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What Hospice Taught Me about Communication

PhysicianTalkingwPtThis is a guest post by Bryan Hooker,  MD Halcyon Hospice Medical Director.

I still remember the fall of 1987 like it was yesterday. I was sitting in a classroom interviewing a mock patient with a headache. Even though our first two years of medical school grilled us in the basic sciences, I could not think of one single question to ask my patient about his headache. All I could think of was the Mark Twain quote: “It’s better to keep your mouth closed and let people think you are a fool than to open it and remove all doubt.” And keep it closed I did, for several painful, awkward minutes until something magical happened. The patient filled in the blanks and I became a listener. Now working as a hospice physician, that encounter serves to remind me that active listening (instead of talking) is but one of the many pillars of effective communication.

Effective communication breeds effective leadership. And in order to be an effective leader, whether in business, the battlefield, or hospice inpatient unit, trust must be cultivated. As Stephen Covey said in The 7 Habits of Highly Effective People, “when the trust account is high, communication is easy, instant, and effective.” Without trust, communication becomes worthless. And nowhere is trust more crucial than in the development of an interpersonal relationship between a hospice healthcare worker and a terminally ill patient.

Developing this relationship requires creating a safety net, not unlike a cocoon, around the patient and the patient’s family, often times in several minutes to a few short hours. Effective communicators in the hospice environment work steadfastly to foster this skill, often through blunders and mistakes, because it is more art than science. So what makes for the Da Vinci of communication?

Hospice has taught me at least five necessary lessons:

1. The best communicators are effective listeners.

Nowhere is silence more golden than in hospice. Strive to learn nonverbal techniques to validate a patient’s emotions with simple facial expressions, gestures, or nodding one’s head as a response. This translates empathy and creates a dignified and safe environment for expression. Again, channeling Mark Twain: “If you have nothing to say, say nothing.” The nonverbal act of validation may be all that is required.

2. This is the hardest one for me, personally: self-consciousness kills effective communication.

Remember that to communicate effectively, the hospice worker must create a safe zone allowing one to share unique thoughts without fear of judgment. This requires suspension of any pre-conceived notions of righteousness and yet simultaneously exposing yourself for judgment. Transparency is paramount. Get to know yourself so you can know others.

3. Effective communication is a bidirectional process.

The famous novelist C.S. Lewis said “communication should combine clarity of expression with accuracy of understanding”. However, this skill requires mastering the one below before it can be conquered.

4. Don’t use words too big for your subject.

Many healthcare workers fail in this regard. Remember the difference between information and communication: “information is giving out; communication is getting through.” Yeats said to “think like a wise man but communicate in the language of the people.”

5. Silence can be golden (but can feel painful)!

This is similar to the first pillar but the redundancy is intentional. Peter Drucker, the famous father of management, taught that the most important things to hear are often what are not being said,” and the most important things are often the hardest to say, because words diminish them. My father used to preach to me and my four brothers “you have two ears and one mouth for a reason: we can listen twice as much as we can speak!”

Work especially hard to be an effective listener and master these other skills and you can become a Da Vinci of communication!

The Da Vinci Experience is Halcyon Hospice’s comprehensive set of expectations that outlines for its employees how to make the Halcyon experience an exceptional one. We take care of our patients, families and each other. And quality customer service combined with effective communication helps us do that. For additional information on Halcyon Hospice and the services we provide please visit our website at or call us at (678) 328-1700.

By | 2017-05-20T19:23:13+00:00 June 11th, 2014|Blog, Hospice Care|0 Comments

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