Importance of building rapport with Patient Party Author Dr. Indu Arneja

Doctor-Patient Communication

 

Building quick rapport with the patient is one of the initial prerequisites of any professional relationship.  It lays the foundation stone of the therapeutic alliance.

Incidentally, studies suggest that we don’t make much effort to build rapport with the patients and their families as we believe that the patient is here for treatment and our primary responsibility is to only treat the patient.

This is true to an extent but let us remember that building rapport with them makes our task easy.  Building rapport creates much needed familiarity and comfort between the two parties.  It helps win patient’s trust and confidence.  It facilitates and fosters our treatment by aligning the patient with us.  Patients start listening and agreeing more with us.

The primary objective of building rapport is to earn patient’s cooperation and compliance for our treatment to work.  For e.g. many of the procedures like inserting I/V cannula, passing Ryle’s tube etc., are very painful and uncomfortable but if we have good rapport with the patient, it becomes easy to do the procedure as the patient would listen to you and cooperate.  Studies also suggest that building rapport improves treatment adherence.

Contrary to our misperception, building rapport does not require time, it requires INTENTION.  Simple gestures like making eye contact, greeting the patient, smiling when appropriate and speaking in a non-aggressive tone are some of the good ways to build rapport with the patient.  These small gestures go a long way in facilitating your job and earn patient’s cooperation.

Building rapport also reduces aggressive reactions and prevents violence in healthcare.  Studies suggest that the doctors and treating team are less likely to experience aggression when they are able to create familiarity and build rapport with the patient party.


Some simple and quick ways to build rapport with the patients-

1.    Making eye contact as soon as the patient enters
2.    Greeting the patient / responding to the patient’s greetings
3.    Attending to patient’s comfort by showing the place to sit
4.    Obtaining/confirming the patient’s name and the attendant
5.    Introducing self (if meeting for the first time)
6.    Starting with small talk before the big talk (e.g. who is this with you or where are you from)
7.    Demonstrate attention and interest in attending the patient by limiting interruptions and distractions.
8.    Accepting the legitimacy of a patient’s views and feelings, without being judgemental.
9.    Using empathy to communicate understanding and appreciating the patient’s feelings or predicament
10.   Expressing concern, understanding,  and willingness to help the patient
11.   Dealing sensitively with embarrassing and disturbing topics.
12.   Respecting patient’s privacy and confidentiality.

Building rapport may seem a waste of time and unnecessary to some of us but it is also a great safety tool for the rainy days.  Creating familiarity and building rapport goes a long way in controlling aggressive reactions and violence.  Most importantly, you win the confidence of the patient for a life-time.  It facilitates and fosters treatment by creating a good work environment for everyone. It does not require time, it requires intention.  My question to you is – Do you have it?

 

About: Dr. Indu Arneja is Founder-Director of Indian Institute of Healthcare Communication, A pioneer in the field of Healthcare Communication in India
She has conducted around 1500 Clinical Communication programs for doctors, nurses and other healthcare professionals in more than 100 hospitals and medical colleges across the country.

She is an external assessor for NQAS, Ministry of Health and Family Welfare and NABH (IRCA), QCI, India.

She is a core group member of Advisory Board on Health and Mental Health for Nation Human Rights Commission.

She is also a visiting faculty to some of the very prestigious organization like IIM Ahmedabad, Delhi Judicial Academy, Maulana Azad Medical College, Delhi University, IGNOU and PHFI.  She has over 30 years of experience in the field of health and training.

She is a regular invitee at National and International Conferences.  Recently, she was invited to attend Annual Summit on "Patient Experience and Empathy" by Cleveland Clinic, Ohio, USA, 2019.  She has been awarded scholarship to attend a prestigious communication course ‘ENRICH’ organized by Academy of Healthcare Communication at Pittsburgh, USA in 2019.

She regularly conducts webinars for national and international audiences. She has conducted multiple webinars for Anschutz Medical Campus, Colorado, US.
She has a YouTube channel in her name Dr. Indu Arneja and has an on-going series under the titles - "Heart to Heart talk with Dr. Indu Arneja" and "Master Stroke with Dr. Indu Arneja".

