Recently I went with a friend to the hospital for a big cancer operation. When we arrived first at the radiology department and then the ward, we were greeted not by a person but by a computer screen, which asked my friend for her name and number, as one would expect in the army or prison setting. The first contact with a person was just before the procedure, 30 minutes or more after arrival in the hospital.
I was appalled that computers have replaced gentle hospitality and wonder whose idea it was.
It is an ancient culture of hospitality and respect that a visitor be welcomed and led into a situation in mercy and kindness, with respect. I always try to meet overseas visitors at the airport, the point of entry to my country as this is as close as I can be to being first to greet them, and similarly I take the guest back to the airport as a similar courtesy.
In Egypt, I believe that townsfolk come out of their town to greet a guest and bring him or her into their town accompanied. In fact, once a town called Assiut in the 1960s was greeting a beloved and respected president, President Nassir, and the community walked 10 miles outside the city to greet him. They ordered the car engines be switched off so that the townsfolk could attach ropes to the vehicles and pull / tow the cars into the town to welcome him. This is a sign of utmost respect and welcome.
When I work abroad representing PRIME, the similar meeting and greeting is performed and I as visitor feel wanted loved and respected. It is a great feeling to be welcomed.
So how do you greet your patient? I walk out to the waiting room, greet them by name and lead them into the consulting room, and settle them in a chair. There are five parts to the greeting that are important: warm, genuine body language; giving patients options; remembering patients names and saying them correctly; checking you got it right with the patient; introducing yourself professionally to the patient and setting appropriate boundaries between the patient and yourself. A bad example of this would be having someone else send the patient in, not looking up when they enter, not introducing yourself at all, and using the patient’s first name without permission to do so from them. Terrible. So you see the greeting sets the tone and atmosphere of the encounter. People won’t always remember what you say but they will always remember how you made them feel.
The next part of the encounter is the getting down to the business aspect and a study from Robinson (1) showed that gaze and body orientation communicate levels of engagement and show when the doctor is ready to listen and when the patient is ready to explain their problems to the doctor.
So when you next meet a patient, observe exactly how things go, and the way it feels and how effective it is to aid the therapeutic relationship.
When a patient visits the doctor or nurse, they may be nervous, embarrassed, scared or angry, and a good start to the interaction is crucial to sorting out the problems that the patient has brought. It is amazing how much of our service as health professionals is for our benefit and not for the patients benefit, from taking telephone calls coming in during appointment time, causing us to run late, to expecting patients to run around for pieces of paper to get medicines late at night. How different would your job be day to day if you really ran the clinic as if it was truly patient-centred – you know, really serving to the patient’s convenience?
Do you think it would take longer? Evans et al (2) evaluated the effect of communication skills training on the diagnostic process. They found that trained students were significantly better at eliciting full, relevant data from patients, were diagnostically more efficient, but took no longer than the controls.
Ros Simpson PRIME Senior Tutor
1. Getting Down to Business Talk, Gaze, and Body Orientation During Openings of Doctor-Patient Consultations
JEFFREY DAVID ROBINSON
Human Communication Research Volume 25, Issue 1, pages 97–123, September 1998
2. Effects of communication skills training on students’ diagnostic efficiency
B. J. EVANS et al
Medical Education Volume 25, Issue 6, pages 517–526, November 1991
3. Three Different Ways Mental Health Nurses Develop Quality Therapeutic Relationships
Fiona Dziopa, and Kathy Ahern
2009, Vol. 30, No. 1 , Pages 14-22 (doi:10.1080/01612840802500691)
The University of Queensland, School of Nursing & Midwifery, Ipswich, http://informahealthcare.com/doi/abs/10.1080/01612840802500691