Communication and working relationships in sport and fitness
Communication and working relationships in sport and fitness

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Communication and working relationships in sport and fitness

1 Applying your learning: learning from doctors

You start by dropping into St Mary’s Hospital in London, where four exhausted doctors discuss whose operation should proceed.

Activity 1 Doctors meet about their operations

Timing: Allow about 15 minutes

A bit of background is needed for this short clip. Consultant Simon Ashworth (seated in his office) controls the Intensive Care (IC) bed spaces, which are needed by other doctors for their patients recovering from operations. He has one bed remaining and two doctors, George Hannah and Richard Gibbs (he remains largely silent), who need the IC bed confirmed for their operation to proceed.

Watch the clip: how does Ashworth’s communication approach maintain his professional relationship?

Download this video clip.Video player: e119_2018j_vid020c-640x360.mp4
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Transcript

LESLEY POWLS
Hello.
GEORGE
Hi.
FEMALE STAFF
Hello.
LESLEY POWLS:
Hello. Hi Simon. It's alright,I thought I'd pop up and see what we can do to help.
SIMON:
I have very few options. And what worries me is we've got no slack for the unexpected that is the norm here.
LESLEY POWLS
Well, I don't want to do Simon, is put you guys under loads of pressure.
SIMON:
I think we're asking for trouble if we try and do...
GEORGE
Yeah, but we are-- we are trying to work out.
SIMON:
George, if you can operate... if you could do it tomorrow, I think the chances are better.
GEORGE
Yeah, but I think …
LESLEY POWLS
I mean, we certainly will - what you can - whatever you've send down from ITU, we will create beds to allow that to happen.
GEORGE
But Simon now is try to keep an empty bed so just as a slack for something to happen.
LESLEY POWLS
How long do you think you're going to be with your [INAUDIBLE]?
GEORGE
I will be very late.
LESLEY POWLS
What's very late?
GEORGE
I will - I will take six hours operating. If we go ahead now, we'll finish by midnight.
SIMON
I think the safest thing to do is to defer it. But I understand the logistics of that are a disaster.
GEORGE
It's not just the logistics. There is a clinical issue here because there's a second cancellation with a dedicated time chemoradiotherapy. And w are not going him to keep a slack in a system that doesn't have the slack.
SIMON
All I'm saying is I've got no ability to manage any other problems.
GEORGE
If he didn't have a bed, I would have no problems. I can understand it. But if we are not doing him to keep a slack, and while we can use our recovery as an alternative, this is a difficulty I have.
SIMON:
But we're very close to the limit.
GEORGE
We are close to the limit.
SIMON
We're very close to the limit. And I think operating absolutely on the limit is unwise.
GEORGE
The question really if we wait another week or another time, this will not be - I'm not sure how this will get better. Cancelling a cancer patient three times is a serious instance. So this is something you need to work on it.
LESLEY POWLS
It's your call Simon. What would you want us to do?
SIMON
You know, we don't have the slack at the moment I don't think to do this safely. We are stuck at that point.
RICHARD
OK. That's fine, sir. Just - just so - so from my point of view, if the option won't get here, we'll do it anyway.
SIMON
We need to get on with whatever we do.
RICHARD
We are where we are.
SIMON
And we'll - and we'll work on the basis that they will be able to give me a bed.

SIREN

End transcript
 
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Discussion

The consultant Ashworth remains calm and tries to explain his underlying values of patient safety that are driving his decision making. Three times he tries to explain the risks of proceeding with George’s six-hour operation as potentially compromising any slack in the ICU bed availability for unforeseen emergencies, e.g. a car crash. He also attempts to show empathy and understanding for George’s situation of cancelling an operation for the second time by saying ‘you know, I understand the logistics of that are difficult …’. Addressing people with their first names and maintaining eye contact to help show that he is closely attending to their messages and trying to connect with them in difficult circumstances. Also notice that at one point, all four people allow a silence of about 3 seconds while they think. Often, such silences can be filled unnecessarily by people feeling uncomfortable and talking. Silence can provide useful space in conversations to reflect on the most appropriate action.

Two of the main lessons from this are first, how those involved maintain a calm consistency in their communication making effective dialogue easier. Second, Ashworth shows good listening skills, including use of empathy and courtesy.

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