January 2022 Communication Tip
New Year's Resolution Tip
I know that not everyone is into New Year’s Resolutions, but I thought that this January Communication Tip might be a nice time to commit/re-commit to even just one communication practice that you’ll really work on in 2022.
So, please consider choosing one of the Communication Tips below, that I have shared over the years, for your 2022 Communication Resolution.
- At the start of the visit, ask something like “What are the most important things you wanted to discuss today?”
- Silence: Try staying silent for just a second or two longer than you might otherwise (and notice how you feel and how the patient responds)
- Respond to patient emotions using the NURSE acronym (naming, understanding, respecting, supporting, exploring). While you are thinking about it, download the Vital Talk Communication Skills App on your phone. https://www.vitaltalk.org/
- Ask for permission to talk about goals of care: “I’m hoping we can talk about where things are with your illness and where they might be going — is this okay?”
- Get feedback about your communication from colleagues in the room: “How do you think that discussion went? What worked well? What didn’t work well?”
- Assess patient understanding of their illness: “What is your understanding now of where you are with your illness?”
- Identify the Durable Power of Attorney for Healthcare (DPOA): “If you got very ill and were unable to speak for yourself, who would you like to speak on your behalf?”
- Take care of yourself: https://psych.ucsf.edu/cope
- Practice the 4 Agreements to having difficult conversations about race: 1. Stay Engaged; 2. Experience Discomfort; 3. Speak Your Truth; 4. Expect & Accept Non-Closure
- Help the patient unfold their story: “That sounds important. Can you please tell me more?”
- Break bad news well: give a headline statement (just a few words) and then allow for silence and the likely emotions to follow
- Explore patients’ goals of care by asking about Hopes and Worries
- Document your Advance Care Planning discussions using the ACP Navigator in APEX (just type “.ACP” in an APEX note)
- Know your patient as a person… and be present as a person too yourself
- Check for understanding with “Ask-Tell-Ask”
- Set an discussion agenda for each visit
- Pay attention to your non-verbal communication
- Most patients can only remember a maximum of 3 take home points from each visit
- Think of medical communication as a medical procedure that must be learned and practiced
- All folks with a UCSF email have free access to the Center to Advance Palliative Care (CAPC) online, self-directed training resources. https://www.capc.org/
- How you are feeling inside impact how you communicate with others. Notice and Choose
- Practice “relationship-centered care.” Use “we” language
- De-escalate communication encounters that are getting heated
- Around COVID vaccine discussions, acknowledge patient concerns without judging
- Understand patient hopes as an expression of who our patients are and what is important to them
- Remember that clinical encounters are often about 2 people in a room (one of them being you!)
- We are wounded healers, and our woundedness equips us to heal.
If you practice even just one communication skill this year, you and your patients may have a Happier New Year.
All My Best,
mike