ABSTRACT: Communication is a tool. It is the most important and frequently-used patient care tool in emergency medicine. Any patient contact, including "refusal of treatment," requires communication. However, unlike other medical tools, communication receives far too little attention during emergency medical training programs - for both Prehospital and Inhospital care providers.

During her exciting presentation, Charly addresses communication and its effect on emergency patients - persons who are suddenly experiencing an altered state of awareness and a heightened susceptibility to suggestion and stimuli. This presentation introduces specific techniques that will improve a provider's ability to establish credibility, rapport and trust with the patient. It also addresses: the sharing of control, specific words and their effects on emergency patients, appropriate and effective body language, scene-communication management, and enhancement of the patient's response to treatment through the use of specific physical cues and verbal phrases.

LEARNING OBJECTIVES: After attending this presentation, participants will:

1. recognize the vital importance of appropriate physical and verbal communication when caring for emergency patients.
2. understand how communication can significantly contribute to positive, or negative, patient responses.
3. develop an awareness of specific words and how patients may perceive them in a positive, or negative, manner.
4. learn to use specific communication techniques, words, and phrases to enhance positive patient responses to medical treatment.
5. become motivated to adopt the truly effective patient communication techniques identified, and to use them often.
6. become motivated to personally develop additional techniques for therapeutic patient communication.

Newly updated and expanded Half-Day and Full-Day Workshops
including ALL Patient Communication subjects are also available!

Special Note! In September of 1998, the Internet EMS "webzine,"
MERGInet.com began publishing a series of my communication articles, entitled,
"The Foundation of Patient Communication."

I wrote these articles using text from the handouts that accompany my various patient communication presentations. ALL of these articles can be found on my Web Site's,

This outline details information presented in 2 to 3 hour sessions. Shorter sessions contain the introductory information and various "basics" of patient communication techniques. Workshops (see above link for workshops) contain all the information below, and much, much MORE!

1. INTRODUCTION: When first developed (in 1993), this presentation was primarily based upon the text, Patient Communication For First Responders And EMS Personnel, by Dr. Donald Trent Jacobs (Brady of Upper Saddle River, NJ, publisher).
   Since then, Charly has significantly augmented Dr. Jacob's valuable observations and information with additional skills and secrets gained from her own experience, her own expertise in emergency patient psychology and effective communication techniques.

   The ultimate premise of this presentation is that, "normal" individuals (even those who religiously watch TV programs such as "Emergency" or "911" or "ER") do not experience emergencies on a regular basis! Therefore, "normal" individuals are psychologically and emotionally unprepared to deal with emergencies. Research has shown that when "normal" individuals are faced with an emergency crisis, they are spontaneously thrust into an altered state of consciousness that can be likened to a state of "hypnosis." A definition of "hypnosis" is provided, along with the assurance that effective patient communication is NOT about "hypnosis" or "hypnotizing" a patient! Instead, this presentation is devoted to the recognition of the emergency patient's spontaneously altered state of consciousness, and the fact that this altered state of consciousness causes emergency patients to "hypersuggestible" to all sensed or perceived stimuli. This heightened susceptibility to suggestion and stimuli can be either positively utilized by responders to improve patient outcomes, or it can jeopardize patient outcomes because the provider is unaware of (or ignores) the patient's susceptible state.

2. EXAMPLES OF THE POWER OF WORDS: The power of BELIEF (in relationship to emergency care) and the placebo effect are explored, demonstrated, and explained. The responsibility to learn/use "appropriate" communication skills, recognizing the importance of patient communication and its impact on patient response to treatment, is further discussed.

3. CREDIBILITY: how our BELIEF in our communication and treatment skills effects patient response.

4. THE "ABC's" OF COMMUNICATION: The human communication skills first learned and last lost - basic, gut-level responses to:
   
   • A: Affect (facial expression),
   • B: Body language,
   • C: Calmness of activity and rate of surrounding stimuli.

5. INTRAVERBAL INTONATIONS: How our tone of voice influences patient responses.

6. EXTRAVERBAL IMPLICATIONS OF WORDS: How our phrasing of a statement or question influences patient responses.

7. RAPPORT: The importance of establishing a positive relationship with our patient; using eye contact, proper introduction, specific contracts, positive reinforcement of patient responses.

8. SPEAKING IN THE LANGUAGE OF THE PATIENT: Use of simple phrases and key words to improve rapport with patients of different social backgrounds.

9. TRUST = NEVER LIE!: Addressing the issue of truth and "qualified" truth during interaction with patients of all ages. The importance of honesty to the patient's current and future response to emergencies.

