The Importance of Listening in Healthcare | Nell Tharpe | TEDxUNE

Summary

The speaker, a certified nurse midwife with 30 years of experience, emphasizes the importance of listening in healthcare. Drawing from a childhood hospitalization experience, she illustrates how being a good listener can profoundly impact patient care. She discusses the necessity of active listening for accurate diagnoses, patient safety, and satisfaction. The speaker advocates for evidence-informed care, personalized to each patient's beliefs and needs, and shares a story of how listening and acting on a patient's needs can transform lives.

Takeaways

• 👂 The importance of listening in healthcare is paramount, as it leads to better diagnosis, patient safety, effective communication, and overall satisfaction.
• 🌟 A personal childhood experience of feeling unheard in a hospital setting significantly influenced the speaker's commitment to being an attentive listener.
• 🤝 Active listening involves being fully present, making eye contact, and engaging with the patient's narrative to build trust and provide personalized care.
• 💔 Difficult conversations are a part of healthcare, and effective listening is crucial in conveying sensitive information with empathy and understanding.
• 👥 A team approach to listening is essential, where all members listen to lead and follow effectively, ensuring clear and directed communication.
• 👩‍⚕️ The American College of Nurse-Midwives emphasizes 'listen to women,' highlighting the need to hear the stories of health disparities that are often linked to social factors.
• 👁️ Listening with intention involves not just hearing but also observing and understanding the unspoken needs and concerns of the individual.
• 💡 The speaker advocates for 'evidence-informed care,' which personalizes healthcare based on individual beliefs and needs rather than a one-size-fits-all approach.
• 🌱 A story is shared about how listening and acting on a patient's specific need for dentures not only improved her health but also transformed her life, demonstrating the power of listening.
• 🌟 The speaker concludes by emphasizing the joy and value of listening with intention in healthcare, which can lead to more meaningful and effective patient care.

Q & A

What skill did the speaker develop over 30 years of practice?

The speaker developed the skill of being a good listener over 30 years of practice as a certified nurse midwife and a woman's health professional.

What childhood experience influenced the speaker's approach to listening?

The speaker's childhood experience of being hospitalized at the age of 5, where they were placed in a bed with bars and forgotten without a call bell, made them a good listener as it taught them about the importance of individual concerns.

Why are listening skills important for healthcare professionals?

Listening skills are important for healthcare professionals because they aid in accurate diagnosis, ensure patient safety, facilitate communication among colleagues, and contribute to patient satisfaction.

How does the speaker suggest healthcare providers express compassion?

The speaker suggests that healthcare providers express compassion by seeing the person as an individual, listening to what they are saying, and providing understandable explanations tailored to the patient's understanding.

What is the significance of listening in difficult healthcare conversations?

Listening is significant in difficult healthcare conversations because it allows healthcare providers to understand the person they are speaking to, which in turn enables them to convey information effectively and empathetically.

What does the American College of Nurse-Midwives emphasize in their practice?

The American College of Nurse-Midwives emphasizes listening to women, as they are often the greatest users of healthcare and the coordinators of care for others.

Why should healthcare professionals engage patients as partners in their care?

Healthcare professionals should engage patients as partners in their care to ensure that the care provided makes sense to the patient and is effective, as the patient is the expert in their own life.

What is the role of listening in transforming people's lives according to the speaker?

According to the speaker, listening plays a crucial role in transforming people's lives by helping healthcare professionals understand the patient's needs, which can lead to actions that improve the patient's health and well-being.

How does the speaker define 'evidence-informed care'?

The speaker defines 'evidence-informed care' as using evidence to inform the care provided to individuals, setting standards for care without standardizing it, and personalizing care based on the patient's beliefs and preferences.

What is the importance of listening consciously in healthcare?

Listening consciously in healthcare is important because it allows healthcare professionals to determine the patient's state of health, emotional state, and overall well-being, which contributes to providing meaningful and effective care.

How does the speaker suggest healthcare professionals approach awkward questions?

The speaker suggests that healthcare professionals should ask awkward questions respectfully, phrase them in an acceptable way, and understand the right question to ask in order to gather necessary information for patient care.

