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I recently went toe to toe with a new grad who had made a mistake in judgement, was passing the pt off to me in report, and I pointed out her mistake and tried to correct her. Let me preface this anecdote by saying, I'm normally very mellow with the new nurses, I definitely don't relish putting them in the hot seat.
She became very argumentative. But, what really then infuriated me was that she then pulled out some scripted, active listening lines on me. "I'm hearing what you're saying" and crap like that. Yeah, Pumpkin, I took the same classes way back when, you aren't helping your cause...
I said "So now you're patronizing me, eh?". Arrogant little brat.
Lesson for the allnurses audience? Don't pull out that scripted nonsense on your coworkers, or actually anyone with an IQ over 100 for that matter. That's my advise for the day...
What I think is really funny about scripted responses is that they are very similar to the cultural standards of double talk communication in the South.
I was trained to talk that way to stupid people, and everyone who hears those phrases in the South KNOWS that you think they're stupid.
It's like "Bless your heart," raised to "Oh, that's too bad," and called with "What would your momma say?"
For those unfamiliar, BYH is an expression that is very condescending, when it is not sincerely meant, and implies that you are dumber than dirt.
"Oh, that's too bad," means "What the heck did you EXPECT to happen, dummy?"
"What would your momma say?" means "You are going straight to HELL, do not pass GO, do not collect $200. I am so offended that I can't speak to you anymore."
So, for example, if you use that "I have the time" crap, Southerners actually hear, "My boss will fire me if I don't say this. Please don't ask me for anything else because I am hours behind."
I think it's funny when they come up with this think tank stuff that is so culturally incompetent.
In psych we use a lot of empathetic statements when talking with patients, which is generally what scripted phrases are supposed to sound like. The problem with scripted statements is that they're, well, scripted. If you're taught to say, "I hear what you're saying," when someone complains, but you don't have the skills to actually listen and follow through with a meaningful conversation, so you just come up with some smart butt response and then stick, "I hear what you're saying, but..." on the front of it, that's annoying.
I try not to use, "I hear what you're saying," because it's stating the obvious, but you can say those types of things in a way that's not condescending or annoying, too. It just requires putting your brain in gear before putting your mouth in motion, and actually wanting to have that conversation, rather than letting a canned phrase tumble out of your mouth while you think of something snarky to say.
It seems like "corporately mandated scripting" and "therapeutic communication" are being used interchangeably here when they're really two different things. Scripting is an absurd waste of time, while therapeutic communication is a legitimate tool.
I have de-escalated many a tense situation by simply listening to whatever the problem patient's irrational concern du jour was, nodding my head, and offering some non-committal sympathy, and then re-directing them to do whatever it was I wanted them to do in the first place. That's therapeutic communication.
I am a new grad who thought there was something wrong with me when I was put off by scripted responses at work. There is someone who clearly uses scripts when communicating. She probably means well, but it gives me the feeling that she is a phony and I can't trust her. It comes off as so disingenuous. It's interesting that the very scripts that are supposed to make another person feel comfortable and validated can actually have such an opposite effect. This is especially the case when the scripts come from classes everyone else took too. I have never heard or seen two people use scripts on each other in the same conversation. That would be interesting.
sjalv
897 Posts
The issue with society is one half prefers that disagreeing statements be prefaced with these apparently positive statements, and the other half just sees them as disingenuous and prefer direct statements, even if confrontational. One cannot win.