October is Breast Cancer Awareness Month, a time when patients with breast cancer and their loved ones experience a variety of emotions and memories. Breast Cancer Awareness Month can be a time of remembrance for those who have lost a loved one, a time to celebrate remission, or a time to face the reality of life after a breast cancer diagnosis. Whatever the situation may be, breast cancer affects everyone differently, and it is important to meet those impacted at the places where they are mentally and emotionally, including the way they describe their situations.
The first step to effective communication is listening.1 Active listening is the highest level of listening; it involves paying focused attention to what is being said without interruption, without interruption, without judgment, and with interest and understanding.2 Effective active listening is crucial to get a sense of how we can better help patients and establish rapport and trust.3
Active listening also involves assessment, making sure we heard and understood what was said correctly and checking for understanding by repeating to the speaker what we heard. Although we often believe understanding is instant and simple, sometimes deeper meanings are missed. I will never forget the moment when a patient stated, “It’s Breast Cancer Awareness Month and I feel like I was diagnosed all over again.”
This patient had been in remission for 17 years, so one might have expected relief or a lack of heavy emotion. However, after assessing her statement and seeking explanation, I realized that she was experiencing the same emotions she felt when she was first diagnosed. This year she was not in the spirit to celebrate remission as she usually was in October. She also felt guilt due to the expectations placed on her as a “survivor.” Examining her statement allowed me the opportunity to understand what she was feeling, and it increased my knowledge of her emotional state.
Assessment leads to correction if a misunderstanding occurs, which can lead to the creation of trust for further dialogue. In this way we can better serve our patients.
Choosing Words Wisely and Providing Support
The words we use are as important as the way we listen actively and attentively. Serving patients is a daily task for those in the health care field, especially the nurses who do so intimately; but in our routines, it can be easy to forget the unintended power of simple communication. The words nurses use can certainly strengthen patient/worker connections and foster further communication and trust.4 However, common words and phrases can easily have unintended and detrimental effects, words such as warrior, journey, and survivor.
On their face, these words seem to have very positive meanings, but they may not match the emotional environment of the person you are addressing. So in our longing to make patients feel better, we wind up using words that have negative impacts in times of crisis. Neutral terms contribute to an openness in how our patients can express themselves and can create a safe environment for more personally tailored communication.5