Friday, December 18, 2009

Contrasting Communication Skills

For the past couple of days, when there hasn't been any snow, I've been working from home and haven't had to go anywhere. I've been pleased with this as I've had a cold as well and have welcomed the opportunity to stay in the warm.

But today, when there's literally - er - inches of snow, in Leeds, I had to find my car under its little heap of snow (Stephen helped) and then set off to the hospital.

I arrived at the Breast Screening department in good time and only managed to get a couple of pages into the well-thumbed copy of Hello before they called me through. I shall never know what Jordan said to Peter now but frankly, I don't care.

I've been having this breast-screening palaver for a few years now. I started younger than most because my mother was given a drug called Stilboestrol when pregnant with me. It was supposed to prevent miscarriages but instead caused womb problems in girl children - and, being one of those girl children, that's why I lost my first baby, until they worked out why.

Also, it doubles your risk of breast cancer, which is a very scary thought.

So I've been having this screening for a few years now. In case you don't know what it involves, basically they squish each boob in something resembling a large-scale vice, or sandwich toaster if you prefer, and then they take a photo that - hopefully - shows any abnormalities. They do each one twice: sideways and horizontally, and then you get the results three weeks later, and mine have always been fine, touch wood. It hurts a bit but as tests go it ain't too bad.

The woman doing it today was efficient enough but was most definitely lacking in smiles and pleasantries and empathy. Because I do a lot of medical roleplays for training purposes, I was tempted to stop her and say "Could we just re-run that bit? Now, what could you do to show empathy?"

"Do you have any problems with your breasts?" she asked grimly.

I was SO tempted to make some kind of wisecrack but I thought no, she'll have heard them all before, and anyway I sense that she's a woman who has no sense of humour at all.

"No, I never have had," I said meekly. "They seem to be okay."

"Ah, well, that's what this test's for," she said. "It detects abnormalities that otherwise might not show up for years. So let's not get too complacent, shall we?"

Well, that told me. But hey, I knew that already. Again I was tempted to say something - - along the lines of "I'm NOT complacent! That's why I'm HERE! And now I'm TERRIFIED!" - - but again I kept my head down and my big mouth shut.

In the afternoon, as a kind of encore to this, I went for my annual Diabetes Check at the doctor's, with a practice nurse who specialises in diabetes.

"Hello, Daphne," she said, "great to see you again. Oh, I do miss your Dad, he was such a lovely man. Always joking - he really used to cheer me up even when he was very ill."

I love it when people remember the Communist in that way. It brings him back to life, in a way.

She was full of praise for the efforts I make to keep the problems of diabetes at bay. She praised my constant efforts to eat healthily and to get slimmer and fitter, even if I don't always succeed. She tested the pulses in my feet and pronounced them excellent, and she managed to make it sound as if I'd somehow worked very hard on them and deserved a prize. She asked if I did any exercise and I told her about the swimming and she said that was wonderful, and sounded as though she meant it.

Finally she took my blood pressure and it was really remarkably low - a hundred and twenty over sixty-four. "Brilliant!" she said. "And you've been under a lot of stress too, I know. That's just fantastic that it's so low. The swimming is certainly helping with that, too."

Now then, because I help to teach Communication Skills I knew that what she was doing was all with the aim of making me feel empowered, and as though I have control over my diabetes, and to build up empathy.

But, even though I knew it, it worked. And she didn't do it in an unnatural way - she was just a warm, caring woman who knew how to do her job.

She could have taken the opposite approach - she could have gone - "Now you really must work to keep your blood sugar low or you could be having a leg amputated like your Dad did - - and you could have all the eye problems that he had" - - and all that's true.

But she didn't do that. I went away feeling great. I'm doing well, and I'm going to do even better. Hurrah for the practice nurse.


Anonymous ruth said...

Two excellent examples.

I've just been reading guidelines from a roleplay company about giving feedback and wonder how the first woman might have reacted to some of these strategies:
"a) Mention what went well in the conversation first." (could you find anything at all?)
"b) Describe whether you felt any effective rapport was being created and, if not, why not.
c) Comment on body language, eye-contact, tone of voice or any other relevant elements...
....g) If appropriate, suggest a few alternative approaches that may have had a more
positive impact on your character." does go on but you get the idea.
I'm thinking she might not take kindly to this.
PS Congratulations on your success in diabetes management and hurrah indeed for practice nurse.

6:26 pm  
Blogger Jennyta said...

Since I moved to Wales, seven years ago now, I am still waiting for a mammogram. I had them before, but although I keep asking my GP about it and being assured that I shall soon be sent for, I am still waiting. Time to have another go, I think!

9:05 pm  

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