No news is not good news
When patients says nothing in response to significant new information it’s generally not a good sign. No news is not good news.
Check for your patient’s understanding and perspective regularly when giving new or significant information
“I told them everything…”
“And what did they say”
“Nothing…”
When discussing new information a new treatment or a change in condition I am most concerned when I hear no reply, and see no non-verbal cues to indicate understanding, agreement, awareness or even that they have an alternative view.
This is when I have the least data to go on to understand how my patient is affected. And its a large STOP sign telling me to check in.
Have I lost them with my explanation?
Are they thinking of something else entirely?
Are they distressed or upset?
Have they checked-out of the conversation?
Every healthcare professional has also been a patient at some time. Have you ever had an experience where you are so sure the doctor isn’t listening that you stop engaging?
I’m sure it’s more common than we think.
Being on the other side as a patient, I know that feeling.
Saying to myself ”This person is not going to listen. Do I use my energy to explain to them what they’ve missed? Or do I just save my energy and get help elsewhere?”
And then choosing the latter, staying silent, and making a mental note that help is not going to come from this particular clinician.
"Silence is not the absence of sound, but the presence of meaning."
Helen Keller
The truth is we don’t know how our communication is landing unless we actively ask and then listen carefully to the response.
This is why it’s useful to check in after 1-2 bits of information to check you are really moving together through the conversation.
Pause regularly, watch what happens in the silence
Chunk information into small pieces and check in
Look for cues that they are following you, and explore cues that they may have a different view (e.g could be as subtle as a frown or a quiet sigh)
Use Ask-Tell-Ask - a question followed by a bit of information followed by another question.
A follow-up question could be
“ It seems like you might have heard this all before, what’s your understanding?”
“What’s on your mind at the moment?“
“I have done a fair bit of talking, what questions do you have for me?”
(or a phrase that feels authentic to your way of communicating)
This is also why if someone is relaying info to me about a conversation with a patient I always ask “…and what did they say?” I want to know where we are in the conversation from the patient’s perspective before I talk about next steps.
If you’re explaining something and notice yourself doing all the talking this is a great cue to yourself to stop and check-in.
What do you think? Have you ever had that experience where it’s easier to say nothing? Have you ever worried about a patient’s lack of reaction?
#healthcarecommunication #chunkandcheck #respondtocues #patientperspective
