Gentle Communication: An Elusive Skill
Authentic patient interactions have a different feel from those in the practice room. The reality of verbal intimacy is precarious to say the least. Over the past couple of weeks, we have spent time in the clinic as sort of a pre-rotation, if you will. The objective is to follow around a physician assistant and perform basic H&Ps (history and physicals). For some reason, this experience is much different than the shadowing we have all done prior to PA school. I am sure it has something to do with all that we have learned and being faced with applicable circumstances.
It was rare for me to be uncomfortable in the presence of a patient in all of my previous encounters. However, I noticed a strange feeling elicited by a certain patient. In short, the patient had multiple signs and symptoms that pointed to cancer. Both my preceptor and I had this diagnosis on our differential, yet the patient never once asked, "Could this be cancer?" I was nervous while the patient asked questions and my preceptor calmly answered with what was known, not with what was supposed. With full candor, the PA gave the patient assuring, eloquent, and educated information. I wondered how I would have responded if I was the provider. Would I have been overtly blunt or insensitive? I reassured myself that being a gentle carrier of bad news would take time to learn. Why did it seem so difficult?
We are taught about all the lethal and life-altering consequences of various diseases and conditions. After collecting the diagnostics and signs and symptoms, it seems the next step is all too easy. Just tell the patient what we found. How difficult is that? However, this delivery requires much more than the facts. We are dealing with real live human beings...like you and me. It takes more than the answers to be an effective healthcare provider.
Communication and empathy are everything when venturing into the intimate confines of a human. However, the reality is that we cannot learn this in the classroom. It takes the face of a sweet elderly woman with probable cancer to teach us how to communicate. When presented with all the answers, we must be careful not to be loose cannons. There are precious people who depend upon our ability to control our tongue. I hope to grow in this elusive skill.