I work for AHS and I’m involved in supporting pharmacy technicians that perform clinical activities in patient care areas. One of the focus areas I’m trying to improve upon is the way in which we connect with our patients through our interactions. Clinical empathy is a big part of this and is a skill that we need to continue to work on developing. It is defined as understanding of what a patient says and feels, and then effectively communicating this understanding back to the patient. It is not to be confused with sympathy, which is a feeling of sorrow for someone else’s misfortune. When we interact with patients, it’s all about how we make them feel, that is key.
We might be overworked, short staffed, or just plain tired, but we have to always appear “on our game”. We sometimes forget that people become patients when they are at their worst, they are sick. This isn’t a good time for them and they may likely be grumpy. We must never take their attitudes personally, meaning don’t give in to negative emotions of your own. There can be tensions within the interaction – you are busy and they are in discomfort. If you feel angry or judgmental it will prevent you from seeing things from the patient’s perspective. They are coming to us for help and support and we want them to feel that we truly care.
Empathy is important because it builds trust, increases patient empowerment and satisfaction and results in higher compliance levels. Patients feel that we are there for them, they matter and that their questions are not insignificant. They feel valued and respected and therefore have an overall better patient experience. In return, we find our work more rewarding and our job satisfaction levels higher.
Empathy is difficult because “we have a job to do”, “we don’t have time”, “we don’t know how”, and/or “it feels uncomfortable”. Our focus is primarily on technical skills, knowledge and getting the job done. While this is important, remember that perception is reality. If the patient perceives that we are robotic, hurried, distracted or distant, how will that make them feel? Will they trust us? Will they feel cared for? When you see upwards of 10 or 15 patients per shift doing best possible medication histories repeatedly, it can be easy to forget that each patient is a person, and one who is probably feeling crappy, anxious, vulnerable or unsure.
Just because you are in a rush doesn’t mean that you have to act like you are in a rush. You can know that you have only 15 minutes but still sit down, which makes you much more connected to the person than if you are standing up. There are lots of easy ways to make yourself truly present that don’t take much time. Many of us in hospital practice are not used to talking directly with patients. Our “customers” that we interact with routinely have been nurses and physicians. How many of us walk into a patient room, glance at the patient, say our names quickly and then begin reading from the clipboard as we start our long list of questions? It takes maybe 20 seconds to walk over to the bedside, look them in the eyes, and introduce yourself before you start reading or writing. Explain who you are and why you are there. Ask if you have pronounced their name correctly – this instantly builds rapport. It shows them that you care. Don’t forget to smile, practice active listening, be patient, nod your head, lean in and use humor when appropriate. Body language is important, a look may make all the difference.
There are times when I can appreciate that my boss looks at me as a human being first and an employee second. I think patients appreciate this concept for themselves too in that they don’t want to just be the diabetic in bed 3, they are human beings. Given the chaos and workload that we encounter in a busy workplace sometimes, it can be easy to miss the signals that a patient is looking for a connection. Try and sense whether this is a person that doesn’t want to talk or is it someone that wants to tell you a bit about themselves, such as they drove for 3 hours to get here? Don’t overlook the human conversation, manage it by looking for ways to direct it into finding out the information that you need. Learning a few details about the patient may actually even help uncover something important that relates back to their care. For example, you may learn that they love milk and take all their medications with milk. This may be important for the physician or pharmacist to know. Acknowledging what they say is important because although you aren’t telling them what they should do about something you are telling them that you understand. For a patient with a fracture in the Emergency department you might say, “I’m sorry you are in so much pain”. Circumstances are also important. Have they been waiting 4 hours? Did they just get a negative diagnosis? Are they worried about missing work? I know that we aren’t in the room long, and we have a targeted mission to accomplish so we aren’t going to sit and chat for an hour, just be mindful that they are a human being with circumstances.
I have noticed many opportunities where small things make a big difference. One patient was in a clinic with a leg infection and she was laying down but the foot of the bed was down. I asked her if she was comfortable since it appeared to be an awkward position and she said her leg was throbbing but she didn’t know how to put the foot of the bed up to prop her leg up. Easy fix for me to do for her that made a big difference. Another patient had her husband with her and he was coughing repeatedly. I asked him if he wanted a drink of water and he was so grateful, he said that he hadn’t asked because he didn’t want to be a bother especially since he wasn’t the actual patient his wife was. I went in with a technician in training to conduct a BPMH interview and the patient was physically shivering. I asked her if she was cold and she said yes she was freezing. I said, “Oh would you like a blanket?” and the technician that I was with turned to me and said, “That’s not our job it’s the nurse’s”. We talked about it after we left the patient’s room. It is ALL of our jobs to do what we can to make the patient comfortable. Whether it’s taking a minute to grab the blanket yourself or passing on the message to another staff member to get one, the appropriate response to the patient is, “Yes I can see you are cold we will make sure you get a blanket right away”.
How do you exhibit empathy in your practice?
Technical Practice Leader, AHS Pharmacy Services