When Difficult Communication Catches You Off Guard

It is a Saturday night at 8 PM. My head was full from participating in a 2-day podcasting conference. I stop at a rest stop on the Atlantic City Expressway to get a quick dinner before driving off into the dark to complete my 3-hour drive home.

The only place serving food is Burger King. I study the menu looking for the healthiest option. The counter is front of me, a refrigerated case to my right and two empty cashier spots are to my left.

After a few minutes the only Burger King employee in sight notices me, takes my order, makes my food and hands me the tray. She says, “The salad dressings are in the refrigerated case.” I acknowledge her and because there is no cash register by her, I ask, “Where do I pay?”

She replies, “They are in the case.”

I try again: “Where do I pay?”

“They are in the case.”

I am thinking, “Why is this so hard? She speaks English (no accent), and I speak English. I ask her, “How do I pay for my food?”

“At the cashier.”

I tell her what she can also see: “There is no one at the cashier.”

“You pay the cashier.”

At this point, I resort to a strategy that we try in health care: If someone does not speak English, we raise our voice, as if that will make a difference. (It never did.)

Slightly louder, I say, “Where is the person who is supposed to take money at the cash register?”

She points at the person standing next to her.

I pay him when he returns to his seat at the cash register.

Difficult Communication When We are Vulnerable

The experience reminded me of what I used to tell my employees when I heard the details of a new medical malpractice case: “Communication is the hardest part of being human.”

We know the huge role miscommunication plays in patient safety. We know that fatigue, accents, distraction, stress, fear, sensory overload can all affect the ability to send and receive messages from others.

Applying the same concept to legal nurse consulting businesses, we know that there are times we feel fragile, vulnerable, and on edge. Those are the times I found when I needed to put a wall up – not take the phone call from the irate attorney or not have the difficult communication with an employee.

It is sometimes hard for nurses to admit they need help. We’re supposed to be strong, all-knowing, invincible, and invulnerable to stress.

But it does not work that way. We need to be easy on ourselves.

When I took my salad to the table, I saw folded money on the floor. There was a dollar bill on the outside, folded around 2 other bills. If I had been feeling more magnanimous, I would have given it to the woman behind the counter.

In that instance, reflecting on what I had just gone through, I felt entitled to it. It was my reward for not getting really irritable with the employee. My $3.00 reward helped to pay for my dinner on the Atlantic City Expressway.

Pat Iyer MSN RN LNCC is usually quite patient. Not that night.

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