The Power of Words: 5 Phrases to Use With Patients and 5 to Avoid

      After many years of interacting with people in emergent situations, I have found phrases that have an almost magical ability to build rapport with patients and phrases that can destroy communication just as quickly. Here is my list of what you should and shouldn't be saying when it comes to patient communication.

FIVE MAGICAL PHRASES

   Try using the following phrases and watch how much easier it becomes to avoid conflict and develop rapport with even the most difficult of patients.

"LET ME SEE IF I UNDERSTAND YOU CORRECTLY."

   If you ever want someone's undivided attention, try repeating their own words back to them. Nothing frustrates people more than feeling misunderstood, disregarded or ignored. When you see your patient becoming agitated, try starting with this phrase. When you do, you send several important messages. You tell them that you are listening, and you show them that you care and that their input is important. You also confirm your own understanding of the situation and open the door for your patient to listen to you. When people feel that they are respected and understood, they are more likely to listen.

"I CAN SEE WHY YOU MIGHT FEEL THAT WAY."

   This is the phrase of empathy. Empathy literally means to see through the eyes of the other and it is the most powerful tool in your communication arsenal. When you use this phrase, you remind yourself of what it means to be empathetic. Notice that you do not need to agree with someone, approve of their behavior or even like them to say this to them. All you are saying is that you can see why they might feel the way that they do. When you make this gesture, your unspoken message is that you have taken the time to see the situation through your patient's eyes.

"WHICH WOULD YOU PREFER?"

   The more choices people are given, the more they feel in control of a situation. Whenever time permits we should ask our patient what their preference might be. It doesn't matter if we are asking about which hospital they would like to be transported to or which color slippers they would like to wear, when we take the time to ask, we send the message that we care.

   It's important to note that the more control we take away from a person, the more we need to emphasize the options they do have. Even an uncooperative individual who has been restrained can make some decisions about their position of comfort, family notifications, etc. The more options we can give an individual, the more likely they will be to cooperate with those elements they are not in control of.

"I AGREE."

   It's not appropriate to tell someone that we agree with them when we don't, however, we tend to rush by the points we do agree on without ever taking the time to acknowledge our agreement. It's as if we have a switch in our brain that says, "OK, we've agreed on this point, let's get on to the next one." Take those opportunities to acknowledge your agreement before moving on to the next point. Those are powerful moments in building a rapport, so don't miss out on an opportunity to look a person in the eyes, smile and say, "I'm glad we agree."

"FOR YOU."

   Everything we do is in the service of the patient, but let's face it, they don't always feel that way. When you sense that the patient is beginning to feel like we are imposing our will on them, try using phrases that end with "for you." For instance, instead of saying, "Sit down on this pram," you might say, "We've brought our pram to the door for you." "I'll lock the door," becomes, "I'm going to lock the door for you."

   For you statements remind the patient that everything we are doing is meant to serve them. It's a gentle reminder to the patient that we are acting in their best interest. After a few "for you" statements, you may be surprised to find patients who were begrudgingly complying with your requests thanking you for your efforts.

FIVE WORDS AND PHRASES TO AVOID

   Just as there are phrases that have a magical ability to build rapport, there are phrases that can tear it down just as quickly. It is far easier to lose trust than gain it. When you sense conflict building between your patient and you, avoid using these common words and phrases, which tend to be verbal landmines in the field of human disagreement.

"CALM DOWN."

   I've never understood why we continue to say this to agitated people. I've never actually seen anyone calm down simply because I shouted, "Calm down!" at them. It's not only a ridiculous thing to say, it's entirely counterproductive.

   If you truly want someone to calm down, there are several more effective options than commanding that they do so. If you ever feel the urge to command someone to calm down, the first step—before you speak—is to take your own advice. Take a deep breath and try saying one of the five rapport-building phrases in a soft, calming tone. See if it doesn't interrupt the patient's pattern. While it doesn't work every time, I guarantee you more success than the classic calm down command.

"LISTEN."