Outlines

00:00

🏥 The Power of Listening in Healthcare

The speaker, a certified nurse midwife with over 30 years of experience, shares how a childhood hospital experience instilled in her the importance of being a good listener. As a young child, she was hospitalized due to dehydration and was inadvertently left without a call bell, leading to a distressing situation. This incident taught her to be attentive to individual needs and concerns. She emphasizes that listening is crucial for accurate diagnoses, ensuring patient safety, effective communication among healthcare professionals, and enhancing patient satisfaction. The speaker also discusses the importance of being present and engaged when caring for patients, suggesting that healthcare providers should listen with their hearts and minds to build trust and provide understandable explanations tailored to the patient's understanding.

05:03

👂 Listening to Women's Health Disparities

The speaker highlights the role of women as the primary users and coordinators of healthcare, often dealing with health disparities related to factors such as poverty, race, gender, ethnicity, and language. She stresses the significance of listening to women's stories to understand these disparities. The American College of Nurse-Midwives advocates for listening to women, and the speaker shares a personal story of how listening and acting on a patient's needs can transform lives. A woman in her practice, struggling with dental problems and unable to afford dentures, was helped by the speaker who wrote her a prescription for dentures, leading to a significant improvement in her life. The speaker underscores the need to listen not just to what is said but also to what is unsaid, to engage patients as partners in their care, and to provide care that is meaningful and personalized.

10:06

💡 From Listening to Action

The speaker discusses the importance of acting on what is heard during patient interactions. She recounts an experience where she wrote a prescription for a woman who needed dentures, which improved the woman's life significantly. The speaker encourages healthcare providers to ask difficult questions and to seek permission before taking action, rather than waiting for permission. She also emphasizes the need to understand the patient's perspective and to personalize care based on their individual beliefs and needs. The concept of 'evidence-informed care' is introduced, suggesting that while evidence-based care is important, it should be used to inform and personalize care rather than to standardize it. The speaker advocates for making healthcare meaningful to the individual by listening and understanding their unique needs and circumstances.

15:10

🤔 Reflecting on Listening Styles in Healthcare

In the final paragraph, the speaker prompts the audience to reflect on their own styles of listening. She acknowledges the importance of listening as a healthcare professional and the impact it can have on patient care. The speaker concludes by emphasizing the need for healthcare providers to be intentional in their listening, to understand the patient's state of health, and to provide care that is meaningful and relevant to the patient's life. She suggests that by listening with intention, healthcare providers can better assess a patient's well-being and provide appropriate care.

Keywords

💡Listener

A listener, in the context of the video, refers to someone who is attentive and responsive to the needs and concerns of others, particularly in a healthcare setting. The speaker emphasizes the importance of being a good listener, which is a skill they developed over 30 years as a certified nurse midwife. The video underscores that listening is crucial for making accurate diagnoses, ensuring patient safety, and fostering patient satisfaction.

💡Dehydration

Dehydration is a condition that occurs when the body loses more fluids than it takes in, leading to an imbalance in water and electrolytes. In the script, the speaker recounts a childhood experience of severe dehydration that required hospitalization and an IV. This personal anecdote serves to illustrate the importance of attentive care and the impact of being unheard, which became a foundational experience in their development as a healthcare professional.

💡Isolation

Isolation, as mentioned in the script, refers to the state of being separated from others, which can be both physical and emotional. The speaker describes being placed in a hospital bed with bars, akin to a cage, without a call bell, which left them feeling isolated and unable to communicate their needs. This experience highlights the negative effects of isolation and the importance of patient communication in healthcare.

💡Compassion

Compassion in healthcare is the ability to empathize with patients and provide care with understanding and kindness. The video stresses that expressing compassion is vital for building trust with patients. It involves seeing the patient as an individual, actively listening to their concerns, and providing care that is both personalized and respectful of their experiences and feelings.

💡Hard Conversations

Hard conversations in the healthcare context refer to discussions that involve delivering difficult or distressing news, such as a cancer diagnosis or the death of a baby. The speaker discusses the necessity of these conversations and the importance of listening and understanding the patient's perspective to communicate effectively and with empathy.

