Patient voices

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Three of our eight grandchildren are remarkably noisy.  Born of an opera singer and a teacher each is blessed with a powerful voice that is used in increasing volume to be heard above the rest. Their energetic voices make it impossible to ignore their delights, disappointments or needs: connection with their worlds is unavoidable!

Being heard is central to our well-being whether we voice sorrow or joy, puzzlement or protest, or simply share stories about our experiences past and present. For most, isolation substantially depletes our significance and our health. We look for an echo, a connected response from people in our hearing, and listening to ourselves helps us shape our assimilation and interpretation of the sometimes blurred thoughts that lie behind our words.

Much of PRIME’s teaching sets out to encourage healthcare professionals to listen to the voices of their patients. Through role-play, case histories and modelling we show the value of giving our patients time, quiet and an attentive ear to whatever they want to say.  With this approach we emphasise that patients’ words are collected not just for diagnostic clues but also for insight into their experience as people – hurting, troubled or afraid – who are telling a human story.  In this setting HUMAN forms a useful mnemonic reminding us that patients want to be: Heard – not just listened to; Understood – with empathy and concern; given Meaning to their experience; able to Ask anything – getting an honest, comprehensible answer; and Nurtured through a supportive and respectful dialogue.

Patients’ voices were at the heart of a project that began around 2002 to encourage and capture users’ experiences of healthcare in the UK. 1 Reflective digital storytelling proved an educational methodology of widespread interest not only to those delivering health care directly but also to those responsible for clinical governance and service planning. To date in nearly 1000 stories have been recorded, and made freely available online. They frequently touch both the heart and mind of the listener, giving insights that are honest and penetrating but presented with a thoughtfulness born of the reflection given to them in the several days’ preparation of the digital record. More recently the voices of patients have been joined by the patient voices of those working in the health service, often recounting incidents that have been especially challenging or rewarding. Staff at all levels are represented including junior doctors recalling their experiences of medical education. The story of the Patient Voices project has recently been told in the book, ‘Cultivating Compassion’. 2

Receptive listening to the voices of our patients and our colleagues, helping us to see the person in the patient 3 and to promote effective teamwork, is a key ingredient in establishing a healthy health service wherever we practise.

Richard Vincent

1. www.patientvoices.org.uk

2. Hardy P. and Summer T. Cultivating Compassion, ISBN 978-1-904235 available at: www.kingshampress.com/index.php?route=product/product&product_id=133

3. http://www.kingsfund.org.uk/sites/files/kf/Seeing-the-person-in-the-patient-The-Point-of-Care-review-paper-Goodrich-Cornwell-Kings-Fund-December-2008.pdf

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