We’re celebrating the 2nd anniversary of HealthCommunicationPartners.com. One of the wonderful facets of my work is the people I get to meet.
Recently, I interviewed Dr. Ann Ancona from Kent State University for 10 Minutes to Better Patient Communication. Dr. Ancona talked about a specific communication challenge she faces as a provider and an educator: communication when the patient (or parent) is a medical professional.
I’m grateful to Dr. Ancona, and I’m sharing that interview here. You’ll learn why this special communication case can be a problem, what can go wrong, and what to keep in mind the next time you’re communicating with a patient or parent who’s a provider. The transcript is below!
Hi, This is 10 Minutes to Better Patient Communication from Health Communication Partners. I’m Dr. Anne Marie Liebel. In today’s episode, I’m talking with Dr. Ann Ancona about a specific patient communication challenge: when the patient is a medical professional. Dr. Ancona tells us why it’s a problem, what can go wrong, and how she and her students are dealing with it.
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Today I’m talking via Skype with Dr. Ann Ancona. Dr. Ancona is an assistant professor and coordinator of the Pediatric nurse practitioner concentration at Kent State University College of Nursing. Welcome to the show, Ann!
Thank you for having me.
I’m so glad you’re here. Can you tell our listeners a little bit about yourself and what you do?
Sure. I have been a pediatric nurse for a little more than 30 years. I began as a bedside nurse at Akron Children’s Hospital. Now I teach at Kent State University in the Pediatric Nurse Practitioner program and the Nurse Educator Concentration. These are both graduate programs which means that my students have a Bachelor’s degree in Nursing and they work as Registered Nurses.
Thanks, thanks for explaining that to me. Now we met a couple years ago through a mutual friend who is also a professor at Kent State University, Dr. Gumiko Monobe. And she introduced us to each other because of our shared interest in health literacy and patient education. So I’m delighted that you can be on the show!
Thank you very much. I have really always been interested in health literacy. And really the importance of this when we talk to patients and Families. This was particularly important when I worked on a toddler floor, since many of those children were too young to understand what I was saying, and too young to speak in complete sentences. So although I was talking to the parents of my patients, I realized how health literacy was important regardless of the patient’s age. I had to figure out how to talk to the parent and figure out how to talk to the kids.
Amazing. And now you’re also figuring out how to educate other providers on how to do this kind of talking. Wow.
So let me ask you a questions for your provider self and your educator self: what’s one of the problems in the area of provider communication that you face, either in your practice as a provider or in your work with your students?
More recently in my work with students, one of the problems is educating families in which one or both parents have a medical background.
Oh! That seems like it would be a special case. There’s probably a few things going on here.
Yes. We can assume that because we each have a medical background, that our patients or parents are on the same page with our thoughts and they’ll automatically follow our words from those thoughts. But this can be dangerous. Emotions really play a role here, where an overwhelmed parent whose child is quite ill might sort of tune out what we’re saying. They’re in a parent role, they’re not in the nurse role or doctor role. So we need to approach the parent side of them.
I had a friend, a nurse administrator, just telling me she’s like, ‘yeah when my kid is sick I feel like everything I’ve every known about medicine and nursing just flies out of my head.’
Yes that’s exactly it. And it’s hard. We need to, to separate that when we talk to them as a parent. An example would be if we talked to a mom who’s a labor and delivery nurse. My students–or me, I might assume that the mother knows what she’s doing to successfully breastfeed or bottle feed their baby.
Just because they are an L&D nurse.
Right we can’t assume they know that. Because they may be new in the mom role. So we have to talk to them as the mom, not as a nurse. And in this I see with my students, where they are educating parents who are also medical professionals. And one of the things they talk about is it they feel funny. They don’t want to overstep, teach the parent something that they think they already know.
Oh so this is something else then. This is a whole other kind of complication of medical pro to medical pro communication is not wanting to overstep your bounds.
Particularly when students, because they’re pediatric nursing students they’re talking to parents of course because you’re taking care of the children. But if the student does not have their own children, that puts them in a different situation. Where they feel that the parent probably already knows what they’re going to say because the parent is one with the kids, and the student doesn’t have children. So that adds another layer of health literacy in breaking that down so they can educate.
Sure. So we’ve got the issue of that kind of confidence or comfort, about having the kind of knowledge that doesn’t automatically transfer because what you do as a medical pro is not necessarily what you would do as a parent.
What can go wrong if, if communication isn’t clear in these medical pro to medical pro scenarios?
Well there are things that can be misunderstood when we when we get to those situations. So one example I can give you is, years ago my daughter had a pacemaker. And we were at a children’s hospital and they knew I was a nurse. But they, when we left, she was discharged, they did not ask me anything about CPR. Whether or not I knew CPR, or my CPR was up to date. So I think perhaps on their part, there was an assumption that because I was pediatric nurse that I knew CPR and it was up to date. So it’s interesting though, that I didn’t think about this until much later, and realized it should have been offered. And certainly offered to my husband. They didn’t teach him CPR or mention ‘go to a class,’ nothing.
So that was, in retrospect, I realize now that is something that should have been talked about with us. In my mom role, not my nurse role, with my daughter in the hospital.
Sure, sure. That’s a great example. That could have had some very serious consequences.
So how have you dealt with this with patients who are medical professionals?
The best way that I can do this, when I know the mom or the dad is a nurse, I’ll just often preface it with, “I know we’re both nurses but this is the education I’m I’m providing you” or “this is what I’d like you to know about your child so you can take care of them at home. And these are your instructions.” So the part of this comes from just doing in practice. But the other part too is that a nurse did this for me. She explained something to me and she said ‘I don’t want to insult you but I’m going to explain this’ and I responded I said ‘please feel free.’ I was so grateful that she explained it to me and talked to me as a patient and not as a nurse.
Wow. that’s great. So how do you, how do you deal with it with your students? You were talking about how they have this sense of ‘I don’t want to overstep my bounds’ or some confidence issues. So how do you prepare them to communicate with other medical pros?
The best way I can do this with my students is, part of their assignments from me are to write a journal. To write a narrative about a particular patient and in the communication and sort of what went on that day. So through this, they tell me how communication’s going with the, with their patient, with a family. And so I take their cues and give them feedback about that, how they could do something different or how perhaps we can improve their communication. So a lot of it is my feedback to them. But also feedback between each other in the classroom. They can problem solve and really learn a lot from each other about how to communicate better with patients and parents.
Fantastic. Reflective practice, journaling, narrative. I love all of this! Do you have any advice for our listeners who might also be communicating with patients or parents who are medical pros?
Probably the biggest piece of advice would be that our job is to educate. You know and in my role as a pediatric nurse, we look out for that child’s health. So the best way to do that is communicate clearly with the parents, with the child if they’re old enough to understand. And so that might mean telling them something they might already know. But really the bottom line is to educate no matter what.
Ann, I love that: educating no matter what. Doctor Ann Ancona, thank you for being on the show today.
Thank you for having me. It’s been a pleasure.
This has been 10 minutes to Better Patient Communication from Health Communication Partners. I’m Dr. Anne Marie Liebel.