Connections

     A recent change of insurance carriers at the college where I work impacted several different areas of my healthcare. One of the most significant changes was that my current dentist was not an approved provider in any of the plans I had to choose from. That left but one choice: find a new dentist. In relatively short order, I found one and went in for my first appointment, which included a consultation, a full set of radiographs and having my teeth cleaned.

     As I moved into the teeth-cleaning phase, the hygienist introduced herself and got me settled in the chair. While she was pleasant and professional, she seemed distant. Over the course of the next hour, my initial impression was strengthened. At NO point did I feel the hygienist connected with me as a patient. More important, she didn't even attempt to. I realize that getting your teeth cleaned is hardly the venue for a full-scale dialogue, but maybe just a "How's it going?" or "Is there anything I can do to make you more comfortable?" Alas, it was NADA. When the appointment was over, I asked if they had another hygienist and scheduled my next appointment with her. In this case, either the inability or lack of interest in connecting with the patient (me) cost this hygienist a client.

     So what happens when we don't take time to connect with our patients? The implications are far more serious, as we occasionally deal with life-threatening situations at worst and work under some serious time constraints at the least.

Getting Connected
     The initial phase of the connection happens when someone calls 9-1-1: A patient needs help, and you provide it. But to cement the patient/provider connection, you must make distinct efforts toward that goal. Once on scene, gaining the patient's trust is paramount. Taking time to introduce yourself and your partner, along with finding out the patient's name and chief complaint, further tightens your connection, thereby improving your assessment and, hopefully, improving patient care. Being polite, professional and compassionate and letting the patient know you understand his problem all contribute to a positive connection with your patient.

Staying Connected
     The most important way to stay connected is to work at it. Continually following up on the patient's complaint(s) is clearly the most important. "Are you still short of breath?" "You told me your chest pain was a 9 over 10 when I first got here. What level would you say your pain is at now?"

     Peripheral or secondary questions that you ask to flesh out your working diagnosis may only serve to frustrate a patient who can't catch his breath. It's not that getting more information isn't important, but if your patient has to tell you three or four times that he can't breathe before you finally catch on and apply oxygen, you are losing your connection and the patient will think you aren't listening. By comparison, if you are continually attentive to what your patient is telling you and wait patiently for his answers to your queries, you are strengthening the connection.

     As the call continues, look for some common bond with your patient. Maybe you are both gardeners or have an interest in cars or art or music. Granted, you have to use common sense here. If the patient has crushing chest pain that you can't mitigate, discussing rose care is both inappropriate and bad medicine. On the other hand, if the patient is stable and the call is moving along uneventfully, identifying a shared interest further adds to the connection.

Reaping the Benefits
     The first and most obvious benefit is that with a tight connection and the right level of trust, information comes more quickly. Time spent crawling through an assessment only delays patient care. As any veteran provider will tell you, you are far better off with too much information to sift through than having too little information and having to guess what's really going on.

     Secondly, when your patients feel you are truly listening to them and doing your absolute best to help meet their needs, patient care moves more quickly and efficiently, and they will tend to go along with pretty much any and all aspects of your patient care plans. The main reason for this is relatively obvious: The patient believes in you and your abilities. Getting that level of buy-in from a patient implies a high level of connectivity.

Conclusion
     The short-term relationships we establish with our patients may only last a few minutes. Whatever the length of time a patient is in your care, getting and staying connected will help reduce your patient's anxiety level, improve information flow, and, in the end, improve patient care.

     Until next month...

Mike Smith, BS, MICP, is program chair for the Emergency Medical Services program at Tacoma Community College in Tacoma, WA, and a member of EMS Magazine's editorial advisory board.

Mike Smith is a featured speaker at EMS EXPO, October 11-13, in Orlando, FL. For more information, visit www.emsexpo2007.com.