How To Host A Difficult Conversation?
12 Lessons That Leaders Can Learn From A GP.
With me(left) is Dr Griffiths (right). She is a general practitioner, a trainer in enhanced communications and she works in the regional palliative care team. I’m also very proud to say that she is also my sister.
To her, part and parcel of her working week is to host difficult conversations. It’s a job that I could never do. I am in awe of her and all GPs and those who work in palliative care). For all leaders, her knowledge and experience offers the richest of opportunities to learn.
And as many know, here at the natural leader we work with how to ‘be’ a leader. That means being exceptional and human connection and communication. So we prefer to turn to the ‘real life’ practicing professionals who experience how to ‘be’ a leader, every day. And when it comes to hosting difficult conversations, who better than a practicing GP.
This morning we went on a walk and asked her how she hosts difficult conversations. These are twelve things she pointed out.
- Working with emotion
It’s worth considering that a difficult conversation is any that involves emotion. Be prepared to deal with the emotion first, only when the emotion is spoken to the person will then be ready to hear any other news and support.
2. Set the climate
The ‘communication climate’ sets the tone and a clear focus for both parties to have an effective conversation. Even before you meet, you can set the tone. Perhaps by sending out an early indicator which may suggest how climate may be. For example, by asking ahead of the meeting whether they wish to bring someone with them for support, letting them know it will be a private room, encouraging them to bring paper to make notes.
Also, before you meet, do the preparation. Intentionally choose the right room or the right seating. Think of what you may wish to leave them with or have any support ready that you may want to provide after the meeting.
3. Establish the ’news’
On meeting, the starting point is always to understand the agenda of the person in front of you. Don’t assume what bad or difficult news is (or isn’t) for them. Take time to establish what they wish to understand or what their perspective is on the situation. This fundamentally shapes the whole conversation ahead of you.
For example, to someone who is wary of even taking a paracetamol, being recommended to take a six week course of medication could be considered a ‘terrible’ news.
4. Clarity is kindness.
When you do meet, a gentle start is to refresh them of how you both come to this point This sets a shared ‘emotional field’ which gently creates a safe space for an important conversation.
For example, ‘We’ve spent the last couple of months looking at your breathing because you were finding it increasingly difficult.’
5. Deliver it in small packages.
Provide one simple piece of information, give it plenty of time to sink in. For example, “So the last test you had was a scan at the hospital and you are here today to hear the follow up. “
6. Invite them to conversation.
Actively invite the person that you are with to be part of the conversation. A simple act but so important in making it a balanced conversation and to build the trust.
For example, “would it be helpful if I tell you my thoughts on what we have found?” Or ‘would you like to hear the results?”
7.Use simple language and be honest.
Be really conscious about the language you use. Resist using any professional or legal jargon where possible. This isn’t the time or place for anything other than a human conversation. An example is “We have found a mass and we think there is a possibility that it is cancer.”
8. Not too much knowledge
Ensure that the knowledge you give is in line with what they are expecting to receive. Giving them too much unwanted or additional information will waste time and loose trust and may lead to their disengagement.
9. Pause, pace and perceive.
Use pause. This is not about the comfort of the person delivering the news, it is about the person receiving it. Pause to let the information sink in and allow any response to come into the space. Let them set the pace. Observe and speak to any response. Saying for example, ‘that looks like it was a shock to hear.’ Or ‘that doesn’t seem as though it is a surprise for you’
10. Sit with the silence, if necessary
Be OK with sitting in the silence. If they are looking away, your cue to speak again is when they make eye contact again.
11. Let them break their news.
If the stages above have been followed effectively, slowly and the process and facts have been clear then the person you are with may be enabled to guide to breaking their own news. Letting them do so, in their own words, is more empowering for them and aids acceptance of it.
12. Offer a support and way forward
Summarise and offer ‘tailored’ menu of options and support, relevant to the person infront of you and based on what you have heard in the conversation. This will help them to leave feeling heard, supported and serve to move their focus to their future.