I have noticed that the spoken word has lost it’s currency. Not in real life, person to person, but in work, organisations and all the times where communication happens and things matter. So to narrow the field I will give an example about work.
I still think the most important interaction is the spoken and listening one.
Let’s give an example of a role in the NHS which scores the highest points for Communications factor and a phrase I have used before; the humble Paramedic.
The most important part of the 999 call once the vehicle has arrived at the scene is the history taking, finding out what happened from the patient, the relatives, the actual caller, bystanders or anyone who was witness to the event that prompted the call. Patients who are in pain can usually describe with a simple series of questions and answers some very comprehensive information which is relevant to any treatment and a diagnosis.
The onset…was it sudden or gradual?
The location of the pain……does it stay in the same place, radiate or move?
Intensity….. is it sharp, deep, dull ache, sporadic, throbbing, acute?
Positioning……….can changing position improve the pain or make it worse?
Then after the history taking the Health Professional establishes if the patient has ever experienced pain of this type before analysing the characteristics and informing the patient why a measurement method is required which in most health settings is a simple scale from one to ten to ask the patient to score their pain against. It is the basis of effective and appropriate treatment of the pain and the patient and puts the patient at the centre of the process.
The measurement of this effective process of communication in a job evaluation process is summarised as follows: “asks question about the pain and completes simple tick box” and is never used to demonstrate skills in communication. The points that have been scored for the communication factor are a result of barriers to understanding that have to be overcome and highly complex information explained.
The HPC are the regulatory body responsible for the registration of Paramedics. In their “Standards of Proficiency for Paramedics” document there are 9 bullet points about communication in all its forms regarding patients and only 2 bullet points about being “able to maintain records appropriately”. That doesn’t mean there is four times the emphasis from the HPC on communication or that record keeping is four times less important but it is telling how the Service has translated those standards into practice. I asked a sample number of Paramedics if they knew the number of bullet points there were about communication and then the number about maintaining records and I was not surprised at the answer where every single one answered that they thought there would be huge emphasis on records and forms but less on communication.
A Paramedic who documents well, notes everything and files it well will never be struck off and will probably succeed. The Paramedic bible has a famous parable on page one: “If it isn’t written down then it didn’t happen”. That is why the follow up paperwork and attention to accuracy of patient report (clinical record) can often take longer than the call it refers to, increasing the call cycle time of vehicles and affecting performance as much as many of the other contributory factor often cited as reasons for delays (excluding the number one reason of queues outside A and E).
Well, e mail now seems to be the equivalent and many have lost sight of benefits of e mail. For “if it isn’t written down it didn’t happen”read”if it isn’t documented in writing in an e mail thread then it probably didn’t happen”. The emphasis has moved from verbal communication to written. I have personal experience of a debate where I was told “well you didn’t say that in your e mail” to which I responded “well I am saying it now so I am saying it” to which the response from unnamed was “well I’m only acting on what you said in the e mail” to which i said “I’m the author of the e mail and I am the speaker of the words, they are from the same source …..me”. This is an example of how there is a hierarchy of communication, verbal at the bottom of the pile, then e mail the everyday preferred form, a letter and finally the most important words are that duly noted at a meeting with published minutes.
- The Chief mentioned that on the phone
- The Chief was walking down the corridor just now and told me that
- Ive received an e mail from the Chief about that
- The Chief has written a letter about that
- At the meeting the Chief had a slot and presented on that and it is minuted and published and will become policy
Because or in spite of my outspoken views on e mail I was privileged to be one of the two staff advisors at the NHS Partnership Forum Task group which authored the recent NHS E Mail Policy. Link here . My influence was taken into account rather than my words quoted. I think the abuse of e mail is complex and varied, the sheer numbers of unnecessary e mails, the presentee-ism, constant checking and flicking on e mails, people e mailing people sat opposite them in the same office or down the corridor on issues that could be better conveyed in a short chat, the reply all to prove that you have read the e mail, the “me too” agreers who reply all with “me too”, sending the wrong attachments or forgetting to attach the attachment at all and 100 other known and unbeknown abuses in e mails name. None of these things are in the policy and are beyond good e mail etiquette.
I remember an e mail which read “Will the person who owns the blue Volvo in the Staff car park please return to it as you’ve left your lights on”, it turned out this e mail was accidentally sent to 80,000 e mail addresses and crashed the NHS server for hours. Someone replied to all. Disaster. Promise it wasn’t me.
I could write a post three times as long as this one about how Twitter has made e mail virtually redundant for some who are leaders on it and relegated whole swathes of people to declare “Twitter, yes I’m on it but I just don’t get it”. These are the same people who haven’t quite got e mail over the past twenty odd years, no surprises there then.
There is a place for e mail and I see its place but in currency terms it is vastly overvalued.
I have been approached by some very clever people who are creating training courses as part of a suite of modules that will help leaders and others gain confidence in communication. There will be an e mail section and I have agreed to review the final version in a critical friend capacity. It was the tortuous and laborious amount of time I spent contributing to and importantly preventing some content and views from colleagues dominating the NHS group and the document we created that has given me the experience to have been asked. It has been something that I have stated a number of times that “emails sent to you as part of a large distribution list requiring no action on your part, there is no need to reply to them at all”. In other words, if you agree there is no need to answer Reply All. Full stop. I will ensure that when I am able to assist others with training content I persuade them to include some of these as basics.
I will not be writing about NHS related matters on many future posts and as always welcome comments to this blog post as always but will not publish comments.
I will be pleased to receive e mails too but far prefer if you talk with me.