10. SHARING CONTROL WITH THE PATIENT: Control issues within emergencies and emergency care. Addressing the patient's need for a sense of control and learning how to offer "choices" without interfering with the patient's care needs. Avoiding control battles by "agreeing" with the patient and eliminating the phrase "OKAY?" from our vocabulary.

11. "REFLECTION" OF PATIENT COMMENTS: Enhancing the patient's sense of control by verbally "reflecting" back to the patient things that the patient is experiencing. Repeating the patient's comments and statements. Responding to the patient's appearance and tone.

12. REINFORCING POSITIVE RESPONSES: The importance of using the Magic Words of EMS - "Please," "Good," and "Thank you" - as often as possible, to reinforce the patient's positive responses.

13. GIVING ASSURANCE OF A HOPEFUL FUTURE: Probably one of the most important initial interventions is speaking and acting as if we believe the patient will recover.
    DIRECT ASSURANCES OF A HOPEFUL FUTURE: Key phrases and situation exercises using direct assurance. The most positive and honest means of addressing the patient's question, "Am I going to die?"
    INDIRECT ASSURANCES OF A HOPEFUL FUTURE: How our actions, words, and vocal tones can imply that the patient will recover - improving patient response to treatment.

14. SUGGESTION: "Suggestion does not consist in making an individual believe what is not true.
    Suggestion consists in making something come true by making a person
    believe in its possibility." - J.D. Hadfield. Techniques for utilizing the power of suggestion to enhance positive treatment response and improve the likelihood of patient recovery.

15. REDIRECTION OF ANGER, FEAR, and GUILT: Anger, fear, and guilt impede the body's ability to heal, and support negative expectations of the future. Techniques for recognition and positive redirection of these normal (healthy) emotions are discussed.

16. CRYING: Recognition of crying as a "catharsis" - releasing tension, alleviating pain and stress. Techniques for providing an English-explanation of the adrenaline crisis-reaction physiology as being "normal," and encouraging patient "venting" prior to providing redirection to become "more comfortable" are discussed.

17. LAUGHTER: Recognition of laughter as a "catharsis" - releasing tension, alleviating pain and stress. Laughter additionally increases tissue oxygenation, disrupts muscular tension, lowers (or elevates) blood pressure, and distracts the patient from pain. Also, laughter decreases negative expectation and stimulates hope. Techniques for encouraging laughter without minimizing (or demeaning) the significance of the patient's emergency are discussed.

18. GIVING "PERMISSION" INSTEAD OF "ORDERS": How to avoid conflict - but still increase a patient's sense of control - by communicating in a selective, descriptive, creative, enthusiastic and soothing manner.

19. ELIMINATING THE WORD "PAIN": The advantage of substituting the terms "discomfort" or "uncomfortable" for the word "pain," in order to improve patient response to the positive phrase, "more comfortable."

20. ELIMINATING THE WORD "TRY": The word, "Try," implies "effort" and its use indicates the user's anticipation of failure. Relaxing, or calming down, or slowing respiratory rates does not require "effort" and is easily achieved if appropriately encouraged! Techniques for providing suggestion without using the word "try" are explained and discussed.

21. AWARENESS OF THE SURROUNDINGS AND HOW IT AFFECTS THE PATIENT: Explanation of how what a patient hears, sees, and feels personally influences patient condition and outcome. Discussion of how to avoid situational and peripheral stimuli from causing detrimental patient effects by managing external and peripheral stimuli wisely.

22. SUMMARY: Summary of presentation points and encouragement to practice positive patient communication techniques, in addition to expanding upon personal techniques of effective patient communication. Also, encouragement to read Dr. Jacobs' text if students are interested in pursuing further instruction on "special" or "esoteric" aspects of patient communication (communication techniques specific to cardiovascular emergencies, burns, anaphylaxis, childbirth, and so on).

For longer presentations (3 to 4 hour sessions & workshops)
additional information regarding the specifics of
PEDIATRIC and GERIATRIC Communication Skills are included
SAMPLE Interview Secrets and other Interview techniques may be added.

USE YOUR BACK BUTTON
To Return To Wherever You Came From

OR:
Return To CHAS' PRESENTATION LIST

OR:
Return To the PATIENT COMMUNICATION & INTERVIEW SECRETS Directory

OR:
Return to CHAS' HOME PAGE

Email Charly at: c-d-miller@neb.rr.com
Those are hyphens/dashes between the "c" and "d" and "miller"

This COUNTER was reset July 31, 2002
(when my site moved to new Web Server)