Linda Stetter: Well, hello! It's Chaplain Linda, thinking about the profound power of listening. I'm so glad you're here with me to take the effective listening practices we already use with our patients, colleagues, families, and friends, and to add to our storehouse of understanding concepts toward even deeper listening.

First, let's remind ourselves of how through college or hospital training, we have already mastered active listening skills through thousands of interactions over time. We use habits like asking open-minded questions or probing questions to elicit important details. We paraphrase to ensure our understanding of what was said, and we affirm our mutual understanding with smiles or nods. We verbally repeat previously shared information to begin a new conversation to which we will link new information. Depending on the culture, we maintain eye contact, and we avoid sudden movements that distract from conversation. These skills portray us as empathetic, which is critical to developing rapport and trusting relationships.

Let's focus on the patients we meet daily. Much of our healing care is in the form of procedures. Procedures have a beginning, middle, and end. It takes boundless knowledge and years of experience to practice to perform some procedures with fluency. Our patients rightfully expect caregivers to be prepared, proficient, and prompt in follow up. But, you know, we talk so much that we probably take conversation for granted. And I wonder what would happen if we began to regard each conversation with a patient as a bona fide medical procedure. When we are in a room or treatment area, we practice the skills we reviewed above. And we have developed these skills over years. Thanks to the neuroplasticity of our amazing brains, we have constructed fast and almost automatic capacities to talk, listen, and respond and, therefore, to get many tasks done in rapid succession throughout the day, which is necessary to do the volume of work we need to do during the day.

But the downside of our amazing neural speed is that some of our questions and responses are automatic. We may hear what we expect to hear and retain less. Teaching listening skills to college classes, I discovered that adults consistently hear and retain only about 35% of what is said, even if they are focusing on the information. This has huge ramifications for the amount of time students have to study to retain material. It also has huge ramifications if we are only internalizing half or less of what patients tell us and if they are only internalizing half or less of the instructions we are giving them for self care and medication-taking. I propose to think of our usual listening skills as the procedure itself, the middle part of the process.

But what can we do better to prepare for more robust listening procedures with patients? As with any procedure we do, science underlies the procedure. So we look at what brain science, along with social studies and social intelligence and emotional health, have to teach us as we refine our process of hearing and listening with patients so that our connections with them will accomplish the healing we hope to give them and the healing they hope to receive from us.

The first learning step is to be willing to experience moments of growthfulness daily. Take a daily moment in the mornings or at the beginning of your shift to think about how far you have come as a caregiver. Feel gratitude for where you are today. And spend a moment just imagining how proficient you will become in the future. Take that moment of joy that comes from being rightly proud of yourself. Take that feeling and determine to stretch it to last throughout the day, no matter what else happens. This simple daily exercise sets up your brain as a caregiver to be its most elastic, amazing self for the day.

Concept one, our tasks are guided by clock time. But our brains perceive time in their own way, and I'll call this a brain time zone, starting with the ancient philosopher Aristotle, and validated by modern experience, such as David Eagleman's at Baylor University. Brain time zones are real perceptions of time, predicated on a well-articulated relationship between time, energy, and the human biological body. In our daily caregiving and support role routines, we stay busy with many tasks, encounters, and experiences, so our brains perceive that time is passing fast. Our work days sometimes are over before we even get everything on our to do list done. If something emotionally satisfying or pleasurable happens that day, our sense of time passes faster and is reinforced. The more intense the pleasure of the experience, the faster brain time passes. This is why vacation time or a funny movie seem to go by more quickly. Science has verified that we may each experience a minute as two or three seconds shorter than clock time. Over the course of a day, these seconds can add up.

Now, think about our patients enduring medical processes all day long with episodes of non-clinical activity in between. Science has likewise proven that time drags for folks who feel grief, mourning, dread, fear, or pain. Brain time passes so slowly, that seconds are added to the brain perception of each minute, and those longer minutes add up during the day. No wonder our patients perceive that they should be receiving their pain meds sooner than the clock ticking away on the wall says they should. Add to this the science regarding metabolic differences. Being busy, or being in the zone as we call it, helps our brain perceive that time flies. Our heartbeats per minute can respond optimally, but the converse is also true. Patients under stress experience changes in hormones, and time slows even more significantly. Patients with a higher body temperature experience brain time more slowly as well.

