The single biggest problem in communication is the illusion that it has taken place. – George Bernard Shaw


The blog has been rather quiet recently, and that is because I have been getting to know the medical profession a little better. A sudden health scare found me in the emergency room of our local hospital – a little unsure of what was happening and a little frightened of what might be going to happen.

It was then I became personally aware of some of the barriers that impact on the need for clear communication.  The medical staff in the emergency room were professional and obviously caring – but they were not communicative.

In any emergency it is important to ensure that everyone involved understands what has happened, what needs to happen now and the hoped for outcome.  In a hospital emergency ward that is even more important – there is always an ‘outsider’ that causes the emergency and who needs real reassurance that is more than just platitudes.  That reassurance can be affected by three simple problems that create solid barriers to emergency communication.  They are:

Being a Specialist  ~  The trouble is that we look at the situation from our own point of view, believing that everyone knows what we know. We come from a position of speciality and we presume that everyone knows our special jargon and ‘in-house’ speak.

Ensconced on the gurney in the cubicle and attached to a variety of machines I was more than a little apprehensive – but most of all I wanted to know what was happening to me. The doctors and the nurses gathered around my bedside spent a considerable amount of time discussing the various messages being beeped out and flashed up and it was as if they were speaking another language. It was certainly not one that I recognised and as no one bothered to translate my apprehension increased and my blood pressure went up.




Now of course your workplace may not be a medical emergency ward, but stop a moment and think about it.  Are there special terms you use or any industry jargon completely understandable to those in the know, but totally incomprehensible to those outside the loop?  Almost all companies, organisations or specialist industries have developed a special kind of language which we used instinctively – but to do so in the presence of those not in the know isolates the listener and places them outside the conversation.  This was not good for my blood pressure, and it is not good for your business.

In-house jargon is one of the main reasons that emergency communication fails, If I don’t know the language you speak then I will not understand your message.

Another barrier to clear communication which was demonstrated by my emergency was :

Being in a hurry ~ Most of us work under pressures of some kind or other and have to make quick decisions.  This can lead to communication without due consideration.  It was obvious that the staff needed to communicate efficiently and clearly between themselves which they did – but they isolated me in the process.  What communication was directed at me was of the juvenile kind – ‘It will be all right’ – ‘there’s nothing to worry about’  along with the patting of the hand and the ‘there, there’  as they dashed off to get another needle, chart or whatnot – none of which was designed to allay apprehensions I can assure you.

And finally, I realised just how irritating it can be when it is obvious that someone is:

Not listening ~ or should I say, not really listening.  Being in a hurry and yes in an emergency the emphasis must be on speed of response it is easy to overlook the maverick in the room– but surely it is obvious that the patient needs to be listened to.  Yes, I know – they ask the questions and the patient answers them – that is diagnostic communication.  But what about listening to the silent messages?  Reassurance that consists of platitudes does nothing, but a clear message of what is happening and why it is happening and hopefully what might be the outcome will lead to a more informed patient who will be far more willing to cooperate.

In my case I was getting more and more apprehensive about my prospects until finally I pinned a busy doctor down and demanded an explanation.  While obviously harassed he realised that failure to address my concerns was not doing my blood pressure any good and as he explained they were concerned that I had suffered a stroke that was not a bright idea!

Once he had explained what the machines were measuring, how the information would help them decide if a stroke had occurred and the likely hood of another one, all my efforts were then directed to trying to maintain a relaxed attitude to reduce the pressure.  I began to work with the medical staff not in opposition – and all it took was an effort to communicate clearly.

As an aside, it turned out that I had suffered a stroke and a quite significant one too, but as it had happened in what was judged to be ‘an unimportant part of the brain’ I came out of the experience more or less none the worse for wear and with a large box of medication. It is my opinion that my good luck was really that so much of my brain is actually considered to be unimportant! — However I digress ..

It comes as a shock to realise that as much as 70% of our communication is going to be misunderstood, rejected, or distorted – and that is 70% in your workplace as well as in that emergency room!

Clear communication in emergency situations is essential so that everyone is on the same wavelength and understands what needs to be done.  When one of the people in the equation is not party to the expert jargon, they should not be isolated but included by rephrasing into plain speak.

Even in emergencies we must take the time to inform everyone involved what is going on.  It might seem a waste of precious time – but allowing some people involved to be isolated and kept uninformed is never going to lead to a positive outcome.

And finally, be aware when people want to ask questions.  Be alert for the signals that indicate someone wants to be listened to.  Brushing people off because you’re in a hurry, and this is an emergency only makes people more scared, and if they are also ignorant of what is going on they can inadvertently behave in a manner that has a negative impact on the outcome.  My increased apprehension was leading to stress which was impacting on my blood pressure – not a good thing for a stroke victim.

Not all of us are going to be medical staff in the emergency ward, but we are all going to face at some time or other a stressful situation that needs immediate and urgent action –; and the factors I have highlighted here are just as important in your very own emergency room as it was in mine.


Michele @ Trischel

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