#hospital #hospitals #accreditation #nabh #jci #treatment #medicine #medicationerros #patient #patientengagement #patientsafety #patientsrights #communication #patientcommunication  #effective #right #doctors #family #relatives #technology #medicalpractitioners #nursing #nursingcare #healthcareworkers
 

Communicating With The Family of the Patient by Dr. Indu Arneja

This article would help healthcare professionals understand the importance of communication to reduce and eliminate confusion and aggressive reactions in patient-care.

When the patient is unwell, it is the family who acts on behalf of the patient. Especially in the Indian context, you don’t treat the patient, you treat the family.  To the extent, most of the decisions about the patient are taken by the family of the patient.  On the other side, studies suggest, we look after the patient but refuse to attend to the family of the patient or address their concerns.  Communicating with the family of the patient is important as family being the primary caretaker of the patient needs to be not only engaged in patient care but also need to be explained and updated on a regular basis about the patient’s ailment, recovery and prognosis.

Some of the practitioners are really good at developing rapport with the family, while others find it cumbersome and unnecessary.  Developing rapport with the family is a helpful way to earn cooperation, compliance and adherence to the treatment protocol.  It also helps win their trust and avoid aggressive and violent reactions. Following are some of the helpful guidelines to communicate with the family of the patient:

1.    Identify the primary caretaker: It is helpful to identify the primary caretaker/s of the patient.  Through little effort and observation, you will be able to identify the primary caretaker/s of the patient.  It is better to communicate with the same set of members to avoid any communication gap.  One can also ask the patient and family whom they wish to identify for regular communication.  This will also save you of the hassle of communicating with multiple people.  As per the patient’s rights, it is better to ask the patient to ensure the confidentiality of the patient’s medical information before sharing any confidential information. There will be multiple visitors who might act as caretakers but we need to identify and know clearly whom to communicate. Knowing the name and relationship of the caretaker with the patient helps develop essential rapport.
 
2.    Engage the patient’s family: Family members are often essential in providing support and care for the patient. Identified family members should be involved in the patient care right from the beginning.  Since they are close to the patient they will know the finer details and have a set of information useful for making the diagnosis and planning the treatment.

Involving the patient’s family in decision making by explaining the patient's condition and discussing the options for treatment is helpful in obtaining their cooperation and adherence. The family feels empowered when they are involved in decision making.

A lot of care of the patient can be managed by the family with little training and supervision.  For e.g. Changing patient’s position, keeping an eye on the I/V fluid bottle, care of the back of an elderly bedridden patient, physical exercises, etc.  Engaging the family in these simple activities can help them learn these under the supervision of hospital staff and prepare them for home care.

3.    Empathize with the caretakers:  When a member of a family falls sick, it is the family who faces the brunt of the situation.  Looking after the patient while performing all other daily responsibilities can be quite exhausting for the family.  With no proper place to sit, relax, eat, or sleep in the hospital, family members are literally lying in the corridor or vacant places in the hospital.  Family members are usually under tremendous stress and expect us to be kind and nice to them.  It is important to be aware of their challenges and being more empathetic towards them.
 
4.    Address their concerns:  The family members would have a lot of concerns about the patient.  They may be concerned about the well-being and comfort of the patient. They may be apprehensive about the recovery and complications.  They may have financial concerns and may be worried about the expenditure.  It is essential to address their concerns and fears through regular communication.

They would also have a set of expectations like prompt care, quick recovery, best treatment, etc.  Addressing and fine-tuning these expectations is helpful in making these expectations realistic and unburdening the doctor and healthcare team.  It will also help avoid conflict and aggressive reactions to any unexpected outcomes.  Keeping them in the loop by regularly updating the family of the patient’s condition is helpful in letting them know the present situation and prepare for any eventuality.

5.    Prognosticate clearly:  It is very important to prognosticate clearly as the family should know the seriousness of the condition and the likely outcome of the treatment.  When we fail to prognosticate clearly, the family assumes the outcome of the treatment to be good and can over-react when the patient deteriorates.