💡Team Approach

A team approach in healthcare involves collaboration among healthcare professionals to provide comprehensive care. The speaker mentions the importance of listening within a team, where each member can be both a leader and a follower. This approach ensures that all perspectives are considered, and care is coordinated to meet the patient's needs effectively.

💡Healthcare Disparities

Healthcare disparities refer to the unequal access to or quality of healthcare services. The script mentions that listening to women's stories can reveal disparities related to factors such as poverty, race, gender, ethnicity, and language. Addressing these disparities is crucial for providing equitable care and improving health outcomes for all individuals.

💡Evidence-Informed Care

Evidence-informed care is a practice where healthcare providers use evidence from research to inform their decisions but also consider the individual patient's context, values, and preferences. The speaker introduces this term to contrast with evidence-based care, emphasizing the need for personalized care that respects the patient's beliefs and circumstances.

💡Mental Health Evaluation

A mental health evaluation is an assessment of a person's emotional and psychological well-being. The speaker incorporates such evaluations into their routine clinical visits, using questions about life circumstances, feelings, and coping strategies to gain a deeper understanding of the patient's overall health. This approach highlights the importance of considering mental health in comprehensive healthcare.

💡Patient-Centered Care

Patient-centered care is an approach to healthcare that prioritizes the patient's values, preferences, and needs. The video discusses the importance of engaging patients as partners in their care, listening to their concerns, and tailoring healthcare to their individual circumstances. This approach aims to make healthcare more meaningful and effective for the patient.

💡Active Listening

Active listening in healthcare involves fully concentrating, understanding, responding, and then remembering what is being said. The speaker emphasizes the importance of not just hearing but truly listening to patients, which includes processing the information and considering it from the patient's perspective. This skill is crucial for providing quality care and building strong patient-provider relationships.

Highlights

The speaker developed strong listening skills over 30 years of practice as a certified nurse midwife.

A childhood hospital experience where the speaker was left without a call bell during an IV treatment impacted their understanding of patient care.

Listening is critical for making the best diagnosis, ensuring patient safety, and improving patient satisfaction.

The speaker emphasizes the importance of being present and fully engaged when caring for patients, including making eye contact and using phones less.

Listening with compassion builds trust between healthcare providers and patients.

Healthcare providers must listen not just with their ears, but with their hearts and minds, to understand the patient as an individual.

The American College of Nurse-Midwives teaches 'listen to women' as a key precept of practice.

Women, as the primary users and coordinators of healthcare, often face disparities based on race, ethnicity, gender, and economic status.

The speaker recounts a story of helping a patient in need of dentures, illustrating how listening and acting on what is heard can change lives.

The speaker advocates for healthcare professionals to engage patients as partners in their care, recognizing them as the experts in their own lives.

Listening involves understanding not only what is said, but also what is left unsaid, and requires emotional intelligence.

Healthcare providers should use 'evidence-informed care,' personalizing care based on the individual's beliefs and preferences.

The speaker highlights the challenge of asking awkward questions in healthcare but stresses that these questions are vital for patient well-being.

Compassion and professionalism are not mutually exclusive; they can coexist and enhance patient care.

Listening attentively helps healthcare providers assess a patient’s physical, emotional, and mental state, contributing to better health outcomes.

