Difficult Seasons

Becoming a good listener is a life-long quest.  It requires effort, focus, and mastery of skills.  While some of us seem to be better equipped to be good listeners naturally, all of us can become better listeners if we work at it.

Listening in a way that we really comprehend what the other person is trying to communicate and so that they feel heard is challenging.  There are lots of reasons for that:

• The words actually spoken reveal only a small part of the message.
• The tone in which they are spoken and the body language with which they are spoken including the facial expressions actually convey most of the message.
• All of us tend to only communicate partial messages in conversation.  Getting the rest of the message requires questioning, clarification, and other conversational interchanges.
• Actual communication is taking place on multiple levels.  If we’re just tuned in to the surface level, we likely miss the most important part of what’s being said.

Here are five basic listening skills that will carry you a long way.

1.  Rapport Building is establishing an emotional connection of trust at the outset of a conversation.  Smiling, maintaining eye contact, and synchronizing your body language and pace of your speech to the other person help enhance rapport.

2.  Paraphrase is saying back to the speaker in your own words what you heard the speaker say.  Paraphrase helps you be sure that what you heard is what the speaker meant to say, and it conveys to the speaker that you’re really interested.  It’s the “What I heard you say was…” tool.

3.  Asking productive questions invites the person to provide information they would like to share, helps fill in missing information, and check out possible distortions.  Curiosity is your biggest asset here.  It’s also one of the primary ways we show the person that we’re interested in them.

4.  Behavior description (body movement, physical changes, or tone of voice, as well as actual verbal quotes) helps you distinguish between what you are inferring and what the person is saying.  For example, if someone says “I’m fine,” but they’re tearing up as they say it, saying “I heard you say that you’re fine, but your tears suggest that there may be more going on,” provides an opportunity to go deeper by giving them permission to speak freely.

5.  Perception check is a way of testing your perception (guess) about what you believe the speaker is feeling.  Making a perception check lets the speaker know that you are sensitive to their inner emotional condition.  Since you’re just guessing, always phrase your statement tentatively.  “I’m guessing that based on what you’ve told me that you’re feeling pretty discouraged.  Is that close?”

So, these five tools comprise your basic toolbox for listening.  And remember, practice makes perfect you better.

Photo Credit: Amarand Agasi

Don't Make Promises

I’m not sure why we feel like we need to make promises when we visit people in the hospital.  But generally, we do, at least until we get some experience under our belts.

Maybe it’s because we want to do something nice for them.  Or maybe it’s because we want to give them something to look forward to.  Possibly, it’s because we want to help.  Perhaps it’s because we really plan to do whatever it is that we promise.

And just maybe, it’s because our minds shift us to doing something because it’s easier to deal with than being with someone going through a tough time.

For whatever reason, promises seem to want to slip out.  “I’ll be back to visit you.”   “I’ll call and we’ll have lunch when you get out.”   “I’ll … whatever.”

It’s so easy to make a promise.  “I’ll find you a sleep mask and get it to you” is one I made one time.  The lady was having a hard time sleeping because she’d lost her sleep mask, and I wanted to help.  Only later did it dawn on me that finding a sleep mask meant a special trip to a store, and getting the mask to her meant arranging for someone to deliver it in order for me to keep my promise.

I did get the mask to her, keeping my promise, but I learned a couple of important things from that experience:

• Even simple promises to someone in the hospital are easy to make, but can get hard to fulfill.  I need to stop and think long and hard before making a promise and be sure that I have the energy and resources and opportunity to fulfill it before I make it.
• While getting her the mask was a nice thing to do, it didn’t make me more effective in providing pastoral care, because I’d stepped out of the role of being with into the role of doing for.  Spiritual care (or pastoral care), at it’s core, is being with a person who is going through a difficult season.  When that’s done well, it requires all of our energy and focus.  When we mix doing with being, it detracts from both our energy and focus, and we run the risk of being less effective.

I’ve now accepted the wisdom of my mentors, and accepted the guiding principle, “Don’t make promises.”  And you know what?  I then recognized that patients are not expecting you to do stuff for them.  The gifts of presence and caring are more than sufficient.

Don't give advice.

Giving advice is a hard habit to break.

In the workplace, we’re often rewarded for having answers and suggestions.  In our interpersonal relationships, many of us feel that our value is being able to help people figure out what they need to do. And, in some of us, a codependency gene rises up and we think it’s our job to fix folks by telling them what they should do.

But when you make hospital visits, don’t give advice.

