Scenario: Following a routine check-up, a woman’s doctor asks how she’s dealing with her husband’s failing health. She’s been asked this question many times before, and has always smiled and replied, “We’ve got this!” Today, she informs her doctor between sobs that her husband passed just a few weeks before, and she’s barely holding on. As she breaks, the doctor is silent, thoughts racing: How do I console such pain? Is it even possible?
Offering a good patient experience when it comes to grief can be difficult for anyone. It’s hard to know what to say or how to try to put a smile on another person’s face. Here’s the easiest tip: Don’t. Rushing someone through grief is more about you than them, and your patients will notice — quickly. To understand better, let’s review some important points and practices regarding grief.
Understanding types of grief
While many are familiar with the five stages of grief — denial, anger, bargaining, depression, and acceptance — many are not aware of the different types of grief and how dealing with them properly can enhance the patient experience. Stephen Dudley of the Seattle Washington School of Medicine outlines five concepts for understanding grief:
- Anticipatory grief is identified by the worry of what it would be like without a loved one and mourning their impending loss. This can last for years, based on the diagnosis or status of the loved on.
- Bereavement is the act of experiencing the loss and overlaps with grief itself (see below).
- Grief is the active internalization of loss — things like crying, sadness, and loneliness — and lasts up to a year.
- Mourning is the personal or public way some one may grieve, i.e. having funerals, wakes, or celebrations of life, and going through this process can take up to a few years.
- Complicated grief is protracted, disabling grief which isn’t as common for most, but can last several years.
As any of these concepts can overlap, much like the five stages of grief, it’s important to know that you can’t rush anyone through any stage, as people grieve differently. So how do you improve the patient experience during this difficult time? Through listening to the voice of the patient with empathetic listening and employee engagement.
What is empathetic listening?
Empathetic listening is a more advanced form of active listening — it’s a dynamic and compassionate process where you are showing you care about an individual and what they feel, and you are truly trying to understand them, even if you don’t agree. While it can be used in any area to recognize problems and find working solutions, it makes healthcare staff part of the healing process for those who are grieving, and in turn, creates value for patients.
Along the lines of what I described in a previous blog about how employee engagement can improve the patient experience, empathetic listening is an excellent way for employees in a healthcare system to show engagement and support the patient-centered approach to care. At its most basic, empathetic listening is letting someone know you’re there, you care, and you are willing to help, even if it’s just by being there. It doesn’t have to be structured with a full script of the “correct” words. Empathetic listening is more intuitive than that.
Ask yourself how you may want someone to be there for you when you are hurting or sad. This doesn’t make dealing with grief a one-size-fits-all approach, but it’s a good starting point for showing compassion.
To help you with this process, we’ve put together a few pointers.
Listen more, talk less
When someone says, “I know just how you feel,” it typically creates anger in those who are suffering from grief. They often feel this is a patronizing way of making the situation about you. You couldn’t possibly know the history, experience, background, or culture that underpin their reaction to their loss. You can’t. What you can do is empathize and listen. Give them time to cry, release, and talk about how they’re feeling. Encourage them to have this moment without judgement.
It’s about the voice of the patient, and not you. For this moment, let the world revolve around them. Everything they are sharing is important.
Pay attention to what’s not being said
Humans give many non-verbal cues. For example, being hunched with arms across the chest could possibly mean an individual is on the defensive or protecting themselves. Are they silently crying but saying nothing? Then don’t feel like you need to fill the space with words. You may be much more helpful simply by being there and placing a tissue within reach. A simple “I’m here,” or “I can listen if you want to talk, but I’m here even if you don’t,” can go a very long way.
Context, context, and more context
You might understand the literal words the person is saying, but also try to understand the context of the words, too. “I’m hurting” tells you one thing, but this statement in response to the question, “How are you holding up?” says they aren’t “holding up.” With empathetic listening you must give the person your undivided attention and remember what has been said to you. It’s a process many don’t use, but is essential to healthcare.
Be a mirror
You are reflecting the patient’s emotions. This doesn’t mean you have to shed tears with them if they are. But you shouldn’t look unconcerned or as if you’re dispassionately talking about the weather. You should be able to repeat their thoughts or what they’ve said in summary if asked. This is how you know you are actively listening and taking part. Interject when appropriate with small summarizations of a statement before you ask a question about it.
Give them time
This is true throughout the grieving process. You can have check-ins with them when they are no longer in your building. During the initial conversation, don’t rush them. There is no set schedule for when someone will be better or “okay.” In fact, when it comes to grief, it’s okay to not be okay. As long as the patient feels you are with them along the journey, it’s good.
Empathetic listening and patient experience
The stethoscope is designed to listen to sounds produced in the body. Be your patients’ emotional stethoscope and carefully monitor what they are saying or feeling. You are the first line of defense and support when there is an ailment, but some patients may not have a support system helping them through their hour of need.
Because the patient experience is about what your patient feels overall, it’s important to make it the best you possibly can, no matter the situation. Through empathetic listening, you can show you patient they are a valued members of your healthcare system, not just a revenue source.
Grief isn’t easy for anyone. In fact, healthcare employees experience grief with the loss of their patients as well, and this can affect the patient experience, too. Make sure you are equipped to deal with grief as you work with your patients.
Sogolytics has excellent tools to help you gain feedback about what your patients are experiencing. Omnichannel feedback, HCAHPS-approved surveys, and more can help you understand what they’re going through.
If you want to learn more about capturing the pulse of your patients’ emotions and sentiment — and know where to take action on what they are saying —find out more here.