Posts Tagged ‘Medical’

The Giant Spider

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This past weekend I attended a dinner party along with several deaf guests. In addition to speech-reading, they signed; so I dug up from the recesses of my brain some American Sign Language I learned back in high school. One of the women asked about my siblings. As I signed my reply, I remembered the importance of using location in ASL. When I spoke of myself, of course, I pointed to myself. But my sister and brother weren’t present. I “set up” locations that would stand for them: I pointed to a specific spot on my left to represent my sister and a spot on my right to represent my brother. From then on, I simply pointed to “the spot” and everyone knew who I was talking about.

Even if you don’t sign, you know that location holds memory. One morning, over a decade ago, I reached into the back of my lower kitchen cupboard and pulled out a pie pan, only to discover an ENORMOUS spider running around inside of it. (It was “THIS BIG.”) Even now, after years and years of spider-free pie pan fetching, I anxiously hold my breath every time I get it, remembering that once it contained a terrifying arachnid.

Effectively using location helps us communicate more clearly and consistently. Nonverbally, we can help people remember what we want them to remember and help them compartmentalize (forget) negative news or interactions.

For example, last week as I rehearsed parts of the Nonverbal Classroom Management workshop for Sari, she would sometimes call out, “You’re telling a story! Move to your story spot!” By delivering content in a different physical location from where I gave illustrations, participants knew to tune-in to the subject matter when I stood in the “teaching” spot and to access the right side of their brains when I moved to the “story” spot. They were able to switch mental gears and remember more when I was systematic in my use of location.

We can do this on a daily basis in our offices, courtrooms, classrooms, or wherever we are. To make a strong point, detach negative information from productive work space, change subjects, or “mark off” any part of our message, we can move or shift location to create a separation.

The pie pan in the back of my lower cupboard will forever be associated in my mind with that giant spider. If I can find a place in an upper cupboard to store the dish, I will likely forget the whole incident.

Off to rearrange my kitchen cupboards…

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Why I fired my doctor and how she could have avoided it

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I recently had an x-ray on my back. When I sat down with my doctor to hear the results, she said the x-ray had incidentally shown that I had vascular calcification on my carotid artery. This meant I could have a stroke at any minute. She looked me straight in the eye and said, “this is serious.” And then she walked out the door.

As it was a Friday, I had to wait until Monday to get the ultrasound done on my neck to see how blocked the artery was. I don’t exaggerate when I say that was one of the longest weekends of my life. I had the ultrasound and found she had misread the x-ray. I was relieved, yet furious. I have since found a new doctor.

I don’t blame her for misreading my x-ray. What I do blame her for is how she communicated the information. With that in mind, here are my top three tips for medical professionals:

Communicate both your position and your person. We patients are pretty darn vulnerable sitting in a waiting room, usually without the benefit of our clothes. We need to feel that you care about us personally, but we also want to believe you know what you’re doing. You need to communicate both empathy and expertise. To communicate your person (empathy), use eye contact, curl the voice up at the ends of statements, smile, and use more relaxed body language. To communicate your position (expertise), straighten your posture, curl the voice down, and focus your eyes on the matter at hand.

Don’t look at the patient when delivering bad news. Ever hear the phrase, “don’t shoot the messenger?” Oftentimes it isn’t what we say that causes us to be “shot” it’s how we say it. Eye contact is the number one way to attach information to yourself. To separate yourself from the message, look at something else. In my case, the x-ray would have been helpful. This is true for those who work in medical offices as well. When discussing a bill with a patient, look at the bill. Where we look is where the responsibility lies. It wasn’t my doctor’s fault that there was a shadow on my x-ray. So look at the x-ray. This doesn’t mean we never look at people. It just means we’re systematic about when we look and when we look at something else.

Separate the problem from the solution. After looking at the x-ray together, she could have looked at me to discuss solutions. For example, -looking at the x-ray- “if you’ll notice this shadowy area here, that’s what we’re concerned about. It appears as though you may have some vascular calcification on your carotid artery.” Looking at me she might say, -”Now, the way we’ll find out for sure is to have an ultrasound done on your neck.” Turning back to the x-ray- “If it does turn out that there is calcifcation,”- turning back to me, “here are our options.” Then she could go on to list them. By using eye contact in a systematic way, she associates the problem with the x-ray, and the solution with her. Looking at the x-ray = problem. Looking at me = solution.

I know she meant well, even if she didn’t get her message across. Which just shows how difficult it is to communicate what we really mean sometimes. Increasing our nonverbal intelligence will assist us in clarifying the intent of our message, especially when that message is negative.

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The Biggest Communication Mistake You Can Make

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I love pajamas. If I’m at home, I’m in my pajamas- no matter if it’s 10 a.m. or 2 p.m. Sometimes I even wear them to run errands. I wish I could wear them to work. But just like one outfit won’t get you through life, neither will one communication style.

Thinking it will is the biggest communication mistake you can make.

What do I mean by communication style?  It depends on who you’re listening to these days. One school of thought says you can be an expresser, driver, relater or analytical. Another divides it into colors. Yet another says people can be categorized as doers, thinkers, creators and listeners. Even one of our programs uses the analogy of household pets to understand the different ways people communicate.