Transcripts

alright I'm a good listener

I've developed this skill over 30 years

of practice as a certified nurse midwife

and as a woman's health professional but

what made me a good listener was

something that happened to me when I was

5 years old I got one of those dreaded

stomach viruses where you can't keep

anything in in any possible way and I

got dehydrated so I got carted off to

the hospital never been to a hospital

never seen a hospital had no idea what

hospitals were about but they decided to

start an IV and of course I'm 5 years

old so they bundled me into a bed it's

not any ordinary bed though it's a bed

with bars and there's bars that go up

the side and there's bars that go over

the top it really was a glorified cage

and so the nurses put me in this cage

they've got my IV running there making

sure I'm not dehydrated they put me in

isolation so they walk out they close

the door and they forget to give me the

call Bell so what happens when you give

a five-year-old IV fluids and no call

bell well the inevitable happened and of

course I'm locked in this cage I can't

get out I can't ask for help and the

nurses come in and the first nurse says

to me well what did you do that for and

clearly she was not looking for an

answer

so she and the other nurse get me tidied

up remake the bed put me back in my cage

with the top down walk out the door

close the door and forgot to give me the

call bell so what happens again they did

not forget again and I never forgot this

experience it's made me a good listener

about what issues concern the individual

because I may have been being treated

for dehydration but I got more than I

bargained for as health care

professionals we all need to have skills

for listening and why are they important

because skills for listening aid died

the best diagnosis is made by listening

they also are critical for ensuring

patient safety for communication between

colleagues and co-workers and for

patient satisfaction one of those things

that drives healthcare these days how

hard is it when you're caring for people

to be in the moment how many of you keep

your phones in your hand how many of you

make direct eye contact on a regular

basis how many of you listen with your

heart with your mind with your full self

the way we express compassion to the

people who come to us for care as

healthcare providers is one of the

things that builds trust

it means we see that person as an

individual and we hear what they're

saying to us then we're able to give

them understandable explanations

explanations that are understandable to

them not to us because they have to be

understandable to the person who is

hearing them sometimes in health care we

have to have hard conversations I've had

to tell people that they have breast

cancer that their baby has died that

their baby has malformation that even

though they thought they were in a

monogamous relationship that they have a

sexually transmitted infection we have

to listen and know the people we're

speaking to to know how to convey

information when we have these hard

conversations we can listen using a team

approach that means that we are

colleagues we are team members we are

all leaders and we are all followers we

have to listen to be able to lead well

we have to listen to be able to follow

well we engage with our clients as

partners and then each of us needs to be

able to put boundaries on these

conversations a set of parenthesis so

too

speak so that there's a beginning

there's a middle there's an end and it's

directed in a way that people know where

they are in the conversation and they

don't get lost or feel like wait a

second we didn't finish which is often

an occurrence that happens the American

College of nurse-midwives has a saying

listen to women and we're indoctrinated

in it I guess that's not too strong a

word during midwifery education and it's

a key precept of practice women are the

greatest users of healthcare in the

United States they're also the ones who

coordinate health care for other loved

ones and who often provide care

continued that care when it occurs in

the home when you listen to women you

hear the stories of health disparities

that can be related to poverty they can

be related to race to gender to

ethnicity to language there are all

kinds of things

the American College of nurse-midwives

is particularly interested in women

because we do women's health but we need

to listen to all people that we provide

care to know who is the expert who is

the expert in your life who is the

expert in your life well you are of

course right everybody assumes they're

the expert in their own life until you

go to see a health care professional who

says well they're the expert in the

problem that you're coming to get care

for and yet we need to engage the

individual as a partner in her or his

care in order for that care to make

sense to them and for it to actually

work we need to listen for what is said

and we need to listen for what is not

said we need to listen with our eyes as

well as our ears and with our hearts as

well as our minds if we're going to be

able to provide quality care to people

people who come for health care visits

at any setting are more concerned

with their life and if you look at all

of these things we all have hopes we

have dreams we have aspirations we have

things that we want things that we're

doing things that we hope to do we all

have challenges we all have history we

all have good things and bad things that

have happened to us but nowhere on just

about anybody's map of their life is the

state of my health because it's really

not central to most of our lives we take

it for granted health is just part of

who we are at any given time so in order

to partner for health we have to

actually meet people where they are we

have to see them as individuals so I'm

going to tell you a little story about a

woman who came to my practice she came

for a routine women's health exam and I

will say that many people came to my

office and the reason for their visit

that was given when they made the

appointment was not actually the reason

that they came for the visit that waited

