Make a personal connection in the ER

After a relaxing weekend with my daughter, son-in-law and 2-year-old grandson, my wife and I made our way to the Atlanta airport to begin our trip home. The end of a trip — even a short weekend — is always sad. I never look forward to the travel home and usually want to snap my fingers and skip the travel.

My wife and I have trouble packing light and so, when we arrived at check in and our bag weighed 51 lbs, I sighed. My frown quickly disappeared, however, when the Delta attendant joked, “You just HAD to push the buttons… and see what I would do. 50 lbs just couldn’t cut it so you went for 51.” My wife and I smiled as we walked toward the security line.

Later, as we boarded the plane, I noticed another attendant making friendly comments to each passenger as they boarded. For some anxious travelers, this personal connection was all they needed to calm their nerves as they entered the aircraft. As I boarded with almonds in my hand, she commented, “Oh snacks! Delicious! How did you know I have been on my feet working for hours and could really use something. Thanks!” Again, I smiled as I boarded the plane.

These two very simple interactions made an otherwise uneventful flight experience one that I remember and talk about with friends and family. The goal of the flight was to get me from one point to the other — but Delta did more than that. They provided me with an experience I won’t forget.

Over the past several weeks I have thought to myself, wouldn’t it be great if our patients left the ER feeling the way I did as I left that plane?

As our patients enter the emergency room, we can assume that they are generally not happy to be there. Yes, our job is to get them better. But part of getting them better means helping them relax — making sure we are communicating effectively and minimizing any barriers to quality care.

We recently began working with a communication consultant to strengthen our ability to make personal connections with our patients. Last month, she spent some time in our emergency rooms observing our patient interactions. She shared that throughout our time with our patients, moments arise when personal connections are possible, often initiated by our patients. Perhaps a patient mentions a family gathering, or how they wish their spouse could have accompanied them to the hospital — these are small moments when we, as providers, have the opportunity to connect personally.

Recently, a middle-aged woman came to the emergency room for abdominal pain. After completing the physical exam and history intake, there was a pause where the physician was thinking through the case and identifying next steps. Suddenly, the silence was broken while the patient commented through a giggle, “Oh dear … My husband doesn’t even know I am here.”

Several days later, a male was seen for rectal bleeding. He described his symptoms at length, completed the history intake and had a physical exam. After all was complete, he took a nervous breath and anxiously commented, “You know … I woke up at two in the morning and after seeing what I did, I turned to my wife and I knew I had to come in … I just couldn’t wait.”

In both instances, our patients were looking for a connection. The first was concerned that her husband had no idea that she had been in the hospital for several hours. This was her attempt at making a connection with her physician through something other than her physical ailments. She likely would have welcomed a response, such as, “If my spouse was in the hospital, I might be worried. Would you like us to call him for you?”

The second patient example relates very closely to the airline story mentioned above. Many of our patients are extremely worried — the emergency room can create an intimidating environment. As physicians, we can’t always predict the outcome for our patients. However, we can have the empathy to comfort them. Perhaps we could say, “I know this can be scary but you did the right thing by coming in to see us. We will check everything out and take good care of you. You are in good hands.”

If we look for it, we will find evidence that our patients are looking for that personal connection. And it is our jobs as physicians to express that. Just like the flight attendants, we must actively listen to identify the moment when this connection is possible.

The most integral part of our job is helping our patients get well. But, if we can do this, all while creating an empathetic, enjoyable experience for our patients, then job well done!

David Klein is an emergency physician who blogs at The Shift.

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  • RuralEMdoc

    A great article with an excellent perspective. Sometimes we become so engrossed in the daily grind that we forget about the point of view of others.

    Being in the emergency room is a scary thing. Most people are in pain, it smells like anti-septic (which is very unpleasant to the uninitiated), and there are needles everywhere.

    This article is an excellent wake up call for all of us.

  • medicontheedge

    So right, and it is very easy to just have a simple chat-up with a patient. That is all it takes. At least with the ones who are respectful and appreciative. The ones who are assaultive and abusive? The only connection they will get is a visit from out security guards.

  • Doug Capra

    It’s great that you had an observer to study communication. But — did the patients even know they were being observed by non-medical personnel, and/or were the patients asked permission to be observed?

  • T H

    IF there weren’t these little connections to be made every day, my position as an ED doc would be unbearable. As it is, despite there being much that I dislike about the job, I look forward to each time I get to go to work.

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