LAUSR

Communication skills for a caregiver, medical as well as nursing, are of utmost importance in providing quality emergency care. The Institute of Medicine in 2001 described “patient centered care” as one of the pillars of quality in healthcare. Effective communication between the patient and provider is integral to patient centered care [1]. Patient and family satisfaction are directly related to the quality of timely and effective communication between clinician and patient’s family [2–9]. The most common reasons for litigations and complaints in any leading medical center are related to poor communication and inappropriate conduct of healthcare givers rather than perceived sub-optimal treatment. There is no doubt that government medical facilities are often overwhelmed at all levels of care. The situation is further compounded by the lack of formal competence-based training in human factors. A multitude of reasons such as high volume of critically sick patients, perpetual shortage of trained staff, lack of availability of senior personnel especially at odd hours and inadequate facilities at primary and secondary levels make most emergency departments a challenging area to provide adequate communication consistently. Time is always at premium. Medical and nursing staff in a tertiary care emergency department (ED) are always overstretched and over-burdened. In such settings, it becomes all the more important to provide information that is accurate, valid, razor sharp, empathetic, considerate and crisp. A timely and efficient process of communication has to be evolved for such scenario especially in emergency which is often managed by resident doctors. It should not appear as a distraction by doctors and nurses from the vital clinical tasks that they must perform. The communication skills are all the more relevant in a busy ED especially in lowand middle-income countries, where any illness is a social event and huge crowd can visit hospital at the time of emergency. The need for an effective crisis communication strategy can be highlighted in the following four points. Firstly, the patient is often acutely and critically sick, leaving little time for a detailed explanation. Secondly, the situation of the patient is often rapidly changing that require more frequent monitoring and interventions. Thirdly, the diagnosis is often not clear during the primary survey when a patient is being assessed and simultaneously resuscitated on the basis of physiological derangements. On top of all these, the patients and their accompanying family members are, not surprisingly, extremely anxious. The atmosphere is often so charged that the reports of violence and skirmishes are common occurrences. An observational study from Australia demonstrated the need for better training in communication for emergency personnel as shown by the analysis of 1286 distinct communication episodes [10]. A number of exemplary consultants/attendings set up an example for resident doctors and interns in purposeful and effective communication. However, not everyone is so lucky to have worked in a clinical department that provides opportunity to learn communication skills. Though there are individuals who have inherent power of communication but for the majority health care providers there is an urgent need for structured mandatory training in communication skills across all disciplines. The authors believe that the development of good quality communication skills would not only improve patient care and family satisfaction but also enhance the job satisfaction of doctors and nurses working in the emergency settings. Having * Akshay Kumar [email protected]