While prognosticating it is important to be sensitive but straightforward as any attempt to give unrealistic hope can be counterproductive and create confusion.  Answering their questions with patience and honesty will further help them take a realistic decision and build trust on the treating team.  Their decision for second opinion, shifting the patient to another set up or going LAMA should not be viewed as an insult or offense.
 
6.    Seek formal permission from the patient before sharing any information with the attendants:  While sharing a patient’s information, it is best to exercise all precautions and seek formal permission from the patient before sharing the information with anyone other than the patient.  It is important to ask privately to the patient so that the patient can give an honest reply. 
 
Even while handling couples, it is best to treat them as two individuals, and information of the patient should not be shared with the partner, without seeking formal permission from the patient.  Don’t assume that the other partner would know everything or should know everything.  It is completely the patient’s choice whether to share the information with the partner or not.
 
In case of breaking bad news like complication or death, it is advisable to communicate with the family member, whom you are familiar with and have a rapport.  Breaking bad news to a new or unfamiliar member can lead to aggressive and violent reactions.

Communicating with the family of the patient is one of the primary responsibilities of the healthcare providers.  Effective communication with the family helps build rapport and win their trust essential for treatment compliance and better healthcare outcomes.  Involving them in decision making, addressing their concerns, and keeping them in the loop by regularly updating them are some of the essential communications with the family of the patient.

Dr. Indu Arneja is a visiting faculty to some of the very prestigious organization like IIM Ahmedabad, Delhi Judicial Academy, Maulana Azad Medical College, Delhi University, IGNOU and PHFI.  She has over 30 years of experience in the field of health and training.

She is a regular invitee at National and International Conferences.  Recently, she was invited to attend Annual Summit on "Patient Experience and Empathy" by Cleveland Clinic, Ohio, USA, 2019.  She has been awarded scholarship to attend a prestigious communication course ‘ENRICH’ organized by Academy of Healthcare Communication at Pittsburgh, USA in 2019.

She regularly conducts webinars for national and international audiences. She has conducted multiple webinars for Anschutz Medical Campus, Colorado, US.

She has a YouTube channel in her name Dr. Indu Arneja and has an on-going series under the titles - "Heart to Heart talk with Dr. Indu Arneja" and "Master Stroke with Dr. Indu Arneja".

#hospital #hospitals #treatment #medicine #patient #communication #effective #right #patientsrights #doctors #relatives #family #accreditation #technology nabh #jci #technology #patientcommunication  #patientengagement #medicalpractitioners #nursing #nursingcare

INGREDIENTS TO HEALTHY RELATIONSHIPS

 

Calibre Creators met up with Ms. Japneet Anand and Ms. Minu Joshi, both Counseling Psychologists, Clinical Hypnotherapists as well as NLP Trainers.  They are also the co-founders of “Awaken…The Titan Within” for a tête-à-tête over a cup of coffee to find out causes which affect relationships and simple and effective strategies to that can save them from breaking.

CC: First of all, what is a healthy relationship?

MJ: A healthy relationship is formed when two people have a healthy sense of their identity and they come together willing to regularly and openly confront their authentic self in the presence of their partner.

CC: What does it take to have a healthy relationship?

JA: In a healthy relationship, each person finds joy in sharing the other person’s growth, in playing a role in completing the ‘other’. It works on reality which brings openness, transparency, understanding truth, agreement, humility, submission, and harmony.

CC: What should couples do to have a firm and strong relationship?

MJ: Relationship flourishes when one partner is willing to forgive past hurts and disappointments from other partner. Even if one partner may have committed some mistake, one should never constantly dig the past, play blame games, use the dump words like “I don’t need you….”, “I want a divorce….” and other such conclusive statements. It is important not to call names or compare individuals, personalities, use words or actions which can cause lasting psychological damage and affect somebody immensely.

CC: How should couples resolve their conflicts in a relationship?

JA: Healthy and great relationships develop not from the absence of conflict, but from determining an agreeable pattern for how to resolve conflict as it does not necessarily jeopardize the relationship. In fact, at times, disagreements bring two people closer to each other but the key is how to handle it.

