Starting the right way leads to successful communication
I’m not sure about you but talking to strangers is not something I’m very fond of. In particular, starting the conversation, especially when the person was not expecting to speak to me, is something I worry about. I often think through various options in my mind of what I might say and how the person might respond before I even approach the person.
Why am I telling you this? Well, because I know many of you worry about the same thing when starting to speak to a patient. In your working day, you can speak to many different patients in different settings and to discuss very different healthcare situations.
You can’t start every conversation exactly the same way. If you do, you will sound rehearsed and the patient will struggle to trust what you are saying.
Different ways to start a conversation
At a basic level, how you start a conversation with a patient you have met before (1) should be different to a patient you are meeting for the first time (2).
Hello Mr Jamieson, it’s good to see you again. How have you been feeling since I last saw you?
Hello Mrs Patel, my name’s Janet, one of the nurses here. I’m going to talk to you today about insulin injections.
There are also other things to consider, for example if the patient is visiting you for a routine situation (3) or due to an urgent healthcare issue (4).
Thanks for coming in today, George. I understand you’ve been experiencing some pain in your left calf, is that right?
Hello Helen, I can see you’re in a lot of pain. I can give you something for that but first I need to ask you a few questions. Is that OK?
For each of these 4 groups, you can then further divide your conversation opener based on whether the patient is expecting good news (a) or bad news (b)
a) Hi Mr Minghella, I have some good news for you about your recent test results.
b) Thanks for coming back today for your test results Mrs Vu. As you know we took a biopsy from the lump under your armpit. Are you ready for me to tell you what we found?
Getting the start of the conversation right can really impact on how well the rest of the conversation goes.
Consider this scenario:
You are talking to a patient (Mario) who is due to have a hernia operation today. The scheduled time for his operation was 1pm. It’s now 4pm. Mario has been nil by mouth since 6am. Nobody has spoken to him about the delay. You arrive to give him an update.
How do you think the conversation will go if you start with:
Hi Mario, my name’s Emilia, one of the ward nurses. How are you feeling?
It’s unlikely to go well. Mario is likely to respond angrily about the fact they have been waiting for 3 hours, nobody has informed him what is going on and that he is feeling anxious and hungry.
What about if you started with:
Hi Mario, I’m so sorry you’ve been kept waiting for your operation. My name’s Emilia. I imagine you’re feeling unhappy about the delay. I’ve come to update you about what’s going on.
Mario is still likely to be frustrated but is unlikely to be so angry as he feels he has been shown understanding and empathy.
There are many ways to start a conversation. Thinking about how your patient is feeling, the purpose of your visit and their expectations of you in the conversation are a good place to start. This information will help you to choose the best language to start which will give both you and the patient confidence for the conversation ahead.