Difficult Conversations Podcast
Lessons I Learned as an ICU Physician
Episode 179 | October 31, 2022
There's a Snake on My Head
Speaker, Consultant and Coach
Welcome to Difficult Conversations with Dr. Anthony Orsini. My guest today, is Mindy Spigel. Mindy has dedicated her career to improving healthcare and helping patients get over their fears of the system. She has a master’s degree in nursing, has worked in both inpatient and outpatient settings, and has taught in both academic and clinical fields. Her passion is helping people create meaningful connections as a leader and team member while providing the best care. She enjoys helping leaders build strong teams in exceptional work environments. It’s her desire to alleviate fears, build trust, and create an exceptional experience for all. Mindy has been honored to have presented at numerous national, state, and local conferences, she recently published a research study on the “Fears of Parents When Their Child is a Patient, and she just released her first book, There’s a Snake on My Head! Strategies for Alleviating Fear and Anxiety in Healthcare, which we are going to be talking about today.
Mindy tells us about her journey and what gave her a passion for patient experience. She expresses why she’s been a very big advocate for shared decision making and asking the team how can we make this work? We hear about the inspiration behind the title of her book, There’s a Snake on My Head! Strategies For Alleviating Fear and Anxiety in Healthcare. Dr. . Mindy and Dr Orsini discuss why it is such a big mistake when hospitals try to t way to improve patient experience is treating hospitals like hotels. She tells us about things she learned in her research about what people are afraid of. In her book, Mindy talks about Five Relieving Strategies, and the first one is build a relationship. It’s about finding commonality, and Dr. Orsini talks about how we could find commonality in just about everyone. Mindy explains her second strategy which is, choose your words carefully. She shares an aha moment story. In part two of her book, Mindy talks about how healthcare team members are people too and she explains more about this. Also, we find out what prompted Mindy to write her book, what she hopes will understand after reading the book. Mindy talks about what she is currently doing and her hopes for the coming months in her career. We end with Mindy telling us the most difficult type of conversation she’s had, and advice on how she navigated through it.
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Mindy Spigel (2s):
So imagine there’s a Snake sitting on top of your head right now and you’re afraid of snakes. Maybe it’s a rattlesnake. Maybe you’re not afraid of snakes. But usually when I say to people it’s a rattlesnake, he’s sitting on your top of your head and shaking his rattle. And I come in and I say, I have really important things I need to tell you. So that, you can take care of your child or yourself, whatever it is. When you go home, how much are you going to hear while there’s Snake on your head? And when I say this to a crowd of people, they all go, nothing. And I go. Yes. And that’s what we do every day to people when they walk into our doors, every day people walk in our doors afraid. May not be that they have a Snake on their head obviously, but there’s something else they’re worried about.
Mindy Spigel (43s):
They have a different Snake and we don’t know what it is. And while they had that Snake on top of their head, they don’t hear anything that we’re saying to them. And So I think part of our job is to help get that Snake off their head so they can hear us.
Welcome to Difficult Conversations Lessons I Learned as an ICU Physician with Dr. Anthony Orsini. Dr. Orsini is a practicing physician and president and CEO of The Orsini Way. As a frequent keynote speaker and author, Dr. Orsini has been training healthcare professionals and business leaders how to navigate through the most difficult dialogues. Each week you will hear inspiring interviews with experts in their field who tell their story and provide practical advice on how to effectively communicate. Whether, you are a doctor faced with giving a patient bad news, a business leader who wants to get the most out of his or her team members or someone who just wants to learn to communicate better, this is the podcast for you.
Dr. Anthony Orsini (1m 44s):
Well, Welcome to Difficult Conversations Lessons I’ve learned as an ICU Physician. This is Dr Anthony Orsini and I’ll be your host again today. Well as many of you know, I’ve done several episodes and I really in the hottest topic in medicine. And that’s the patient experience. I personally been the large part of my group as you know, researching ing healthcare Professionals, how to use effective communication to build relationships with patients and improve the overall patient experience because it, my belief and I’m sure my guest today, would agree that the needs of good patient experience, the relationships that we build and really the human side of medicine.
