It is a good idea to make sure that your patients and families know that they’ve been heard. As I’m sure you are aware being a good listener and communicator is a skill worth mastering, especially in the Emergency Department where you will undoubtedly be meeting most families for the first (and hopefully) only time. Especially for histories that are layered and complex practicing “reflective listening” can pay dividends.

Simply put reflective listening is a verbal demonstration that  you are paying attention to the patient/parent’s history. The key elements are:

  • Repetition: This shows that you have heard specific details – repeating back key symptoms and points, and choosing very descriptive words is important. For instance, if the parent says pain – repeat back the word “pain.” Using a synonym like “discomfort” runs the risk of minimizing their concerns.
  • Paraphrasing: This makes sure that you’ve interpreted the history correctly, but also respects the parents intelligence and time.
  • Summarizing: This indicates that you got the “main idea,” and in using your own words it indicates that you’ve absorbed everything they’ve had to say.

It is definitely not just parroting or repeating exactly what the parents or patient said to you as that runs the risk of making you seem insincere and robotic. If done right, you are perceiving the main points of the patients history and situating them in the context of the current visit in a way that conveys empathy, understanding and shared decision making. This is definitely a skill, and something that we can all master. Interrupting the patient too early, making assumptions and overly relying on jargon can derail things. Resist the temptation to cut the “rambling” parent off. Many times in the Emergency Department the parent is seeking care after seeing multiple providers over time, especially for longstanding problems. Giving the parent space to talk (or vent) will make it much harder for you to fall into the trap of parroting them.