Emergency Responder Communication Skills

This is an excerpt from Emergency Responder Communication Skills Handbook by Brian Everard Walsh, PhD, JP (Ret.): Chapter Two: Actions, Words and Senses

In an emergency, what you say and do for patients is just as critical as the medical attention you give them. Employing good communication skills can help them focus on what is beneficial to relieve discomfort and enable recovery.

Your Actions

When you see a patient for the first time, be aware of your facial expressions. Avoid outward expression of shock and ensure that your face exudes calmness and a sense of confidence that everything will be OK. Consider removing sunglasses or a hat. Communication is improved when you can see into each other's eyes.

Move down to the patient's eye level (if culturally appropriate) and briefly touch his shoulder, forehead, or hold his hand while reassuring him or giving instructions. Tell him what you're doing and include nearby family or friends to decrease any general anxiety.

Words are important, but a great deal of communication is nonverbal. Nonverbal cues include voice cadence and tone, hand motions, gestures, facial expressions and posture. Ensure that your body language does not convey any doubts about the patient's potential for recovery. Always display an air of confidence.

Your Words

Research has shown that it is 30% more difficult to understand a negative statement or question than it is a positive one. Since patients are already in a fragile condition, make it as easy as possible by using positive statements. For example, use phrases like: "That will be more comfortable; that looks better; you're doing a good job." It's important that patients hold a positive image of the future. Ask about their family or vacation plans. Have them focus on something to look forward to and the good things in life.

Indirect language is characteristically vague and leaves room for wide interpretation. Typically, a speaker implies something and expects the listener to deduce the correct message. Common examples are sarcasm and irony.

When giving a patient directions, use direct language to ensure understanding and compliance. Giving him a task will distract him from his discomfort and anxiety. For example: "Take slow, deep breaths. It will help you be more comfortable," or, "Hold this oxygen mask to your face and breathe normally." Keep your language positive, supportive and real. Once the patient is stabilized and convinced you understand his predicament, it might help to use some subtle humor, such as: "I bet there are a lot of places you'd rather be right now," or "You'll have a good story to tell your family and friends."

In times of uncertainty, victims and their families are disoriented and confused, but their anxiety can be reduced when they know essential facts. As a professional, you have a duty to facilitate the flow of vital information. Following are questions that may be asked by your patients:

• What is really happening? Saying nothing to patients allows their imagination to run wild. You don't have to go into detail, but give them enough information to quell their fear.
• How will this affect me? You will be making decisions about what will happen next and about how, when and where it will happen. Sharing with them how the next step will help will make you more than someone just doing a job.
• What are you doing? Avoid details, but keeping them in the loop will thwart bizarre assumptions. Let them know who you are (paramedic, EMT, firefighter, etc.) and what you are doing or about to do.
• What do I need to do? Giving specific direct instructions will distract their attention from the pain or injury. Remember, this is very frightening and traumatic, so be reassuring and calming.

How Surroundings Affect Patients

You have the power to improve your patients' situations. A calming demeanor, intentional words and actions can significantly lessen the impact on their already magnified senses.