider and patient in the therapeutic relationship.

I definitely agree that empathy towards a distressed client should be echoed in verbal and non verbal communication. It is not helpful to say all the right words with a facial expression or body language that shows disinterest or judgement. In my view, our body language, facial expression and general aura exuded, sets the tone for empathy and empathetic words to have the desired impact. Empathy can easily steer the patient's progress in a positive direction before much else has been done.

A clear explanation is simple, concise, and explained through a cultural lens that mirrors that of the patient so that the explanation minimizes gaps in understanding.

We know that noise increases or is often an adverse stimulus that contributes to an escalation of issues, but it’s not only noise, it’s the intensity and tone of the noise as well as other physiological responses. When we decrease the intensity and soften the tone, while monitoring the slowing of our breath and relaxation of muscles, it will help with the atmosphere by promoting calmness. Softened facial expression can instantly lower tensions with others

If I'm calm and clear, it projects confidence as we progress towards diagnosis and a treatment plan. Builds upon the trust previously established.

When patients are emotionally charged, I take the time to write a few notes for them on the diagnosis, plan and medications. I'll frequently add some points relevant to follow up on and for them to note in the interim. Occasionally I'll add a few words of support on encouragement. Like most humans, the details of an encounter can be a blur when emotionally charged. They almost always have my little notes with them on the next visit. I take the time to hand write these notes and that personal touch is usually greatly appreciated.