Three communication strategies that can make a big difference to the experience of your patients and relatives.

Recently we had to take my 7 year old son into hospital to have biopsies under anaesthetic. It was a very long and very traumatic day; to see your son sobbing, screaming, clinging to you for dear life. You know you are doing this in your son’s best interest but when he screams and sobs and begs you to take the experience away you question it. It took two attempts to complete the surgery because he was so distressed the first time they couldn’t get the mask on. They had to give him a sedative and try again later. 

I have worked in the health service in the UK for many years but it’s always a valuable experience being on the receiving side of health care. Our recent experience motivated me to highlight 3 of the key communication strategies I always share with the doctors I work with. Our day was always going to be terrible, but if the surgeon had implemented these three strategies our experience would have been better.

• Always introduce yourself with your name and your role.

This may sound simple but it makes a huge difference. When I arrived in the room next to theatre with my son, a man came in. He said my son's name and called me ‘mum’ and then started talking. I can’t remember what he said. I was too busy trying to work out who he was and what part he played in my son’s procedure. In this hospital everyone wore the same uniform...he could have been a nurse, the surgeon, the anaesthetist or a porter. We had seen so many people that day I honestly did not know who he was.

When I sat in recovery hours later he came back in and started telling me how it had gone. Only then did I realise he was the surgeon who had performed the procedure.

Always introduce yourself with your name and your role.

• Never underestimate how much more difficult it is to process information when someone is physically and emotional exhausted.

When you come into contact with relatives and patients in your role as a doctor, often you are speaking to them at a time when they are physically and emotionally exhausted. When people are in this state it becomes harder to process information. I experienced this in the recovery room. It had been an exhausting day already and emotionally very difficult. As parents we had had to stay strong throughout for my son and now I sat with him in recovery where it took 3 hours for him to wake from the combination of the sedative and anaesthetic. When the surgeon came in he told me how it had gone and then gave me a lot of information. What to expect with pain, what pain medication to give, what level of fever would be normal and the level of fever I would need to contact the ward. When to expect the results and which medication I couldn’t give him while he recovers. It was a lot of information.

The surgeon was nice, he smiled and was thorough. The problem was he gave me too much information and too quickly. I was struggling to process it all and anxious I would forget. He didn’t tell me that I would get the same information on the ward written down and that the nurses would also go though it with me. Because I didn’t know that it was stressful trying to keep up with everything he was saying.

When giving information to patients and relatives:

1. Choose the key bits of information you need them to understand and don’t overload them.
2. Pause between each bit of information and check they are clear. Watch their facial expressions and ask them, "is that clear".
3. If possible and appropriate provide them with written information as well. If they are going to get the same information written down tell them this too so they know they don’t have to remember everything.

• Always, ALWAYS allow time for questions.

My son’s surgeon never asked if I had any questions. I did. There were a few key things about the procedure I was confused about and this caused ongoing anxiety afterwards. The surgeon could have answered my questions in a few minutes and given us the understanding we needed. He also told us not to use one of our son’s medications while the stitches were healing but he didn’t tell me for how long. I had to ask the nurse later who had to ring the surgeons to answer. This ended up taking more of everyone’s time. 

It was my brother who answered our questions about the procedure two days after. He is a consultant in the UK and spent some time in the medical library during a break at work. In one paragraph over WhatsApp he gave us the clarity we needed.

Never underestimate the importance of asking your patients and relatives whether they have any questions. 

You can’t change the fact that for many of your patients and relatives these experiences are difficult. Here, however, are three communication strategies that will improve their experience during what is often a very stressful time.