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'What do we really mean by listening?'

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Over the last few weeks I have found myself wondering what I would do if I had a child with a similar condition to Charlie Gard, the terminally ill baby whose parents unsuccessfully challenged Great Ormond Street Hospital for the right to take him to the US for experimental treatment. Would I grasp at every possible treatment or accept the professional judgement of the team caring for my child?

The case has reminded me of the complex issues nurses deal with every day and highlights that medicine and nursing are not exact sciences. We all know that clinical decisions should be based on evidence but sometimes the evidence is weak. Even when it is strong for a particular intervention, related factors such as comorbidities and the opinions of patients and families have to be considered. This is where the knowledge, experience and clinical expertise of nurses and other members of the multiprofessional team are vital.

Health professionals need to help patients and their families understand the rationale and implications of treatment options – particularly when difficult decisions need to be made. I know from experience that this is not always easy. Families often want clear-cut answers and being unable to provide these can lead to anger and frustration.

The partnership between health professionals, patients and families depends on all parties listening to each other. This is easy to say but what do we really mean by listening?

”Being a good listener is not easy, particularly in busy clinical situations”

We all know someone who is a good listener. They do not interrupt when you are telling them something – or trump your problem with something worse, and they give you their undivided attention even when they are busy. Being a good listener is not easy, particularly in busy clinical situations but it is a skill that has to be learnt and needs to be practised regularly.

In this week’s archive issue we focus on learning how to listen, with a two-part series that looks at how to improve your listening skills and practising your skills. In part 1 the author takes us through the SAGE and THYME model for listening; part 2 provides practical exercises.

The third article in this issue explores patient narratives – what we can learn from patient stories and how we can use these to reflect on and improve practice. This article provides scenarios and points for reflection and forms part of a seven-part series that looks at different aspects of patient care including consent, empathy, professional boundaries and power and empowerment.

What is clear from the three articles is that good listening skills can have a positive effect on individual patients’ wellbeing and that listening and reflecting on what patients tell us can help us improve care.

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