Telephone consultations: working with verbal cues

Latest from the Blog

Cancer Keys: Thrombocytosis and L.E.G.O

Cancer Keys: Thrombocytosis and L.E.G.O

Reactive thrombocytosis can be indicator for several underlying causes, which are either self-limiting or serious. These can include infection (e.g. H.pylori), inflammation, blood loss, anaemia and a number of cancers. Helpful hint Depending on the presentation, NICE...

read more
Cancer Keys: Salty Foods and Stomach Cancer Risk

Cancer Keys: Salty Foods and Stomach Cancer Risk

Eating too many foods that are high in salt such as salted meat, brined fish and pickled vegetables can increase the risk of stomach cancer. Higher rates of stomach cancer are found in countries like Japan and Korea, than in the UK, where these foods are more popular....

read more

Related Posts

Too young for bowel cancer?

Too young for bowel cancer?

Although bowel cancer is a disease that becomes more common in patients who are older, it is still possible to for the disease to develop in younger patients. Specialist viewpoint: GatewayC’s colorectal cancer course introduces Simon, a patient experiencing abdominal...

read more

Monday 10th August 2020

GatewayC and the Maguire Communication Skills Training Unit have partnered to produce this resource below. Missed our free webinar on Effective Telephone Consultations? Watch it here.

What are cues?

It is often the case that people do not disclose their worries and concerns explicitly, but test the water by hinting in a verbal or non-verbal way that all is not well. These hints of worries or concerns are referred to as cues.

Cues can be defined as hints or a statement of negative emotion that suggest there may be an underlying concern. Cues need to be actively acknowledged and explored in order to establish if there is a concern and what it relates to. As we discussed in a previous blog, establishing concerns is crucial to a patient-centred consultation.

Many healthcare professionals are anxious that when managing consultations on the telephone, important information may be missed because of the lack of visual cues.

However, although visual cues are helpful, the verbal cues offered by patients are often even stronger hints but we may be less used to recognising them.

How to work with cues: acknowledge what has been said, pause to allow patient to respond and continue, follow up with a question or clarification if needed to explore further in order to establish the nature and extent of the concerns.

Why is acknowledgement of cues important?

We may know that we’ve heard, and it may seem implicit in the questions that we go on to ask, but verbal acknowledgement makes sure the patient knows they have been heard and allows them to confirm, correct or expand further.

What’s the difference between acknowledgment and empathic acknowledgment- and why does it matter.

 Acknowledgement:               “You asked about the future” or “I understand”.

Neither of these examples explicitly name nor take an educated guess at the emotion the patient is experiencing.

Empathic acknowledgement:  “I can hear that you are upset and worried about the future”.

Empathic acknowledgement helps to dampen strong emotions thereby reducing distress and promoting cognitive processing and decision making  (Harari et al, 2000).

Why does the pause matter? When a patient has the opportunity verbalise the emotion, neural pathways are stimulated in the prefrontal cortex and the hormone oxytocin is released. Oxytocin acts to immediately dampen the effect of adrenaline and cortisol.

Without the pause for example “you must be upset, can you tell me why” or “I can see you’re upset and this is what we can do for you”, the patient loses the chance to say out loud…”Yes I am upset”. As a consequence, there is no change in the activity of the neural pathways, and the patient remains upset/ distressed.

For further advice and training in effective, compassionate communication please contact the Maguire Communication Skills Unit the-christie.maguire.unit@nhs.net

Find out more:

Follow us: LinkedIn | Twitter | Facebook