PRIME - Its good to talk

An advertisement for British telecommunications company leads with the words ‘It’s good to talk’.

This could equally be the attitude of many healthcare professionals particularly when they find themselves in difficult situations.

When faced with patients who are in pain or distress or relatives who are angry and frustrated it’s easier to appear to be active and keep talking than to be quiet and keep listening. But is this best for patients or just easiest for the professional?

A recent randomised controlled clinical trial looked at how doctors and nurses should communicate with the relatives of dying patients. Listening more and talking less significantly reduced relatives’ anxiety, depression and post traumatic stress (N Engl J Med 2007;356:469-7.)

Listening requires the act of paying attention. So what do I allow to grab my attention? - The clamour of my selfish heart, the urgency of the day, the voices of the world around me?

We need to discover the lost art of listening.

But, there does come a time to speak.

During my last visit to Russia we were asked to see a patient dying of cancer. He asked to see us particularly because he knew that we were doctors and so we should know about death. We sat by the side of his bed as he lay back looking weak and ill. He turned towards us and whispered ‘How will it be when I die? What is going to happen to me? Where will I go?’

One day you will sit in my place and the patient will ask you the same questions.

How will you answer?

How will you know how to answer unless you have first listened and have understood?

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