A rash of incivility has hit the nation. Experts agree that being less than civil, especially in the workplace, is the "thing" people are doing. Often, it is not that a person wants to be rude, but that they do not know how to be any other way. In health care, this is an important issue. We all have had our bad days, our "needy" patients, our trouble cases, and our unrealistic bosses and coworkers. Still, the art of being civil need not be lost. If you have ever taken a communications class, and, as respiratory therapists, I am sure you have, you know that effective communication can overcome many areas where civility is lacking.
Let's take introductions, for example. We all introduce ourselves to our patients. This singular act often sets the tone for care. Patients and families decide if they like us, if we are fit to provide care, and we decide if this patient is one we will enjoy working with, or if they will be someone to tolerate until we can get them discharged. In some instances, we already know our patients. Maybe we see them at the store. Perhaps they are a well-known business person we often deal with outside of the hospital. Maybe they are a coworker. Already having this kind of knowledge of a person can be good or bad, depending on your opinion of the person. Still, being the great professional you are, you know that you should treat everyone the same, and the rules still apply, even if you are on a first-name basis with the person in the hospital bed.
First, embrace the idea that less is more. Brief introductions are always best. Give only the information the person needs to know about your role in their immediate future. Tell them who you are, what qualifications you have to care for them (if that is necessary), and how you plan on making them better. That may be all they need to know, for now at least.
Second, be appropriate. I have worked in places where patients refused to be seen by one person or another because they were inappropriate. There is no room for this in a professional setting. If you have nothing pertinent to say, then shut up. I do not know of any respiratory therapist who has been fired or sued because they did not comment on something a patient said, or because they did not say something inappropriate.
Third, don't try to impress the patient. Look, if you want to impress your patient or a family member, provide the great care you are known for, and nothing else. You are not a chaplain, nor are you a psychologist, nor are you the hospital CEO, so do not pretend to be. Even if you are one of those who are "in the know" about happenings at your facility, keep it to yourself. Do not try to impress your patient with your position or tenure; impress them with your care and professionalism.
Fourth and finally, focus on the patient. This is where we are losing ground. In the all-consuming world of the big dollar, we tend to gloss over our patient interviews, relying instead on notes on the computer for history and physicals, conversations with nurses or other professionals to develop our treatment plans. Remember this, the best way to gain a rapport with a patient, or anyone else for that matter, is to listen to them. Let them do the talking. Let them describe what is going on to you, not vice versa. The simple fact is that the mouth and the ears do not work well at the same time. Close your mouth and open your ears. The old saying is that "people do not care how much you know until they know how much you care". Listening to them, no matter how boring or exciting it is, shows that you care enough to let them talk and express themselves.
I spent years in the hospital environment. I was often the therapist requested by patients. This was not because I was a better therapist than my coworkers; I have worked with some amazing people who were smarter than I ever hope to be. It was because I have never stacked treatments, always communicated with patients the best I could, and I let them talk. Sure, I have taken part in conversations that had nothing to do with their care, but in the end, it all has to do with their care. If the patient is worried about costs of their stay, they may hesitate when you suggest something new. Talk about it. If the patient has a spouse in the hospital, too; perhaps the result of a car wreck, they likely will be more concerned for him or her than themselves. Listen to them, figure out their issues, and work through them. You just cannot do that if your mouth is working overtime.
In my opinion, civility is not completely lost in the workplace, but communication is. We are pressured to provide more care with fewer supplies, less therapists on our shift, and more patients. Get over it or get out. That's just the way it is. Good managers know this, and take steps to correct it as best they can, but sometimes you just have to roll with the punches. Still, there can be no excuse for not listening. I don't mean just letting the patient talk, but actually listening.
Listen between the lines. Ask questions where appropriate, and make sure you understand the real problems. We communicate these days in many ways; body language, technology (text messages, beepers, etc.), and what we actually say or do. Take a look in the mirror. Practice how you will deliver bad news to a family, as well as how you deliver good news. Check your body language. Speak into a tape recorder (are those still around?) and hear yourself talk. If you were in the patient's shoes, how would you sound?
Even amongst ourselves, communication is lacking. We have spoken of some instances through this blog; communication with the AARC or state societies, etc. Communication is lacking everywhere, including health care. Fix the problem, at least in your little world. Once you are an accomplished communicator, you, too, will be the therapist patients know by name, ask for on admission, and look forward to seeing every four hours.
That's just my opinion.
Jim Thacker, MHA, CRT, AE-C, Lexington, Mo.