Dr. Anthony Orsini (2m 26s):
And it is the basis for my book “It’s all in the delivery” and the basis really for my guest today. Today another guest who has dedicated her career to improving healthcare and helping patients get over their fears of the healthcare system. Today my guest is Mindy Spigel, Mindy has both a bachelors and master’s degree in nursing. She has worked in both inpatient and outpatient settings and is taught in both academic and clinical setting. Her passion is helping people create meaningful connections as a leader, the team member, while still providing the best care. She enjoys helping leaders build strong teams in exceptional work environments .
Announcer (3m 8s):
Mindy is is committed to the teams respect for each other and work effectively. It is her desire to alleviate the fear, build trust and create an exceptional experience for all. She’s been utter presented on numerous national, state and local conferences. She had published a research study on the fears of parents when their child is a patient and just released the book, which we’re gonna spend a lot of time talking about with a great name. “There’s a snake on my head, strategies for alleviating anxiety in healthcare” and I think paid for anxiety and healthcare. Well welcome. Thanks so much for taking the time out of your busy schedule to be here today.
Mindy Spigel (3m 45s):
Oh, well thank you so much. That was great introduction. Thank you. Yes, I’m excited to be here and talking with you today.
Dr. Anthony Orsini (3m 52s):
Yeah, so let’s start up because you know you and I both, I read your book and it was great by the way.
Mindy Spigel (3m 59s):
It’s actually gonna be released August 16th on Amazon, both in Kindle and a book form.
Dr. Anthony Orsini (4m 5s):
So by the time this It can be sometime in September, it’ll be very easily to be purchased and we’re gonna spend a lot of time talking about that book. But both of our plots are very similar and that we believe in relationships and that’s how you improve not only healthcare but also business and the best leaders learn how to communicate. So in that vein, let’s talk about how we can build a relationship with you. So let’s start out by telling us who Mindy is. Tell us a little bit about your background, where you’re from, how you came this as we like to joke around here the pinnacle of your career being on this podcast.
Mindy Spigel (4m 41s):
Oh absolutely. The pinnacle of my career. I love this. So actually I started off in Florida, another connection we have, I started off going to nursing school in Florida and started off as a pediatric nurse as well. And immediately realized that it’s all about relationships. I toyed between whether I wanted to be a psych nurse or a pediatric nurse. Knew my love was working with children and worked with children with cancer early on in my career. And all of that was about establishing relationships with patients and with their families and communication. I currently live in San Antonio, Texas where I worked for a hospital system there, a six hospital system, one of the hospitals being a children’s hospital where I started.
Mindy Spigel (5m 30s):
And then I branched out into the adult world and I really worked there for almost 30 years. And most of my time I was there was focused on creating first a great experience for the clinicians in the healthcare team as a whole because I believe that has to come first so that ultimately we can create a great experience for patients and families. So that’s really what my passion is and what led me to do my research.
Dr. Anthony Orsini (5m 54s):
Let’s come back even further, born in Florida? What’s your likes, dislikes. We need to get to know Mindy as a person before we trust her to give us advice.
Mindy Spigel (6m 3s):
Oh, okay. Well I love that. Always know something about that person that has nothing to do with why they’re here. So I actually was born in Detroit, but my parents moved me to Florida when I was three. So I, consider myself a Florida girl. So. I usually stay. I’m from Florida.
Dr. Anthony Orsini (6m 19s):
Mindy Spigel (6m 20s):
In Florida? St. Petersburg. Beautiful beaches. I’m a Florida West coast girl. Love the beach, love the water. That’s my happy place. If you wanna know a little bit about me, that’s it. I love walking on the beach. I do a lot of yoga and meditation and if I’m do that, I think of myself laying on a raft, floating in the water, gently rocking, did yoga on a paddleboard once and thought that was amazing cuz I didn’t have to pretend that I was rocking on the waves. And yoga on the beach is the best. It brings all the things I love altogether. So that’s who I am on the Florida girl at heart. Left for one year to get my master’s degree in 1979 and haven’t quite moved back yet, but my family is there.
Mindy Spigel (7m 3s):
So, I, go back and visit as much as I can.
Dr. Anthony Orsini (7m 6s):
That’s fantastic. So, but there’s a lot of nurses and a lot of doctors and a lot of healthcare professionals who are really very good at their job that don’t take the kind of path That you and I have taken. We still care for children and adults. But what really got you into, when you talk about it in your book a little bit, you’re gonna mention that book multiple times and I wanna hear about the title. But what really got you into this path and really your passion for patient experience?