   There's nothing wrong with the word listen itself. What makes listen a damaging word is when we habitually use it to interrupt people while they are speaking. We could also add the words hey, look and wait to this list. I'll be the first one to admit that it is sometimes necessary to interrupt people while they are speaking, but there is a better way to do it.

   Do you have a habitual word that you use to interrupt the patient in mid-sentence? If you do, I would suggest replacing it with the patient's name. I have found that the only polite way to interrupt someone is to say their name and then immediately follow it with one of my rapport-building phrases, preferably, "Let me see if I understand you correctly."

"WE CAN DO THIS THE EASY WAY OR THE HARD WAY."

   Explaining to the patient that they have multiple options is a useful persuasion tool. The problem with this phrase is that we forget to recommend or even suggest that the easy option is also the better option. This phrase is counterproductive because it is often interpreted as a challenge. I find that when we offer options in this kind of tough guy manner, too many patients opt for the hard way.

   A better way to use this strategy is to sell the patient on the easy way. Let them know that you want them to pick the easy option and let them know why. For a patient who is unable to refuse transport, you may say something like, "Mr. Jones, I can see why you might not want to get checked out at the hospital tonight, and if you come along cooperatively we can make you comfortable and get you back home as fast as possible."

   Now instead of challenging the patient, we are selling the benefits of choosing the easy option. When we present these kinds of easy way/hard way options to the patient, it's important to clearly spell out the benefits of the easy option and politely ask the patient to chose that option.

"I PROMISE."

   In essence, all promises are empty promises. When you make a statement or a commitment to a patient you do so using words. A promise is nothing more than additional words.

   There are two good reasons to avoid saying "I promise." The first is that it is pointless. If the patient didn't believe your words, they have no better reason to believe your promise. The second is that a promise often erodes trust. When we say "I promise," our unspoken message is that our words by themselves are not enough to be trusted without something additional. If you feel you can guarantee an outcome, say so and say no more.

   Another powerful, though counterintuitive, way to gain someone's trust is to admit when the outcome is uncertain and say something like, "I can't promise you this, but I'll do my very best." When we admit that an outcome is uncertain, we build trust. Our unspoken message is that we are willing to be honest about uncertainty. Saying, "I can't promise you this," reminds the patient that many things in the world are beyond our control and we are willing to be authentic about that fact.

"BUT..."

   When you are disagreeing with a patient or presenting a conflicting point of view, see the word "but" as your enemy. The word but basically invalidates everything said before it. When you say, "I agree, but…" or, "That's a good point, but…" you are saying, "Now I'm going to contradict myself and invalidate what you just said."

   A much better way to present your thought without invalidating the patient is to use the word and. Now you can say, "I agree and I also think it's important that …" or, "That's a good point and another good point to think about is…" Now you're recognizing the patient's view and adding your view to it instead of invalidating their point with the but word. You'll find that people are far more receptive to you if you banish but from your conflict vocabulary.

CONCLUSION

   While the many techniques of influence and persuasion may seem complicated, keep in mind that the fundamentals of communication are simple. Smile and introduce yourself. Be honest, likable and empathetic. Treat people with dignity and respect. Soon you will find that your ability to persuade and influence others positively flows as much from who you are as from any phrase or technique you've learned.

Bibliography

   De Becker G. The Gift of Fear. New York, NY: Dell Publishing, 1998.

   Hogan K. The Psychology of Persuasion: How To Persuade others to Your Way of Thinking. Gretna, LA: Pelican Publishing Company, Inc., 1996.

   Lieberman D. Get Anyone To Do Anything and Never Feel Powerless Again. New York, NY: St. Martin's Press, 2000.

   Thompson G. Jenkins J. Verbal Judo: The Gentle Art Of Persuasion. New York, NY: HarperCollins Publishers Inc., 1993.

   Robbins A. Unlimited Power. New York, NY: Simon and Schuster Inc., 1986.

   Steve Whitehead is a firefighter/paramedic with the South Metro Fire Rescue Authority in Colorado. He is a primary instructor for South Metro's EMT program. He can be reached through his blog at www.theemtspot.com.