Friday, March 23, 2012

Be Careful How You Say It

Communication is an art. It’s a two-way process that involves speaking as well as listening. Perhaps nine out of 10 people may hear the same sentence and understand it the way the speaker meant it; the 10TH person will hear something entirely different.

Recently, I was speaking with a group of nurses at our weekly hospice meeting. One of the nurses discussed how one of her home health patients had totally misunderstood his physician.

The patient, whom I’ll call Sam (for confidentiality reasons), was very sick with cancer. He had undergone major surgery and some chemo and radiation treatments. At a follow-up visit the physician ordered more tests. After those results came back, the physician told Sam that they had “done everything we can do for you.”

The physician was very fond of Sam, and it was quite difficult to deliver this news. He didn’t elaborate, thinking Sam understood that his treatment had not been successful and there were no more options. The doctor told Sam that he should prepare himself for an eventual death and get his affairs in order. He shook his hand and quietly left the room.

Sam was elated. He thought the news was great. His take on this was that his healthcare team had done everything they can. The treatments had worked and his cancer was cured. Now he didn’t need any more treatments and could get on with his life, and yes prepare for that eventual death down the road. 

Sam went home to celebrate. He called his home-health nurse and conveyed what the doctor said. She knew it was a misunderstanding and her heart sank for him. She called the physician and told him what had happened, who then called Sam to explain. The news was certainly not what Sam wanted to hear, but his prognosis was poor and he had decisions to make about his short-term future and end-of-life care.

This story gives us pause to be careful how we say things, and even when the conversation is painful, we should make sure the listener understands.