Learning to listen

Once, when I was a non-clinical department manager, I received a call from administration advising me that the adult son of one of our patients was irate about the fact that his mother was scheduled to be discharged. The man believed his mother was too sick to go home and was making accusations about the care she received. He was demanding to see his mother’s medical record. The man was referred to me because I don’t think anyone else knew what to do with him. He had been making repeated calls and threats to administration and to the unit where his mother was a patient. It seems that everyone was afraid to let him see the chart because they assumed he was looking to find fault with his mother’s care. We tend to get upset when others are upset and sometimes develop a defensive posture rather then trying to help.

I did not look forward to receiving his phone call, and was somewhat annoyed that the situation has been “passed on” to me. But, of course I had no choice but to deal with it. When the dreaded phone call came, the man introduced himself to me. I could hear the anger and frustration in his voice. I asked him to explain his concerns and questions to me. With that, the man virtually exploded with his whole long story. Since he was so emotional, and clearly distraught, I could do nothing but simply listen to him. There was no opportunity for me to say something, even if I had wanted to. The more I focused on listening to him, the more I could hear the frustration and sense of powerlessness in his voice. He had an objective and had met nothing but obstacles every step of the way.

I calmly and quietly listened until he stopped talking (actually yelling). At that point he became silent for a moment. I remained silent in case he wasn’t yet done. He said “Are you still there?” I replied, “Yes. I’m listening.” With that, his voice immediately became calm and he said in an even tone, “Thank you for listening to me. You are the first person, of all the people I have spoken to about this, that took the time to listen and I appreciate that. Everyone else has had the need to become defensive and cut me off.” The conversation progressed from there. Although the man was still very upset, I was able to ascertain that he primarily wanted to look at his mother’s medical record and this had become a power struggle between him and the hospital staff. Since many staff people didn’t know if it was legal for him to look at his mother’s chart, they kept putting him off, which only infuriated him more and made him think they were trying to hide something. I told him that patient confidentiality was one of our prime concerns and that I needed to check with our director of medical records to see what the procedure was for such a request. I asked if I could call him back and he flatly refused. He demanded an immediate response. He was so frustrated that he also refused to let me put him on hold while I called the director of medical records. I told him that if I could not put him on hold, I would have to put the phone down and walk to that department and try to find the director. He reluctantly agreed to that, but cautioned me to hurry back and not leave him hanging. He was demanding an immediate response and resolution to his request. I cautioned him that the director might not be available, even if I went to her office. He insisted that I try.

Much to my relief, the director was in her office when I arrived. I posed the situation to her and she advised me that he could look at the record as long as his mother signed a release granting the hospital permission to allow him to do so. I ran back to my office to give him this news. I told him we only needed to get his mothers written permission and he could come down and review the record. He wanted to know when. Of course I really couldn’t answer that, but we set a tentative date and time and I assured him I would do everything possible to make that happen. I prayed that all would go smoothly, and in fact it did. We got his mother’s written permission. He came in the next day and  reviewed the record and agreed to have his mother discharged. That was the last we ever heard of him. My listening, patience, and effort to help my other patient, the medical patient’s son, paid off. The bottom line is that not only should you allow someone his or her say, but through concentrated listening, you will be able to really understand what is going on and come up with a solution to the problem.