FEEDBACK: Using medical jargon ("infection control practices") confused Joe. It's important to use plain language when speaking with patients.
TINA: You'll need to practice frequent hand hygiene.
JOE: You mean... washing my hands?
TINA: Exactly.
JOE: Well, then... okay. I'll wash my hands.
TINA: And, a lot. You'll definitely want to wash with soap and water after using the restroom, being out in public, and before eating. Frequency of hand hygiene is key
JOE THOUGHT: "Hand hygiene"? I mean, I know what it means... but who says that?
TINA: To make sure your hands get really clean, we recommend scrubbing-- a really good, sudsy scrub -- for at least as long as it takes to sing Happy Birthday, twice.
JOE: (jokingly) Well, my grandson will love helping me with that
TINA: I'll bet he will! And if soap and water aren't available, you can use an alcohol-based hand sanitizer
JOE: Can do.
TINA: You'll remember to wash your hands a lot, right?
JOE: Uhh... sure.
TINA: Great.
FEEDBACK: Next time, try an approach that provides more than a yes or no answer and encourages him to open up about questions he may have.
TINA: Before we move on -- tell me Joe, what are the three main steps you'll take to help avoid infection during treatment?
JOE: Uhh... the flu shot, which I got. I need to... wash my hands more often, sing two Happy Birthdays, which is definitely a lot longer than I take now. And... uhhh…
TINA: (a friendly hint) Someone's... coughing?
JOE: Ah! And stay away from anyone sick.
TINA: You got it!
TINA: Let's talk about the signs to look for that could mean you have an infection.Even if you follow all the precautions, there's still the risk you could get sick,so I want to make sure you know what to look for.
JOE: Alright...
TINA: If there's anything you REALLY need to know, you could call us if you want.
JOE: (not convinced) Oh. Yeah... sure.
FEEDBACK: It's important that patients know they can contact their medical team with ANY concerns at ANY time.
TINA: A temperature of 100.4 or higher is problematic.
JOE: ...Why?
TINA: A fever could be a sign of infection, so it's considered an emergency - you'd need to let us know.
JOE: Yeah. I just... I dunno... I don't want to be a bother or anything...
TINA: Do you have questions about anything else?
JOE: Yeh, uhh... you said stay away from sick people... so does that mean I shouldn't go out? Like, in public?
TINA: You'd be fine to go out in public, just... use common sense, okay?
JOE: Well... yeah. Okay.
JOE THOUGHT: "Use common sense." Well, yeah, obviously. But I've never done this cancer thing before. Everything's... complicated.’
TINA: I'll give you some take-home materials on things like hand hygiene and other infection control behaviors.
JOE: (a little lost) Oh, uhh…
TINA: Yes. I'll also write down the link to a CDC website that has a lot of information about staying safe during chemo.
JOE: Good. Definitely won't remember all of this! Memory isn't what it used to be... (coughs)
FEEDBACK: Using jargon such as "hand hygiene" and "infection control behaviors" confused Joe. Next time try using accessible language.
TINA: Okay Joe- we’ll see you next time, then...
JOE: Alrighty.
That was a sample of the conversation. Here is some feedback on what could have gone better.
Tina struggled to explain the concepts in a way that Joe understood. As a result, he is likely to have low adherence and put himself at higher risk for infection.
Tina used jargon when explaining neutropenia, nadir, ways to avoid infection, and signs of infection. She also missed opportunities to check for understanding and see what concepts Joe was struggling with. This made it hard for Joe to understand the topics and retain information. Next time, Tina should try using more plain language and checks for understanding.
Tina did not reinforce the importance of Joe reaching out to his medical team. Telling Joe he should reach out “only if he had to” didn’t make him feel comfortable reaching out with any question. Next time, she should be sure he knows to reach out to them at any time for any reason.
There were times when Tina was impatient with Joe and did not show empathy for his situation. This made Joe feel unheard and unsupported. Next time, Tina should use more empathetic statements and avoid showing frustration.
Empathy
To hear a more successful conversation with Joe, listen to the next example.