Mindy Spigel (7m 34s):
I don’t think I realized it at the time that was happening, but as a very young nurse of all of 21 years old, I was working in a general hospital on a general pediatric unit. And so it was the only one unit had a ICU in it. It had private rooms, it had little wards back then, but it didn’t look like it was the right place for children. It didn’t have children’s artwork on the floor and it, we had to, in the book I talk about, I remember one day going, how are you supposed to make a sick child eat shrimp creole? Like children don’t normally like shrimp Creole. How’s a sick child? Because it wasn’t focused for children cuz it was a general hospital. And this is back in the seventies, So I went to my supervisor and I was telling her the things I felt weren’t pediatric friendly.
Mindy Spigel (8m 22s):
Oh and my big one was parents were considered to be visitors back then and they had visiting hours. It didn’t make sense to me. I was like, who’s really the visitor in this child’s life? Their parent or me, You know, I kind of thought I was sort of the visitor. They were sort of their most important people. And I took this list of concerns to my supervisor and she said, If you wanna do all these things Mindy, you’re gonna have to talk to the chief nurse. And I didn’t exactly know back then, That, you didn’t go to the chief nurse with your concerns. And I said, could I? And she arranged that meeting and I talked with the chief nurse and she listened to all my concerns. And then I went off to graduate school.
Mindy Spigel (9m 3s):
And when I came back to visit one day and one of the nursing assistants took me by my hand and showed me there were now beds for parents to spend the night and there was now artwork on the floor and the kids weren’t eating shrimp creole anymore. And So I think if I go back to that defining moment, I have a feeling that this is what I was meant to do. That I was meant to advocate for the patient and family centered care. That’s really a lot of what my career has been around is creating an environment that’s really good for patients and families that they’re in the center of care as opposed to us as the providers.
Dr. Anthony Orsini (9m 43s):
That’s a great story though. I’m guessing though that, you weren’t a shy young woman because that’s pretty bold for young nurse to go up and say this is what we need. I guess that just your personality or was it you just had this calling to do it?
Mindy Spigel (9m 58s):
I think I had this calling to do it truthfully. I’m not sure if I think back to my young self that I had any clue what I was doing at the time. However, the other side is I mentioned that I think it’s important to work on the teams experience and I’ve also been a very big advocate for shared decision making and asking the team how will this work and how can we make this work? Because I think they’re the ones who know how to do their jobs best. So that was really a defining moment in my career. I just didn’t know it.
Dr. Anthony Orsini (10m 27s):
Well now you’re being an excellent clinician, you’re working hard with the patient experience, you’re starting to notice things and call things out. I tend to test as people have heard me talk about it in the podcast and in my book, you know I had childhood epilepsy, thankfully I grew of it by the time I was 12 or 13 years old, as many childhood epilepsys do. But in those days, every time you had a seizure they’d put you in the hospital and there were visiting hours. So here I am five, six years old, some of my earliest memories, but I was very fortunate. And now my father was a police officer in the city of Newark and that’s where I was in Newark, New Jersey. And so he was working the night shift and so he would come in his uniform and of course they’d let him in because he was a coming police officer.
Dr. Anthony Orsini (11m 12s):
And so my dad got to visit me at night and I was fortunate, of course he couldn’t stay all night. But now the idea of five or six year old being in the hospital with visiting hours until six o’clock would be unheard of. You would think that that’s the most ridiculous thing in the world, but that’s the way it was.
Mindy Spigel (11m 30s):
Dr. Anthony Orsini (11m 31s):
Yeah, yeah. I mean it’s pretty crazy And we’ve come a long way and I know you did some stuff with the Beryl Institute and I at all saying, well let’s move to your book. I gotta ask you about the title. You and I spoke about this before but everyone is probably out there going, What’s deal with that? The title, “There’s a Snake on my head, Strategies for Alleviating, Fear and Anxiety in Healthcare”. So tell us about that title and how that came about.
Mindy Spigel (11m 57s):
So I have to give credit where credit is due. I actually did not originate this. It actually started, I heard Colleen Sweeney speak once also in Florida. She’s in Florida. I didn’t hear her in Florida. And Colleen did a presentation one day about her work around patients fears. That’s really what started me on this journey. And she talked about the fact that if you’re afraid of snakes, so imagine there’s a Snake sitting on top of your head right now and you’re afraid of snakes. Maybe it’s a rattlesnake, maybe you’re not afraid of snakes. But usually when I say to people it’s a rattlesnake, he’s sitting on your top of your head and shaking his rattle and I come in and I say, I have really important things I need to tell you. So that, you can take care of your child or yourself, whatever it is.
