Where listening meets caring

CSHP’s Pharmacy Practice in Hospitals and Other Collaborative Healthcare Settings: Position Statements (2016) states that “the core concepts of patient-centred care are compassion, respect and dignity, information sharing, participation, and collaboration.” Seeing the person as more than a patient, being empathetic, and seeing their care as the person sees it are also important. Doing so takes into account their “values, lifestyle, social and family situations, and opinions and ideas about their care.” How does this begin? With a conversation between the person and healthcare professionals.

Listening to a person’s story about their experiences with and expectations for their healthcare is key to excellence. When treatment involves medications, as it often does, it is critical to have an accurate record of what medications the patient is on or has recently taken. That information needs to be complete, accurate, up to date, and accessible in the person’s health record. What does that mean? It includes information about all medications a person is actually taking, whether they were prescribed for the person or not. It also includes information about any bad reactions a person has had with medication or foods, such as allergies, and what problems or successes the person has experienced with the current or previous related treatments. Coupling that information with what is known about the whole person (not just the disease or current health problem) helps the pharmacist to work with the patient and other healthcare professionals create a medication plan that should work for the patient (and not just the disease).

People should feel comfortable speaking with their pharmacist (or other healthcare professionals) about medications and their goals for treatment. Feeling listened to and cared about can help a person open up to tell their story and to ask questions. That can be difficult, though, when the environment is foreign, when there is a lot of worry and stress about unknowns, when there is a feeling of loss of control, or when privacy isn’t readily available. And, sometimes patients are not able to speak to the pharmacist (or another healthcare provider) about their medications. In those cases a family member is usually asked to help out. As well, other sources of information are often relied upon such as provincial drug information databases to reconcile information about the person’s medication treatment, but that’s only part of the story.

When a person’s story is valued, so is the person. (Or is it the other way around?) It is important to listen whole-heartedly, without any assumptions about how the person’s story of their health will unfold. A story isn’t known until it is shared, and one person’s tale isn’t necessarily the same for another. Listen attentively, ask questions to gain a deeper understanding of what is being said. Be empathetic. And when information is shared, check for understanding using ways other than questions that prompt a yes or no answer. Show that you are listening by practising active listening. Listen with your ears, your eyes, and your heart. Watch how the person’s behaviour changes as they speak: what is the behaviour telling you? And, be just as mindful of your behaviour–are you paying more attention to your phone or to other things around you than the conversation. You think you look like you’re listening, but are you barely only hearing? Remember there’s a difference between listening and hearing: you can buy a hearing aid but you can’t buy a listening aid. After a conversation is over, reflect on it: what worked really well, what got in the way of making it better, and remember to apply what you learned to improve the next conversation.

When patients and healthcare professionals work together, good things happen. An encouraging trend is the inclusion of patients on committees and working groups within health care systems; this is leading to large-scale change, but more needs to be done. In terms of medication therapy for individuals, it should mean the patient receives care that is clinically appropriate, safe, and cost-effective, and is based on the best available evidence.

External Resources

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What is Shared Decision Making? 

Decision Support Toolkit for Primary Care

Patient Decision Aids Implementation Toolkit

Shared Decision Making Aids

Mayo Clinic Shared Decision-Making Tools

The Ottawa Hospital compiled list of Patient Decision Aids

Cincinnati Children's Decision Aids to Facilitate Shared Decision Making in Practice

Communication Skills Resources

How to really listen - course by P3 pharmacy *have to register for a free account*

Harvard T.H. Chan School of Public Health - Plain Language Glossaries

Harvard T.H. Chan School of Public Health - Health Literacy Resources

Agency for Healthcare Research and Quality - Universal Precautions Toolkit