The Patient Is Listening
By Frances A. Garcia
Skills in communication, both verbal and nonverbal, are essential to the radiological technologist or student technologist. Verbal communication is the use of language. Nonverbal communication includes the tone of voice, gestures, eye contact, and use of space, touch, time and physical appearance. Verbal and nonverbal communications are used interchangeably in our everyday life as well.
The patients you come in contact with are attuned to these forms of interaction. Patients are exposed to highly sophisticated equipment and technical procedures in a hospital. You, as a healthcare professional, influence the total experience of each patient. Therefore, it is vital for you to communicate effectively with every patient.
The primary form of verbal communication is the use of language. When a patient is first approached and the skin tone and general appearance is observed, never ask, How are you? It is obvious the patient is ill. Start off by introducing yourself and asking if the patient would like to be referred to by first or last name. This approach convinces the patient you are genuinely concerned, and it cues you to be formal or casual in your conversation.
Another approach is to simplify for the patient the examination that will be performed. Depending on the simplicity or complexity of the procedure, the patient should be reassured that the task at hand is not impossible. To establish rapport, talk about a general topic. The weather is a good start.
Keep the patient in mind when others are present in the room. Technologists and students alike tend to dehumanize patients by labeling them as Chests, Upper GIs, Renal
Sonos and so forth. These slips of the tongue are offensive to the patient. You should also avoid using technical jargon and medical terminology that may confuse or frighten the patient. For example, two CT Technologists elaborate in front of a seven-year-old how they will cut through the neck. Up to this point, the child was merely fidgeting. Now he glares, kicks, and hollers, Get me out! This child will always remember this dreadful experience. The trauma is permanent.
One of the nonverbal forms of communication includes the tone of voice. Patients are quick to detect any tension, coldness, or formal and informal tones. When instructing a patient, be firm but conscious of the tone in your voice. Many a caring technologist or student is compassionate until the dreaded command comes out, Dont move! Then you become a lion unleashed. Have you ever been directly commanded not to move? Do you recall how difficult it is to hold still? It is best to apply some humor to the situation. With a smile, which is a nonverbal gesture, explain to the patient, Im going to get loud and tough in a few seconds, but Im not angry. I just want to be sure you can hear me above the noise of the machine.
Another form of nonverbal interaction is eye contact. It is important to look directly at the patients eyes while speaking. If you look away, the patient perceives one of two things: (1) you dont care. (2) There is something wrong with me. An example of this is when you repeatedly inform patients you cannot read their x-rays and avoid eye contact. This creates anxiety in the patient. When you tell the patient you are not qualified to interpret the x-rays and sustain eye contact as you speak, the patient believes what you say.
Space is that unique form of nonverbal communication that allows for acceptable distances we keep between ourselves. It varies between persons, but all of us possess this characteristic. During a radiographic procedure you invade the private sanctuary of space and you even contact the patient through touching. In dealing with these two forms of body language, you must communicate verbally as well, to avoid startling the patient. Patients should be told specifically where they will be touched and why it is necessary to do so. Some patients require firm palpation because of their size. Touching, however, should never be gruff. Ask the patient if there is any pain. Take care not to unnecessarily palpate tender areas.
Time is another factor which is perceived positively or negatively by patients. If they are kept waiting too long, they perceive it as a disregard of their needs. However, any extra time spent on an individual will be perceived as an act of caring. When you look intermittently at your watch and sigh without attempting a conversation during a procedure, it creates a negative reaction in the patient. It is not necessary to carry on a conversation. A smile is a powerful tool. It is the path that leads to a meaningful relationship with your patient.
Years ago, it was required to wear a white uniform if you worked in a hospital. Now, many departments within a hospital may standardize uniforms, but make their own unique mark in the latest look. Patients associate white uniforms with hospitals and illness. So the trend to bring color into uniforms has had a positive effect on them. It is good to wear some color, but you must remember to be distinctively professional. Physical appearance also speaks to the patient.
What you say and what you do influences the patients attitude and probably the outcome of the treatment while the patient is in the hospital. The radiological technologist or student technologist has the responsibility of communicating sensibly and in a professional manner. Then at the end of the hospital stay, the patient will confirm: I was treated as a real person. Keep in mind the patient is always listening.