Using Positive Story

•Goal: Use positive story to help people connect with patients and others, bringing out the best in caregiving effort

•Technique: When introducing a patient to the care team through the HPI or handoff first sentence, use information that frames the patient’s “story” eg “this is an 88 y.o. member of the ‘greatest generation who needs your help’ vs ‘this an 88 y.o. w male’

•Evidence:  An analysis by psychologist Mar of 86 fMRI studies concluded that there was substantial overlap in the brain networks used to understand stories and the networks used to navigate interactions with other individuals — in particular, interactions in which we’re trying to figure out the thoughts and feelings of others. This capacity of the brain to construct a map of other people’s intentions is called the  “theory of mind.” Narratives offer a unique opportunity to engage this capacity, as we identify with characters’ longings and frustrations, guess at their hidden motives and track their encounters with friends and enemies, neighbors and lovers. Mar RA The neural bases of social cognition and story comprehension. Annu Rev Psychol. 2011;62:103-34..

 

•Suggestions for Use: use each time you handoff or introduce  a patient on rounds.  Find 1 or two WORDS to describe this patient as a person to the care team.  (teacher, mother of four, carpenter, veteran)

 

•Barriers and how to overcome: We have developed an impersonal, story-deficient culture in health care that impedes our empathy.  It takes discipline to overcome the customs of communication that strip patients of their humanness.  Use with each patient, each set of rounds or handoffs. Remember, “professional” communication means compassionate communication.  Stripping people of their humanness in our communication is NOT professional.