There’s nothing wrong with learning about ourselves- it can be fun to label and compare. But fun isn’t the same as effective. All effective communicators have more than one way of communicating. They understand that not only do they need to be aware of their own preferences and biases, they need to be aware of other people’s preferences and biases. Good communication only happens when people are in sync. Knowing how you communicate is only half of the equation. Learning how to adapt to the person you’re communicating with is where the magic happens.

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Hats off to nurses

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Three weeks ago today, my dad had a stroke.

Receiving the news, my first thought was: my dad doesn’t have strokes. This is the same man who, after watching me complete a marathon, said, “that doesn’t look so hard” and started training at the age of 65, having never run before. He went on to complete not one, but three marathons. He is always working on something -installing new flooring in his living room, re-tiling the fireplace, fixing the roof- this wasn’t a man who had health problems, much less strokes.

Except that he did. And so I cancelled a keynote, immediately got on a plane and flew to his bedside.

My dad, -my superman, really- was now lying in a hospital bed, his face contorted and paralyzed, his speech and motor skills impaired. As I watched him struggle to put on his eyeglasses, or speak, or do any of the things that a few days before had come so naturally, I felt incredibly helpless. My sister and I took turns crying in the bathroom so he wouldn’t see our grief.

Because there isn’t a lot to do while sitting in a hospital room, I watched the nurses interact with my dad. Most were terrific, a few were ok, and luckily we didn’t have any who were horrible. The best nurses, though, were those who were able to blend their position and their person.

We all want nurses who know what they’re doing, since they administer the majority of care to our loved ones. And yet we also want them to be warm and encouraging. When you’re in a hospital you are incredibly vulnerable- nurses who maintain the dignity of the patient and treat them like people instead of invalids make all the difference in the world. Our trust in the nurses comes from their ability to demonstrate their competence, or position, while at the same time demonstrating their concern, or person.

This balance of position and person is just as important to all of us as it is to those in the nursing profession. There are times when it is appropriate to come from our position -when our credibility must be demonstrated- and other times it is more appropriate to come from our person -when we need to show we care. Charismatic people are a blend of both, and bring out what’s appropriate depending on the needs of the situation.

My dad made a speedy recovery -so speedy in fact, that he is already home, walking up and down the stairs, lifting weights, joking around. He can do everything he did before, albeit a little slower, and we like to tease him that when he talks he sounds a little drunk. When I asked if he ever asks “why me?” he said, “Sure. But then I think, why not me? It happens.”

Thank goodness that when it does, there are nurses like those who attended my dad.

*A big thank you to the nurses and therapists at Presbyterian Intercommunity Hospital in Whittier, CA.

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“Always maintain eye contact” is really bad advice

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Of all the bad advice I encounter in my work -never turn your back to the audience, move around a lot when speaking, always be friendly- the advice to always maintain eye contact has to be the worst.

We have very deeply held beliefs -especially here in the States- about the role of eye contact. We’ve been taught that eye contact equals respect, and that avoiding eye contact is tantamount to disrespecting the person you are engaging with.

This is bad advice and can really get us into trouble.

Eye contact does equal respect when you are in relationship. But there are times -delivering negative information for example- when we want to separate the relationship from the message.

There are three things to remember about the use of eye contact.

1. Go visual with information, especially if it is negative.

You must have the negative information on some sort of visual if you hope to have the person receive it and not attach the negative message to you. If you are working one-on-one, the visual will be small -a piece of paper, report, fax, or memo- if you are delivering negative information to a group the visual will be larger -a PowerPoint presentation, flip chart, or white board. Those in the medical field will also want to adhere to this rule. Although medical personnel almost always have an x-ray, lab report, or diagram handy they rarely use them effectively. A doctor often looks at a patient when saying, “You have cancer.” By looking at the person while delivering this information what he or she is really saying is, “You are cancer.” When the doctor uses direct eye contact the patient has a more difficult time absorbing the information. The patient may -understandably- become upset, volatile, or breakdown. This can be avoided using the next step.

2. Avoid eye contact if the information is negative. Use eye contact if the information is positive.

If a doctor -instead of looking at the patient- looks at the x-ray and says, “The x-ray shows that cancer is present,” the patient is more apt to breathe, take the information in and assimilate it without becoming as upset. The doctor can then turn to the patient and with eye contact say, “Now here is what we’re going to do.” By using eye contact in a systematic way the doctor nonverbally separates the problem (x-ray) from the solution (doctor and patient working together.) This works in the business world as well. When you have to lay people off or tell a group that there is a salary freeze, look at the information (which should be displayed visually) not the person/group.

3. People follow your eyes, not your hands.

These skills are only effective if you understand that people follow your eyes, not your hands. Oftentimes we point to a visual but maintain eye contact with the listener. This is ineffective. Think about it: when you’re sitting having coffee across from someone and they look over your shoulder and towards the door, what do you do? You also turn and look. We’re programmed to follow someone’s eyes, and rarely look where someone is pointing unless they are also looking there. When using a visual to give sensitive or difficult information be sure to look at the visual as well as point to it. This will cause the listener to look where you want them to look.

Nonverbal intelligence is all about having more than one approach. Sometimes we’ll want to maintain eye contact (when the information is positive) and other times we’ll want to look at something else (when the information is negative.) Train yourself to be systematic with your eye contact and you’ll have an easier time separating yourself from the message.

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