So, my conclusion is that we as caregivers usually operate on faster brain time, packing tasks into space and time efficiently, and seldom recognizing that our patients are lagging behind us in gaps of seconds or minutes as the day goes by. Before we can listen intently, receive our patient's information as intended, and retain information and respond with fitting compassion, I suggest that we need to slow our listening procedure down so that we are in sync with patients before we begin our talking-listening procedure.

In our hospital, we have useful space between the hall and the actual door of each patient room. So, I propose that we learn to use this space to actually pause for four or five seconds and to use the two steps of floor space as our between time to slow our brain time so as to sync with the brain time in which our patients are likely operating. Because we can imagine that two brains being in sync helps tremendously for effective two-way conversation to be beneficial to all parties.

Chaplains learn to take a big mental and physical breath before entering a room. Our purpose in that breath is to think of an initial greeting that helps construct a base of communication that comes across as a feeling of safety and security for the patient. In pausing in time and space, we have the opportunity to set our faces to pleasant expressions. We can think of a question to ask the patient, which will elicit a positive or pleasant response, which will help the patient's brain time to speed up a little with the pleasurable interaction. We can also resolve not to come across as intrusive or controlling with our rapid fire instructions, questions, and actions. Anxious people easily feel overridden or insulted by less than personal interactions, and this slows and maintains slow brain time longer. The brain time concept has much to do with how we provide not only effectively healing listening processes, but also how we might use our understanding of transitioning slow patient brain time to faster patient brain time through frequent pleasurable experiences to achieve higher patient satisfaction scores. In order to invoke the incredible neuroplasticity of our brains, we must practice those pauses at the door, like the required timeouts before surgeries, so that we can attune our brains, nonverbal expressions, and our conversation starters, especially in the morning when we set the tone for the entire day to the brains of our patients. If we practice this precursor to listening thousands of times, our brains will create or enhance the neural processes to make them as automatic as our ability to do familiar medical tasks that we repeat many times a day. And the effort of pre-practicing an instant before entering the patient's room will be worth the effort.

There are many more aspects of this topic that can be explored, such as how we can use satisfying experiences with patient during small moments that can reciprocally help us to consciously learn to refill our resilient tanks and guard against burnout. We can also consider how well executed listening experiences can contribute to our ability to shorten our recovery times from very stressful experiences, such that we are ready faster for a rich, positive listening encounter for the patient waiting for us. Thus, profoundly deep listening skills are beneficial to both the caregiver and the patient.

To recap, preparing our magnificent elastic brains for the experience of effective listening is an essential skill to develop so that we can be in sync with our patients and use the skills we have already mastered to their utmost potential. Adequate preparation and skillfully engaged verbal and nonverbal conversations that honor where the patient's brain time is situated can foster truly safe, trusting, and beneficial conversations with our patients and, by extension, with colleagues and families and friends. After all, hospital hospitality is about developing valued relationships about fulfilling what really matters to the patients.

But one more thing, the process of preparing to talk and listen requires an even earlier preparation on our part, even before we come to work. Since science has proven that brain power and compassionate listening have biological foundations, we have one more opportunity to remind ourselves to support our health with good sleep, periodic exercise and fun, and healthy eating.

I close with this poem entitled, Listen to Me, by an anonymous author.

Listen to me, please, I need to talk to you; Give me only a few minutes; Accept what I experience, what I feel, Without reserve, without judgment.

Listen to me, please, I need to talk; Do not bombard me with questions, advice, and opinions; Do not feel obliged to settle my difficulties, Could it be that you lack confidence in my competence?

Listen to me, please, I need to talk; Do not try to entertain or amuse me, It would make me think that you fail to understand the importance of what I am going through.

Listen to me, please, I need to talk; Do not feel it your duty to approve, If I need to tell my story, It is simply to be set free.

Thanks for listening. Again, this is Chaplain Linda wishing you well as you try some of the snapshot ideas I've described. I wish you well in the joys of growing through the adventures of both life at work and in your personal lives. Be blessed.