THE FOUNDATION OF PATIENT COMMUNICATION - Part Eleven

by Charly Miller, EMT-P

This page was originally published in MERGInet.com's August, 1999 issue.

In Part Six, we discussed the three "Magic" Words of emergency medicine:

These three Magic Words cannot be said too often! Saying these three Magic Words over and over and over may seem redundant or sound "hokey" to the unenlightened. However, these unenlightened providers will soon observe that our frequent use of these "hokey" words help our patients feel better and improve faster. After noticing that, they'll start using the Magic Words, too!

Learn to stop using the first of two "Evil" EMS Words.

These two Evil Words are used by everyone in EMS - prehospital and in-hospital providers. We're all trained to use them in our clinical training rotations, as we follow the examples of those we observe. These two Evil Words are the product of very deeply ingrained bad-communication-habits practiced by "experienced" care providers throughout the history!

These two Evil Words are often used throughout a single patient contact. Sometimes, the O-Word (addressed in Part 12) is used multiple times within a single sentence!

I've often wondered why the redundancy of frequently using the Magic Words is so disdained by the unenlightened, while the redundancy of using the Evil Words remains completely unnoticed.

Evil Word Number One: The "T-Word" - "TRY"

"Try" is truly evil and must be wiped from the face of the earth. It must never, ever be uttered by emergency care providers - inside or outside the hospital!

"Try" is evil for two reasons.

Reason Number 1 - "Try" implies Anticipation of Failure.

The only time someone ever says, "I'll try," is when they don't think they'll succeed! The only time someone says, "I'll try," is when they think they'll fail.

Let's pretend you're a student and you have a ten-page paper due at the beginning of class tomorrow morning. At this moment, you've only got the outline and the introduction written. But, you're out shopping instead of working on the paper, and you have to work a night shift tonight. While shopping, you run into your instructor.

Your instructor greets you and asks, "Hey, your name here! Are you gonna have that paper ready to turn in tomorrow morning?"

You know that there's probably no way you'll have your paper finished. Even if you didn't sleep between tonight's shift and tomorrow's class, it's probably impossible for you to have it done in time.

So you respond, "I'll sure try!"

Now, let's change the scenario just a bit. You're still a student and the ten-page paper is still due tomorrow morning. You're still out shopping before your night shift, and you still run into your instructor. But, you've got all but the last paragraph finished.

Your instructor greets you and asks, "Hey, your name here! Are you gonna have that paper ready to turn in tomorrow morning?"

You know you'll have the paper finished and ready to turn in. After all, you can write the summary paragraph once you get off-duty, and still get some sleep. There's no doubt in your mind that you'll succeed in finishing the paper and turning it in on time.

So you respond, "Sure! It'll be finished and ready to turn in as soon as I get to class."

No one says, "I'll try" when they know, without a doubt, that they can accomplish something. The only time the word, "Try" is used is when someone anticipates failure.

Therefore, when you ask a patient to "Try" to do something, you're actually telling the patient you think he'll fail to do it!

Think about how susceptible an emergency crisis patient is to suggestion! When you tell a patient to "Try" to do something - when you tell the patient you think he'll fail to succeed - you've just ensured that the patient will fail to succeed.

Reason Number 2 - "Try" implies Extreme Effort.

The only time someone ever says, "I'll try," is when they don't think that success will occur - OR they anticipate that an extreme effort will be required to accomplish something!

The first scenario: Sure, if you managed to write a lot while at work, and then you stayed up and wrote until you had to go to class, you might - with extreme effort - get that paper written in time. So you respond, "I'll sure try!"

The second scenario: Writing the last paragraph - the summary - of your paper will be simple! It will take little-to-no effort at all, because the rest of the paper is completely finished. So, since you know it won't take much effort at all for you to succeed in finishing it, you respond, "It'll be finished and ready to turn in as soon as I get to class."

Some things EMS providers ask patients to "try" to do?

Do any of these require "effort"? No. They require an absence of effort!

It takes energy (effort) to maintain agitation and physical tension. It takes energy (effort) to continue thrashing about. It takes effort to remain nervous or to keep breathing rapidly.

When you tell someone to "try" to stop doing anything - besides implying that they'll fail - you also imply that it will take enormous effort for them to stop.

Instead of using the Evil "T-Word," Give patients PERMISSION to succeed!

Giving patients permission to do something works ten times better - and faster - than telling them you think they'll have to exert extreme effort to do something, and that they'll likely fail anyway.

Hence, getting rid of the Evil "T-Word" by giving patients permission, ensures that the patient will succeed, and with no effort whatsoever.

What about when a patient responds to our PERMISSION by saying, "I'll TRY" or "I'm TRYING!"?

Nip this evil attitude in the bud!

A patient who says "I'll try!" is actually saying "I'll fail," or "I'll exert a whole lot of effort and probably fail!" Neither of these create a positive patient attitude. Thus, neither of these attitudes encourage success or an improved condition - no matter how well we provide medical care!

SUMMARY:

The word, "Try," is EVIL. Especially in emergency care, the Evil T-Word only effects patients in a negative manner, and it must be wiped from the face of the earth. Certainly, it must never, ever, be used when addressing a patient.

Remember to follow-up the patient's cooperation and success with frequent use of the Magic EMS Words: Please, Good, and Thank You!

In Foundation of Patient Communication Part Twelve, we'll discuss Evil EMS Word #2 - "The O-Word!"

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