- Approach in a disarming manner (empty-handed, measured pace, respects for physical and psychological space, judicious use of eye contact).
- Identify yourself fully, including your name and title.
- Demonstrate benevolent intent (“How can I help you?”).
- Clearly articulate your own and your team’s goals with regard to the situation (“My job is to help you” +/- “We need to make sure that everyone is safe here.”) and, if appropriate, explicate the absence of ulterior motives (e.g., “I don’t benefit in any way from you being treated poorly.”).
- Demonstrate that you are willing to let go of assumptions from previously constructed narratives (“Please tell me what happened”).
- Identify with the patient’s suffering whenever possible (I or someone I cared about suffered similarly), while allowing for differences in individual experiences (“Thank you for sharing this with me because, as a doctor, I don’t often get to experience things from the perspective you just gave me.”).
- Ask what actions you might be able to take to improve the situation.
- Articulate your powers and their limitations (“I can give you something for anxiety, but unfortunately I don’t feel comfortable with giving you IV morphine.”).
- Articulate relevant expectations and rules.
- Promise to make changes, as appropriate, and provide a precise timeframe (“I will put the orders in the chart within the next 10 minutes”).
- Ask/demand reciprocation in terms of change in the patient’s behavior.
- Ask to be held accountable for your promises, and articulate a contingency plan that involves you (e.g., “If, for whatever reason, you don’t see a change as promised, please make sure to ask for me by name, Dr. Smith”).
- Confirm mutual agreement, shake hands on the “deal” where appropriate and express appreciation for their patience/cooperation.
Leave a Reply