Mindy Spigel (12m 40s):
When you go home, how much are you going to hear while there’s snake on your head? And when I say this to a crowd of people, they all go nothing and I go. Yes. And that’s what we do every day to people when they walk into our doors. Every day people walk in our doors afraid. May not be that they have a Snake on their head obviously, but there’s something else they’re worried about. They have a different Snake and we don’t know what it is. And while they had that snake on top of their head, they don’t hear anything that we’re saying to them. And So I think part of our job is to help get that snake off their head so they can hear us.
Dr. Anthony Orsini (13m 15s):
Yeah, I talk about an in my book and I know that I have think evidence to back it up. But one of the mistakes that we make in healthcare and inpatient experience is taking hospitals and saying the best way to improve the patient experience is to make them more like hotel. And I’m always trying to say this is a major mistake. And I had Jason Wolf from the Beryl Institute, which he’s an amazing man, everybody loves him and Jason totally agrees with this. And this is the biggest problem we’re having in healthcare. And I guess I’m going to make some enemies out there. But because there are many Chief Patient Experience officers from hospitals with a hotel background, many of them have been able to take the best on hotel accommodations and the experience for a customer and then learn about what the differences are and have been phenomenal with the chief patient experience.
Dr. Anthony Orsini (14m 12s):
But there’s others that come in and try to treat it like a hotel and it’s not, cause when you go to a hotel there’s no snake on your head. Yeah. So it was a big thing difference. So comment on that a little bit about the mistakes that we make cause of this thinking that the best way to improve the patient experience is by putting nicer carpet in and a big screen tv. Yes,
Mindy Spigel (14m 33s):
Yes. So, I do talk a little bit about in the book about first impressions when you walk in the door, like how things look and feel. But more importantly, if you think about being afraid and I can talk for just a moment about what I learned in my research about what people are afraid of, what are the common snakes now remember everybody’s is different. So you have to find out and you may wanna ask them, what is your greatest worry or concern I can help you with today to find out what their snake is. But across the board we interviewed over 200 families, inpatient, outpatient, ambulatory surgery and er. And we asked them about their fears and across the board they wanted to know is my child gonna be okay? So diagnosis and prognosis came up as number one, communication and then infection.
Mindy Spigel (15m 19s):
Now of those the only even closely related to the hotel experience other than being warmly welcomed and feeling like we want them there. The only other one is that cleanliness, the infection and I do think if the hospital doesn’t look clean then people don’t trust everything else that we do. That’s the one thing I’ll take from the hospital. Otherwise I think if you think about their top three fears of is my child gonna be okay? Am I gonna understand what’s going on here and safe? The second question we asked in my research was what are the most important things we can do for you? And they said, keep me informed again across the board in all the settings, keep me informed, keep me safe, keep me comfortable.
Mindy Spigel (16m 6s):
And So, I really believe if we’re gonna put resources into anything, it is how do we help people feel like we want them to be there, We’re gonna take great care of them and we’re gonna keep them safe. And then even though number one was keep me informed, I think you gotta do two and three first to get that snake off their head so they hear that you’re keeping them informed. So, I really think those are the things more than some of the special hotel features. But I think people do need to have that warm welcome and I think hotels do do that. Well that is one thing we could take in the book I talk about how do people get greeted when they walk into the hospital?
Mindy Spigel (16m 47s):
How do they get greeted when they walk on the unit? I do think those first impressions do matter cuz it sets the tone and we could learn from the hotel industry on that.
Dr. Anthony Orsini (16m 56s):
Yeah, I was reading your book and there was so many different kind of threads between your book and my book. Absolutely. Even the sign that we’ve see in the hospital, you know I saw one my book where it shows people standing in a signal file lot attention and saying, wait here and I give that impression that you’re an invited guest and if you don’t act accordingly we’re gonna throw you outta here. As opposed to somebody who, and you would never say that to your neighbor or your friend, you do 5 revealing strategies. So number one, still the relationship and that’s the one that I feel most passionate about. So tell us more about that.
