What to say…when to say it

“Compassion automatically invites you to relate with people because you no longer regard people as a drain on your energy.” ~ Chogyam Trungpa

For the last several months I have been dealing with the declining health of my mother and the sudden death of my father. It’s been a very difficult time for me, as I’ve weathered an unexpected surgery for mom, my dad’s funeral, and an endless stream of bills.

Most people have been helpful in settling my dad’s affairs and have offered appropriate condolences. Unfortunately, some health care workers have come across as less than compassionate. Whether they meant to or not, at times their words and actions seemed uncaring, or even worse, inappropriate.

A simple “I’m sorry” and “let’s see what I/we can do to help you” would have been nice to hear.

Unsure of what to say?

This leads me to a recommendation I read in an online blog called “10 Ways to Help Nurses Improve Patient Satisfaction.” What stood out for me was the suggestion at the top of the list, called “scripting.”

In nursing school, we all learned the importance of effective communication. Some of us practiced drawing out both patients and other health care practitioners by role-playing. Then we applied what we learned in the clinical setting.

But didn’t you still find yourself unsure of what to say in many important situations? As a new nurse, I know that I did.

Bring on the scripts!

The point of scripting is to provide nurses the words to use in many different situations. Now, before you protest…Geez, don’t you think I know how to talk to my patients?...hear me out.

In his Nursing Leadership Builders Blog, Dr. Michael B. Grossman says that the point of scripting is “to provide a set of comments that have worked well in similar situations and have had effective outcomes.”  He adds, “If you are sincere and truly are there to help the patient, then the script is a gentle reminder of your mission.”

These mission-sensitive scripts could help nurses with a myriad of situations. For instance, scripts can alert nurses how to better… 

• Set the tone with new patients — Warmly introduce and identify yourself and your professional credentials.
• Keep patients and loved ones in the loop — Explain treatment regimens and answer questions.
• Prepare patients for operations — Equip a patient (and his/her support group) for what to expect, before, during and after a procedure.
• Streamline the discharge process — Make sure a patient (and their loved ones) has everything they need for the transition from hospital to home.
• Communicate with team members — Effectively communicate with your manager, or with nurses you manage, with the same tone you want to impart to patients.

Scripting can also provide nurses with the tools for handling potentially volatile patient issues, such as delayed procedures, lost test results…or the death of a loved one. 

Personalize the message

Again, I’m not saying that we should be like little robots and simply memorize words. Nurses are so much more intelligent and caring than that! But a script can lay the foundation of what to say in any number of situations, even more so, if you are new to nursing.

With time and practice, each of us will find a way to personalize the information. With more consistency and accuracy of the message, as well as an emphasis on caring, I truly believe that patient satisfaction will indeed increase.

Now it’s your turn

Sometimes knowing just what to say and when to say it will help control a difficult situation. When emotions are raw and the situation is overwhelming for family and loved ones, all you may need to do is stop what you are doing, look the patient and family members in the eye, and say “I’m sorry.”

Have you ever been in a situation where a health care worker could have used some help with scripting?

How can scripts serve as “gentle reminders of mission?”

For some examples of scripts for nurses and nurse managers, see Dr. Grossman’s Rounding for Outcomes Scripts.