till we were behind closed doors and she

looked like she'd fallen on hard times

she was neat and tidy clean well-groomed

but clearly in some kind of a struggle

and early in my practice I had read a

journal article that suggested that a

mental health evaluation should be part

of any every clinical visit and so I had

incorporated that into my routine with

these basic questions what's going on in

your life how do you feel about it and

what are you doing about it and these

three questions became the backbone of

my practice because I learned so much

information from them and so when I

asked this woman what's going on in your

life she said I've had some dental

problems and I've had to have my teeth

pulled and she's got her hand in front

of her mouth she's feeling embarrassed

and I said well how do you feel about it

and she said well not very good I don't

have any money for dentures and I can't

eat I can't eat enough to hold a job

because I keep losing weight and I don't

have any energy

and I said well what are you doing about

it and she said well I I've gone to the

doctor and they just told me I need

dentures and nobody will help me and so

I asked her is anybody written you a

prescription for dentures and she said

no and so I wrote her a prescription for

dentures that said for medical necessity

and she promptly got her dentures and I

ran into her several months later in our

little town and she looked well she'd

put on weight and she came over to say

thank you and she pointed and she said

look there's my new car I got it with my

job listening is what helps transform

people's lives we listen to understand

so we need to do with more than just

hear we have to think about it we have

to process it and we need to think about

it not from the context of our life and

our cultural background but from the

point of view of the person who were

providing care to and then once we

understand what is actually needed we

need to act so it's not enough just to

have that light bulb moment you have to

actually carry that lightbulb moment out

you need to go the next step you need to

ask those difficult questions that may

be awkward now why didn't anybody else

give this woman a prescription well

maybe they didn't know about it maybe

they didn't think about it maybe they

didn't think to ask someone can I write

a prescription I tend to do the opposite

which is just I'm gonna write it and if

somebody says they can't do it they can

tell me rather than finding out first if

you have permission but there are a lot

of awkward questions when you're in

health care you know I went to my

midwifery program in Brooklyn at the

city hospitals of the yes great great

city of New York and learned to ask a

lot of questions you know are you

sexually active

do you use Khan

have you had any sexually transmitted

infections these are common questions in

women's health practice and then there's

the ones that you don't really think

about how are your bowels I mean talk

about awkward the first time I asked

that I'm like I don't really want to ask

that I got very comfortable with that

very soon and it's amazing what if you

give yourself permission you can ask

someone and the key is to be respectful

to phrase it in a way that's acceptable

and to understand what the right

question is but how do we know what the

right question is well first of all we

ask the person in front of us why

they're there what brought them to us

what is it that they're looking for out

of this healthcare encounter or visit

because it may not be the same thing we

expect it to be there are people who

have cancer who are looking to be cured

and there are people who have cancer who

are looking to make the remaining days

of their life as positive as they can

possibly be and have time to say goodbye

to loved ones each person is the expert

of their life when we talk about making

health care meaning top meaningful for

individuals we run into a across

purposes most individuals are

functioning based on their individual

beliefs

and many of us health care professionals

are functioning on the basis of

evidence-based care and I'd like to

introduce a new term today that's

evidence-informed care that we use the

evidence to inform the care that we

provide to individuals that we use the

evidence to set standards for care not

to standardize care if we want every

woman to have prenatal care then we need

to make prenatal care accessible and we

need to have standards for what is

included in prenatal care and then

within the context of that prenatal care

we personalize it to every woman who

comes through the door and

is based on her beliefs her beliefs and

what's important her beliefs about where

is the best place to have her baby her

beliefs about who's the best person to

help her have her baby whether she wants

a crowd or whether she wants it private

there's many many pieces that come into

this but we want to make the health care

meaningful to the individual and we do

that by listening by listening

consciously as health care professionals

we are experts and we're able to talk

it's much much harder to be silent to

ask the right question and to listen

compassion is a core tenant of providing

quality health care and the wonderful

news is that compassion and professional

practice are not mutually exclusive

they're not mutually exclusive in the

least and it's one of those joys in my

life having functioned as a nurse

midwife in a very small town where I

knew most of the people who came from me

for care and so in an emergency I would

try not to think about who it was

but I would also know who it was and I

would know what they were looking for in

the care that they received it is a

little bit more of a challenge but it's

a worth it challenge when we listen with

intention we can determine if somebody

is peaceful or in turmoil whether they

are sleeping or they are sleepless

whether they're eating well or not

whether they're active and what the

state of their health is all of those

things together make us where we are on

the continuum of health none of us

function in a health bubble we are all

of our life so what's your style of

listening thank you

you