Moving From Listening to Understanding

In order to optimize healing healthcare, deep listening that leads to understanding is an absolutely critical skill and competency. Recently, I have heard story after story (including some from my mom) of patients warning their nurse or phlebotomist that they are a “hard stick.” What that ultimately means is that the patient may be seeking a smaller needle for a successful blood draw or, in my mom’s case, a draw lower on her arm and closer to her wrist where her veins tend to roll less. More often than not, the response from the clinician is the following or similar, “I will be extra careful; I am very good at this” and the result is predictable — a blown vein, pain, and frustration on the part of the patient who concludes, “I told you so but you didn’t listen!”

The patient experience is founded in trust and a sense of partnership between caregiver and the one who entrusts him or herself into another’s care. Failing to incorporate the patient’s experience and overriding their input, suggestions, and caveats increases anxiety, diminishes trust, calls respect into question, and is felt as dismissive and even paternalistic — qualities and realities that fly in the face of optimizing healing healthcare.

In this blog by Robert Whipple, he offers some practical steps that anyone — including nurses, phlebotomists, and anyone caring for others — can use to hear, listen and move toward understanding.

We have all experienced the phenomenon where we have tried to explain something to an individual who appears to be paying full attention. The individual was alert and nodded many times giving the impression of understanding. Later on we found that the individual internalized almost none of the information we were trying to convey. This article explains why this happens and offers some antidotes.

To internalize a message, one must not only pay attention, but the information must sink into the brain enough for recall and action. Listening can be happening even though there is little comprehension. A typical example of this occurs when dealing with two people who have different primary languages.

I noticed this phenomenon often when working with technical people in Asia. They were able to understand English, so we used that for communication. They would nod and give verbal cues (like “uh huh”) when I talked…

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