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Sage & Thyme: Listening and Responding to People Who are Worried

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Have you ever encountered seeing or talking to a person who are worried? Surely, we are familiar with the phrase, “Don’t worry. Everything’s gonna be fine.” But is this really the appropriate thing to say? I want to share what I learned in Sage & Thyme Foundation Level Workshop: Listening and responding to people who are worried and distressed.

I voluntarily attended this workshop because I can see the strong need for me, as a health care professional to develop my communication skills as I am dealing with distressed patients and family members all the time. As a nurse working in a respiratory ward for more than a year, I have dealt with this situation multiple times and it’s hard to think of the right thing to say to address the concerns. With our busy day in the ward, giving medications, positioning our patients, doing the nursing care, etc., how can we actually provide therapeutic communications to our patients?

There is a flyer I saw in our ward’s staff room regarding this workshop. I told myself, “I want to attend.” I approached one of the Palliative Care Nurses visiting our ward, told her I am interested in attending the workshop however I cannot find the email address of the secretary to book my place. She then took my NHS email address and said she will leave the note on the secretary’s desk. And after 2 hours, I received an email from Paula and informed me that there is 1 slot left for the semuinar. Hmm.. I told myself this must have been for me. So I replied that I would be pleased to attend the seminar.

The entire seminar was facilitated by Sally Parr, a consultant for Cancer Support. She was very good in explaining why communication skills matter because it influences patient’s emotional health, symptom resolution function and physiological measures and decreased reported pain and drug usage.

So why Sage and Thyme? I was also curious. In the seminar I found out that Sage and Thyme is an acronym for the model which stands for…

S- Setting : If you notice concern- create some privacy- sit down

A- Ask : “Can I ask what you are concerned about?”

G- Gather: Gather all concerns – not just the first few

E- Empathy: Respond sensitively- “You have a lot on your mind”

&

T- Talk: “Who do you have to talk to or to support you?”

H- Help: “How do they help?”

Y- You: “What do YOU think would help?”

M- Me: “Is there something you would like ME to do?”

E- End: Summarise and close – “Can we leave it there?”

According to Thora, a Palliative Care Nurse, who facilitates the discussion in our group, this model is evidence based and it has been proven effective with clinical research. Depending on the situation, it doesn’t mean that we have to use the whole model all the time. She said we may skip some, but the core thing is to empower the person who is distressed by allowing him to decide what he thinks should be the best decision. We should always seek the patient’s own solutions. This means that we empower and equip individual to recognise and manage their psychological distress. It is more about You (pertaining to the other person) and not Me (meaning myself). She also said that somehow, this lifts the burden in us, health care professionals, that we cannot always and all the time solve our patient’s problems, pain and struggles. We are not a superhero to solve these things and we can only do so much. One more thing that I really like about this model is the fact that whenever we are talking to a distressed individual, it is not always about giving advice. Sometimes, what they need is someone who empathises with them, understands them and listens to them without any judgement. The most important thing is holding back with advice and only make supportive comments. Listening to them means not having to fix or give advice to the other person because this is disempowering.

Saying “Don’t worry. Everything will be alright” is not therapeutic because the truth is, the other person is worried, saying this means you are shutting down the individual.

It happens to me, when I was thinking about my future plans, and that person I talked to gave an advice and negative comments on the situations, and I realized it’s not helping because me and that person have different views and opinions about what really matters in life. I was thinking, I just want to express my thoughts about the situation, I do not need an advice I just want someone to listen. So, I just shrug the negative comments off and ended our conversation.

In my everyday work in the ward, I cannot always run the whole model if a relative or patient has to speak to me because the ward that I permanently work is really busy, but what I will do is to apply the core of the model.

I realized this is not only applicable to my work as a health care professional in the hospital but this is extremely helpful as well when talking to a friend, a colleague, a family member who has a problem or to myself.

I believe in this model that’s why I am sharing it in my blog. To know more about Sage and Thyme, you may visit www.sageandthymetraining.org.uk

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