But if you're too serious or too busy to recognize humor in your workday, then you and your patients are missing out on something powerful. Humor can be helpful in establishing rapport, relieving anxiety, communicating messages and caring, enhancing healing, and providing an acceptable outlet for anger and frustration. Humor carries less risk if it is gently self-deprecating, is externally focused not directed at the patient , is not used as the sole means of communication, is grounded in empathy, and is reciprocal.
When using humor, remember that there are three types of people: those without a sense of humor, those who enjoy humor, and those who generate humor. If you sense the patient lacks a sense of humor, forego this recommendation; humor will only make the patient angry. If you lack a sense of humor, forego this recommendation; you won't be funny. For everyone else, be discerning but please give yourself license to laugh a little. Show some empathy. As discussed earlier, psychologist Carl Rogers included understanding, or empathy, as an important ingredient in communication.
I've put empathy in its own category, however, because I believe it is so vital but so seldom practiced.
For example, patients with highly empathetic physicians have been shown to have better glycemic control and LDL levels and cold symptoms that last two fewer days than those of patients whose physicians are less empathetic. Being empathetic usually involves making an explicit comment concerning the patient's feelings or experience. I can't imagine how devastating this must be. Making a mental note to be explicitly empathetic is important because medical training and medical culture can sometimes erode empathy. For example, you may have learned over the years to consider subjective information as suspect or to disconnect from a patient's experience to ensure technical proficiency during an unpleasant or painful procedure.
By being explicit in your understanding, you communicate your receptiveness to the patients' concern, which may encourage the sharing of more personal, clinically important information. Although no empirical tests have verified the thesis that using these seven strategies will enhance your practice of the art of medicine, the behaviors recommended are based on empirical data.
They incorporate a patient-centered approach to communicating with patients, which has been shown to improve health outcomes, increase patient satisfaction, and decrease malpractice liability. In so doing, you may uncover those changes in perspective, connections with patients, and experiences of making a difference in another's life that bring meaning to your work.
The science of medicine has wrought miracles in the prevention, diagnosis, and treatment of disease. But the art of medicine remains the medium through which illness and suffering are relieved and becomes paramount when biomedicine runs its course and has little to offer the patient. By practicing the art of the consultation, you just might rediscover and nourish the altruistic motivations that called you to be a healer. Already a member or subscriber? Log in. Patient satisfaction with time spent with their physician.
J Fam Pract. Soliciting the patient's agenda: have we improved? Relationship, communication and efficiency in the medical encounter: creating a clinical model from a literature review. Arch Intern Med. J Gen Intern Med. Thousand Oaks, Calif: Sage Publications; Sequenced questioning to elicit the patient's perspective on illness: effects on information disclosure, patient satisfaction, and time expenditure. Fam Med. Cassell EJ. The nature of suffering and the goals of medicine.
N Engl J Med. Recognizing suffering. Hastings Cent Rep. McWhinney IR. Beyond diagnosis: an approach to the integration of behavioral science and clinical medicine. Rogers CR. The necessary and sufficient conditions of therapeutic personality change. J Consult Psychol. A preliminary study of the effects of repeated massage on hypothalamic-pituitary-adrenal and immune function in healthy individuals: a study of mechanisms of action and dosage.
J Altern Complement Med. Human touch effectively and safely reduces pain in the newborn intensive care unit.
Pain Manag Nurs. Wender RC. Humor in medicine. What role can nurses play in improving the care of the dying? Specifically, nurses can contribute to fundamental reform of systems to provide end-of-life care by: Developing creative partnerships with patients, health care professionals, policy makers, and others to make care of the dying a priority. Documenting the comprehensive needs of dying patients and families and identifying individual, professional, organizational, and societal barriers to quality end-of-life care. Participating as members of interdisciplinary groups within specialty areas, institutions, or communities to devise specific solutions to address barriers and develop standards for quality end-of-life care in particular those that address pain and symptom management, holistic care coordination, psychosocial support, and system management.
Advocating for systems of accountability for comprehensive and holistic end-of-life care that includes professional guidelines, protocols, and standards to meet the needs of the dying. Articulating threats to the provider-patient relationship and advocating for systems of care that protect the patient-provider relationship, particularly at the end of life. Participating in the development of interdisciplinary pre-service and inservice curriculums that provide students and practitioners with the tools and skills necessary to provide optimal end-of-life care.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
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