Tatiana is an emergency physician on the northern beaches of Sydney. She is heavily involved in training and education, at both a hospital and a network level. She looks for any opportunity to redress the imbalance between training doctors to be medical experts, and training them to be good managers and communicators. At SSEM22, Tatiana will be facilitating the Communication Toolbox workshop.
Questions and Answers
The workshop uses actors. That’s different. Why?
Paid actors are always better than… whoever will help. They can switch in and out of roles effortlessly. And interaction is the cornerstone of any good education session.
What’s in your communication toolbox?
Whatever I have gleaned from my journey I guess. I’ve got stuff that I’ve perfected because I am a mother, wife, sister… I’ve got good girlfriends. As you go through life’s challenges you fill up your toolbox. I really wish I could start my own school. Every day you would do a lesson on some kind of communication. It would be conflict resolution, what to say to mean people, how you get past an argument…
So why is that important for emergency clinicians?
We train really well in clinical medicine, but we have very little training in communication. Once we become a consultant, especially with the passage of time, it becomes 70-80% of our job. Managing the parents, managing the patients, their expectations, managing our staff, interactions with them, the exec… it’s so much part of our role, and our clinical role shrinks as we move through. Yet our training is dismal, in something that we need more than anything.
Do you actually rationalise it as a toolbox? Do you rummage around for conversational spanners?
Yes. 100%. On an average shift, how many speeches do you have? I mean they are all a tool aren’t they? For instance the woman who has come in with a miscarriage. Once we have done all the beta hCG and organised everything, I sit down with her on her bed, look up at her and hold her hand and say, it wasn’t the piece of brie that you ate, it wasn’t the smoker you stood next to outside… and then once I get those two sentences out they inevitably burst into tears. It’s just acknowledging them as humans.
Do you use touch?
I’m very tactile. I touch everybody. I tend to sit on beds a lot. If you are anywhere over 60 years old I’ll hold your hand for sure. I am on their level. I don’t want to stand over them if it is an important conversation. The only time I regretted that is when I sat on a patient’s bed and 3 days later had Norwegian scabies on my butt.
Have masks got in the way?
I personally don’t think they hamper much on an interpersonal front. We can still talk and laugh. I do find it hard when team leading a resus. I feel I have to shout to be heard.
Can really bad communicators improve?
Yes. If they follow a formula. Like anything. If you’re not good at trauma, you can get really good at it by following a path. Pretty much everyone can get through ATLS. So much comes down to the words you use, the way you phrase something, the way you start and end a conversation. It doesn’t matter if it’s not natural. It still works.
Were you an outgoing child?
I’ve always been social. I did a lot of school plays. I was massively into public speaking when I was at high school. I was captain of the debate team.
Were you a tomboy?
Definitely. Dirtbikes, loved dirtbikes. Horseriding too. A lot of adventure sports. Paragliding, SCUBA diving, climbing, camping, white river rafting, endurance hiking, southern hemisphere stuff. The sun and outdoors. Everything that I did when I was younger, guys did. I found the company of guys much more interesting. I wasn’t natural at understanding female relationships. It took me a long time, way into my thirties, before I discovered the joy and the beauty of women, and how to forge relationships with women. Now I think chicks rule.
Are women better communicators than men?
I don’t think we’re any more eloquent than men. I think we are probably more comfortable with emotions. Men have a brotherhood, they definitely do. Women have a sisterhood. They are not necessarily your friends. Friendship is not required for the sisterhood. But when your need is greatest, the sisterhood will be there for you.
What was the naughtiest thing you did at school?
I was in an all girls high school. I went on a camp. I got into a boy’s sleeping bag.
Your worst communication stuff-up.
Oh. There are so many. When I was a medical student, on a teaching round, I asked a man with heart failure if his feet swelled. He was a double below-knee amputee.
Tatiana Lowe will be facilitating at the Spring Seminar on Emergency Medicine, Noosa, 18-21 October 2022.
Spring Seminar on Emergency Medicine
Noosa, 18-21 October 2022