For once my formal training & the real world in hospital have coincided. And it’s all about communication. According to the lovely gentleman from an organisation that provides medical indemnity, most complaints against doctors are about communication. Which I thought we all knew…
And then I walked straight into a communication disaster with a mother on the ward. Did I commit a communication “sin”? No, I don’t think so. I took a nurse; said “hello my name is”; asked her to start with her concerns… and fell straight through the communication black hole that I could not find my way out of. Let’s just say it did not go well. Basically, I was having one conversation and she was having a different one; it didn’t even feel that we were talking about the same baby at one point.
I love talking to people. One of the highlights about doing nights on the neonatal unit was the chance to catch up with parents outside the business of the day-shift. I love the chats about siblings & getting back to school; remembering what pets people have; where their families come from and is it a long drive…
One of the things that’s changing is that increasingly, I have to tell patients & parents things. And if it gets difficult or I haven’t got the message across, then there’s a limited number of people I can pass it on to. Sometimes, it’s quite straightforward transfer of information for people who are looking for answers. Sometimes, it’s not so easy, and none of the things I was taught in communication skills sessions at medical school seem to make any difference.
I’m looking at definitions again.
Communication: the imparting or exchanging of information.
Exchanging. How much of our communication in hospital is about exchanging information; having information pass both ways?
One of the big challenges is that the exchange of information has to be received by both sides. And that means that both groups have to be ready to have the same conversation. If I’m telling parents that I agree that their child is sick, that we need to do some tests & start antibiotics, then we’re usually having the same conversation. Parents have brought their child because they’re worried about them; they want answers; an action plan; they’re waiting for the information that I’m giving them. It’s never easy telling families that you’re worried about their child too, but at least you’re having the same conversation.
Sometimes, there’s just a huge gap and I don’t know how to bridge it. Sometimes, there’s such a difference in expectations & wishes & priorities that we might as well be speaking different languages. And I don’t know how to do it. How does a doctor communicate with a family that their newborn, beautiful child isn’t a “quiet baby” but seriously ill? How does that family get across that what really matters to them is that their child has their first breastfeed that they’ve spent 9 months waiting for, or wears the cardigan that their grandmother poured her love & care into making?
How do we do it? Because when we get it wrong, and if we can’t at least have the same conversation, then it all goes horribly & badly wrong 😦