"Medicine is a technique, and treating others is an art. Recently, Shen Zhenyu, an "Internet celebrity doctor" and associate professor of pediatrics at the First Affiliated Hospital of Sun Yat-sen University, shared this when he gave a lecture on "Doctor-Patient Communication and Cooperation Ability Training" for medical staff in Guangzhou Development Zone Hospital.
Listening makes doctor-patient communication twice as effective with half the effort
As a pediatrician, Shen Zhenyu is often faced with small babies who cannot communicate in words, but he can always use his own methods to understand the pain and troubles of babies, and patiently answer the "100,000 whys" of parents, so he has become a "male god" passed on by many mothers.
Shen Zhenyu
"Listening plays an important role in good doctor-patient communication. Unfortunately, the need for patients to be listened to is not being met, both abroad and at home. Shen Zhenyu introduced that a survey of general practitioners in the United States showed that general practitioners could not help but interrupt when listening to patients for an average of 107 seconds, while the results of a similar survey in China showed that outpatient doctors began to interrupt patients and ask questions when listening for an average of 60 seconds.
"Listening may seem like a time-consuming process, but it is actually more efficient to address the patient's problems in a more targeted manner in a limited amount of time. Shen Zhenyu explained that when listening to the patient, in addition to understanding the patient's medical history and feelings, he can also understand the patient's real demand - whether to obtain an accurate diagnosis, do examinations, health management, surgery, or vent emotions. "For example, during the outpatient clinic, I noticed that some mothers would go out of their way to tell a lot of details about taking care of their children, and I could see that their daily life was very hard, and if the doctor could give them a little affirmation and praise, the mothers would be comforted and encouraged. ”
When dealing with medical disputes, listening plays an even more important role. For example, Shen Zhenyu said that when he was handling a medical complaint on behalf of the department, he was very emotional when he was faced with more than a dozen members of a large family at the same time. He took out the paper, listened carefully and recorded every problem reflected by the patient's family, and listened to it for more than two hours, recording more than a dozen pieces of paper, and there was a "reversal" at the end of the meeting, and the patient's family members chose to give up the complaint after calming down, which is closely related to their catharsis in the process of being listened to, and at the same time they were respected and understood.
Listening is not an easy task. Shen Zhenyu explained that there are two meanings in this. First, listening is a "tiring" thing, and the work of medical staff is not only physical and mental work, but also emotional work, which requires medical staff to change their concepts. The second is that listening is a "technical job", and effective listening requires Xi and training, including encouraging the person to communicate with, paying attention to verbal and non-verbal communication, ensuring understanding, and empathy rather than empathy.
How do I tell the "bad news" to a patient/family?
How to tell a patient/family member "bad news" (e.g., a patient is critically ill) is a common challenge for medical staff. Shen Zhenyu explained in detail the SPIKES Structural Communication Method, which is a 6-step approach to informing patients and their families of bad news proposed by Dr. Walter Baile of M.D. Anderson Hospital in Texas, USA (the initials of each step become SPIKES).
Choose the right environment when you talk. Preferably, it is necessary to have a comfortable, quiet, separate room with plenty of undisturbed time, where the medical staff can sit down with the patient and family members, avoid obstructions between the two parties, and have a glass of water and tissues readily available.
Understand the patient's needs before informing them. Doctors need to know how much the patient is aware of the disease and what to expect, so that the gap between what the patient knows and what the doctor is prepared to tell you is. Doctors can ask open-ended questions to understand the patient's perception of the disease. For example, "Tell me about some of the treatments you know so far" will interrupt the patient's defense mechanisms and pave the way for the next step in telling the patient.
When patients and their families are told "bad news", a series of psychological changes may occur, such as denial, anger, negotiation, depression, acceptance, etc. "In this process, patients or family members may make desperate or unreasonable demands, medical staff should not rush to deny or refute, understand that patients or family members are in a 'negotiation period', and what the medical staff who communicate with them should do is to understand their feelings and help them move to the next psychological stage. Shen Zhenyu explained that when the patient or family reaches the acceptance period, the conversation between the medical staff and them can enter the "technical level" to discuss the treatment plan and make a decision.
Shen Zhenyu's lectures are light, humorous, and full of humanistic care. Hospital leaders, department heads, head nurses, doctors and nurses, administrative support staff and medical guides who attended the lecture said that the lecture was simple to understand, full of dry information and easy to practice. "This lecture has updated my understanding of communication. Communication is an art, we must understand the needs of patients in our work, infect each other with sincerity, use profound knowledge and skilled technology to make the families of patients have a sense of security, use superb language control ability to resolve conflicts in doctor-patient communication, and make ourselves become medical workers recognized by patients and better serve patients. Deng Yu, secretary of the Party branch and deputy director of the pediatric department of Guangzhou Development District Hospital, said.
Zhou Daoping
Zhou Daoping, vice president of Guangzhou Development District Hospital, said in his speech that a word, an action, and a small flaw of medical staff may lead to medical complaints or medical disputes. He urged medical staff to improve their communication skills and humanistic qualities, and strive to become a new type of medical worker with medical professional skills and good communication skills, so as to provide better medical services for patients and help the hospital create a top three.
Text/Reporter Chen Huitu/Courtesy of the hospital