by Marion McCrary MD FACP
You want to help your colleague who is struggling but are afraid you will not have the right answers for them!
What can you do?
Stop, look and listen: Physicians will often bring their expert hat to these conversations and can be prone to interject solutions just like they would in the exam room. Due to our analytical training, it is not natural for many physicians to simply be present, listen to understand, ask open-ended questions, and express empathy instead of sympathy.
Listening to Understand
Stephen Covey describes five levels of listening in his book Seven Habits of Highly Effective People. The lower two levels are when we ignore the speaker or just pretend to listen. Selective listening is one step up. In this category we often are looking for certain information and when we start to lose interest, we miss part of the message.
Attentive listening is the fourth level where we are focused on the other person in the conversation, allow them to finish what they have to say, and ask follow-up questions. This type of listening can be valuable in peer support but can still be superficial.
The highest level of listening is termed empathetic listening.
Here the listener again is focused only on the speaker and through careful listening starts to understand the feelings behind their words. The listener is mostly silent and does not make assumptions. By coming to this conversation with a beginner’s mind we see things through the speaker’s eyes and treat it like the first time we have ever encountered this.
This is where we often feel stuck. We have been a good listener but what do we say now?
How do we help?
Reflecting
Reflecting back the emotion and the need you just heard from your peer’s words is a powerful validation and expression of connection. Using the formula described in Non-Violent Communication you state the emotion you observed and the need the speaker expressed. Sometimes the need is noticeably clear because they explicitly say it, but sometimes you may need to infer it.
“I hear the frustration you have due to your team member’s lateness. You need them to be on time so you can see your child before bedtime.”
“You are overwhelmed by the number of admissions daily. You need some support to be able to appropriately take care of these patients because you highly value the work you do.”
Then pause. Give them a chance to respond. It is ok to have some silence to allow your colleague to process what you just said.
You may have hit the nail on the head, and they respond with a thoughtful “yes.” If you slightly missed the mark, they have the opportunity to clarify and even deepen the conversation.
Notice, in this method of conversation, you do not have to supply a solution with your reflection or in the next step when asking a question.
Using Specific Phrasing of Open-ended Questions
We have been taught to use open ended questions with patients and we are intermittently good at that. We often interrupt after we have asked our question, or the question is more to help us decide what we need to know. Try to approach your questions to your peer in a way that helps them determine their own solutions. They know the best way forward for them.
Start these powerful questions with either “what” or “how.” Stay away from sentences that start with “why” because they can sometimes come across as judgmental.
“What would help you feel more in control in this situation?”
“How would you like this to go?”
“What type of support would you like to see?”
If the colleague specifically asks you to tell them what to do, defer by asking “first, what ideas have you considered already?”
By using skillful listening, empathetic reflections, and specific open-ended questions, you can support a peer without having to know all the answers. In doing so, you have strengthened your connection and empowered them to produce a solution that is right for them.
Start practicing today. Your colleagues need you!
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