If you care about the person, then consider adopting few strategies as part of the way you communicate with him/her when you are trying to resolve a conflict as people with poor conflict resolution skills typically engage in “Fight, Flight, or Freeze behaviors”. They fight and stay mad, sometimes holding grudges for years. They flee and avoid important issues by sweeping them under the carpet.  Or, even after endless arguments with no resolution in sight, they freeze emotionally and shut down completely. Someone who freezes in a relationship typically goes through the motions on the outside, but has stopped “caring” on the inside.

People with good conflict resolution skills have the ability to solve problems maturely through mutual discussion and let it go. They focus on taking care of the issue at hand rather than attacking the opposite person. Even when angry, they find ways to be upset and stay close at the same time. Once the matter is resolved, they forgive and forget.  Most importantly, successful couples have the ability to learn and grow through their interpersonal difficulties.

Partners need to see the issue from other person’s perspective. This does not mean we have to agree with their viewpoint; it only means that we must try to see the issue from a different perspective. Empathy can at least help us to understand where they are coming from, and why they have their particular mindset or a stand on the cause of the conflict.

Another key reason of conflict in many couples is that we expect people to behave in a certain way and we get upset when they fail to live up to our expectations. We need to be tolerant of their mistakes and limitations and respect their decisions on how to live their life.  This detachment, however, is not indifference; we should preserve, show care and concern, but there comes a point in time where we need to give people the freedom to make their own choices – even if we don’t agree with them.

It is also important to learn to deal with anger.  If we respond to situations by constantly getting angry, flaring up or losing control, we will only exacerbate the problem further. Anger embodies a feeling of aggression and condemnation which people struggle to deal with. Invariably, it encourages people to respond in a similar way.

If we really give importance to having a harmonious and lasting relationship, then we will go to the extra mile make it happen, whatever it takes. But if we give more importance to proving ourselves right every time and to our own ego, then there will be a constant feeling of superiority and inferiority which breeds conflict and which is not good for a healthy relationship

CC: What do you believe is the secret of a healthy relationship amidst these conflicting situations?

MJ: Generating a feeling of oneness is the real secret of a good relationship which means being happy at the success of others.  It also means understanding and empathizing when the other person experiences difficulties, and making a conscious efforts to avoid hurting the feelings of the other person.

A relationship becomes unhealthy when one of the partners suffers from insecurities; he/ she unconsciously become judgmental and critical about other person. Relationship naturally becomes smooth when we are at peace with ourselves and don’t rely on other people to give us security and praise. Often we want to blame other people for bad relationships, but the only thing we can do is to work on ourselves.

At times of conflict, talking can be the most effective way of moving past the problem.  However, it is easier said than done. At the same time, it is not advisable to bring up old but non-related conflicts. While talking, we should try to converse on positive issues, look for things which we agree on and can work together on.

It is also important not to get upset about little things. If you find yourself getting worked up by a series of small but insignificant things, take a step back and try to evaluate their relative importance.  You will feel that good qualities of a person are far more important than minor indiscretions.

CC:  Japneet and Minu, Thank you for these wonderful tips.  Our readers will surely benefit from them.  We wish you lots of success and that you are able to help at lot of couples who relationships can be saved.

Awaken…The Titan Within is a progressive Mumbai based organization and our primary objective is to provide the right platform and holistic environment to the Youth for their overall development. We believe that knowledge and competence go hand- in-hand and it further amplifies the chances to widen the arena and success of the youth at a faster rate.

It endeavours to develop the innate potential of our nation and to help the youth in Awakening the Titan within them.  It will assist them scaling new heights as sky is the limit, it believes that counseling, coaching and training helps in setting better goals, take more action, make better decisions, and use one’s potential to the fullest. It is an important requisite for cleansing of the mind and spirit.

Services offered by Awaken…The Titan Withn

• Counseling for Individual as well as for Group
• Mentoring and Life Coaching for Individual
• Training Workshop for Schools
• Students
• Youth
• Teachers
• Parents

• Training Workshop for Corporate
• Customized One Day Workshops

Japneet and Minu can be contacted on:

Tel. No. : +91 9820138551

Tel. No. : +91 9820327583

Email Id : awakenthetitanwithin@gmail.com

www.awakenthetitanwithin.com

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