The Importance of Listening in Healthcare | Nell Tharpe | TEDxUNE
Summary
TLDRThe 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
🏥 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.
👂 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.
💡 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.
🤔 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.
Mindmap
Keywords
💡Listener
💡Dehydration
💡Isolation
💡Compassion
💡Hard Conversations
💡Team Approach
💡Healthcare Disparities
💡Evidence-Informed Care
💡Mental Health Evaluation
💡Patient-Centered Care
💡Active Listening
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
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