Don’t use phrases that begin:

“If I were you I’d …”

“What you should do is …”

“What you need is…”

“If you’d only … then …”

“I know a … who can …”

If the person you visit expresses frustration with the medical staff, listen to their frustration, and maybe ask if patient advocacy is being helpful in resolving the issues.  Don’t suggest that she change doctors or add to her frustration by chiming in with your opinions on the medical staff’s performance.

If he mentions problems with insurance or housing or parking, listen and make him feel heard.  Sometimes patients like to talk about these kinds of things as a way of getting rid of frustration with everything else that’s going on as well, and just being heard is enough.  If, however, it seems that the issues need further attention, you might ask if they are working with their hospital social worker, and how that’s going.

You see, it’s not our role to take on their problems and suggest solutions.  Hospital patients have a whole team of people who have the expertise to help them with medical issues, problems with the service they’re getting, and even with their needs for help with insurance companies, temporary housing, and paying for parking.

What they need from you and me as we visit them in the hospital is simply our caring presence, and a willingness to listen.

Photo Credit:  Laughlin

The privacy and confidentiality of the people we visit in the hospital are important.

Those of us who make hospital visits as employees or volunteers of a hospital are well aware of HIPAA, the federal health information privacy rule.  Patient information, except what is required for treatment, may not be shared.  If we’re not affiliated with a hospital, as lay chaplains, church leaders, or family and friends, we still need to be aware of HIPAA.

The good news is that we really don’t need any of the information protected by HIPAA to make effective hospital visits.  Even if we don’t know the person we’re going to visit, all we really need to know is their name and room number.  We don’t need to know why they’re there, who their doctor is, how they’re being treated, how they’re doing, or any other such information.  We’re making a visit to show them that we care about them as a person, and why they’re there is incidental.

But whether or not our visits to patients are bound by HIPAA, we need to respect the privacy and confidentiality of what we learn when visiting a hospital patient.  The person we’re visiting has a right to expect that what we see and talk about during the visit is confidential and will not be passed on to others.

Unless the person asks you to share something, or unless you obtain permission from them to share certain information, you shouldn’t do so.

This includes something as simple as putting them on a prayer list or putting information in a church bulletin.  Some folks just don’t want others to know about their illness or what they’re struggling with.

It also includes talking to others about the person.  We’re often tempted to do so because it’s interesting, maybe even dramatic, and because we have “inside” scoop to divulge because we’ve been there.

So, if there are things that come up during a visit that you think it might be beneficial to share with someone else, make it your practice to ask permission first.  “Would it be okay if I put this in our prayer email, or in our bulletin?”  “Would it be okay if I shared what’s going on with Dick or Jane?”

Maintaining your integrity as a person who can be trusted with sensitive information is big.

Wash Your Hands!

Hospitals have lots of rules.  They tell you about hygiene and safety, where you can and cannot go, when you can visit, what you need to do before you enter a room, what information you are allowed to know or share about a patient, and all sorts of other things.

While you may not always understand the why behind a rule, it is important that we follow them.  Nearly all of the rules are to protect you, the patient, or the hospital and staff.  Besides, we’re guests there, and we want to remain welcome.

Here are some major rules that you’re likely to encounter in any hospital:

1.  Always wash your hands just before and just after leaving a room.  In most cases, using the alcohol gel will suffice, but on some occasions, you’ll be instructed to use a special soap and water.  This practice is to prevent the spread of infections within the hospital, a significant problem.

2.  Sometimes you may be required to wear protective clothing:  masks, gloves, gowns, shoe covers, or even caps, depending on the patient’s condition.  This is either to protect you, protect the patient, and/or to prevent the spread of infection.  Signs will be clearly posted, and if you have questions, the medical staff will be happy to help you.

3.  Some units in hospitals have restricted visiting hours, particularly Intensive Care Units.  Call ahead if you’re uncertain.  These will also generally restrict the number of people who may visit at once.

4.  Some patients have visitor restrictions, either due to their own wishes or imposed by the hospital because of their condition.  Honor these, and if in doubt, check with the patient’s nurse.

5.  Patient privacy is a huge issue for hospitals and for us as vistors.  HIPAA, the federal Health Information Privacy rule, strictly limits what information may be shared about a patient.  The hospital staff can provide only very limited information.  That’s okay, because you really don’t need to know any details about a patient’s condition to make an effective visit.  And, by-the-way, you should not talk about the patient’s condition either.  We’ll deal with that in another post.