Mindy Spigel (17m 32s):
Yes and you did That, you modeled it perfectly with having me introduce myself. I think people need to know you care about them as a person first. And so one of the things I challenge everybody to always do is to find out at least one thing about them that has nothing to do with why they walked in the door today. And if we could find out one thing about them, then they become a person to us and not patient number 564 that we’re seeing today. Because for them it’s their first encounter. It doesn’t matter what encounter it is for us, I think that helps to build that connection. And then if we take the time to sit down as we talk to people and I think in the book, I think those pictures I have those two pictures of the, I was preparing your presentation to give actually to physicians one day and I ran in across the street to our children’s emergency room with my phone.
Mindy Spigel (18m 26s):
I mean it wasn’t even fancy camera equipment. And I grabbed a couple staff people handed my phone to one, I pretended I was the patient sat down in a chair and I had two staff people talk to me while they were standing and I was sitting and they took a picture and then they sat down and talked to me. And it’s so powerful the difference. And I encourage you to even try that, talk to somebody with them standing and then while you’re standing and then sit down and feel the difference. And one of the things people say to me is when people are standing, they’re talking at me and when they sit down they’re talking with me. And I think that right there helps to build the connection.
Mindy Spigel (19m 7s):
So I think eye contact matters. Sitting down matters and knowing something about them that makes them a person first.
Dr. Anthony Orsini (19m 15s):
Yeah and that’s really important. I That, you know this work in the hospital, I’ve been the hospital before where even if the doctor, they’ll call me and they’ll say Dr. Orsini, the baby in 52 has a high bilirubin and I will very politely saying the name and they’ll say Let me look that up. And you know my subtle message is the baby has the name and I know it’s easier for you to remember 52. But that’s how we have to bring that human side to medicine again. And they don’t mean anything by it, but it’s a culture. And once you mention it to them, they do go, well you know that kind of makes sense. So it’s kinda easy.
Dr. Anthony Orsini (19m 55s):
I had a colleague, I joke about it in my book, my TED Talk, also sharing personal information with the patients because people are gonna be very reluctant to share their fears and anxieties and their personal relationship with someone that they can’t relate to on a personal level. And it was called finding commonality. And I firmly could find commonality everywhere. It doesn’t matter what your race is, your ethnicity, where you’re from, your background, the country, how poor, how rich you are. There is something That you can find commonality in. And Gregor Alexander is a wonderful former colleague in mine, but that’s, I’m not sure we’re gonna have his interview on right after yours, but Gregor could meet anyone from anywhere in the world and within five minutes you like their best friend.
Dr. Anthony Orsini (20m 47s):
We hit the joke. So Gregor how you related to that baby because he would find out that, oh you know this person who knows this person or I’ve been the li, my aunt lives in whatever he wants. If you watch the patient as soon as that connections made, there’s So, I mean go down a little bit, their anxieties and people go, well that doesn’t really make any sense. And I said kinda like the snake thing, I would say to him, imagine you’re in a hospital in I don’t know France and no one speaks English. Your fear is known to be super I that all of a sudden a nurse won’t in and it speaks perfect English to you and it happens to be from New York where you’re from, what’s gonna happen to your, your anxiety, it’s going to decrease.
Dr. Anthony Orsini (21m 35s):
So let’s work on that first. Right? I mean it’s so important
Mindy Spigel (21m 38s):
And we do kind of speak a foreign language even if your language is English and in healthcare don’t we speak a little bit different English, right? It’s kind of confusing as you just said, all of that about finding commonalities. I just have to say today happened because we were on a Zoom meeting with a whole lot of other people and you started talking and you shared That, you were in Florida, That, you were a neonatologist and That, you really cared about communication with patients and families And I messaged you and said, I wanna meet you because we have so much in common, right? We had that immediate Yeah and you weren’t even talking directly to just me. But immediately I felt that connection cuz of those three things, So,
Dr. Anthony Orsini (22m 22s):
I’m so glad you reached out because I’m cannot to say this was gonna be something like our 80th fifth episode by the time this drops and I can say I feel that I’ve had a friendship with every single one of my people that I’ve interviewed. Because you have half hour conversation and you become friends with people. And so take the time as a clinician to get to know those people. It’s very funny you talk about the sitting down thing, it’s crazy how many doctors and nurses speak to family members standing up and So I did a lecture once and I brought a chair on stage and I said, I’m gonna share a secret with everyone out there where we’re talking about sitting down and I love the chair to the center and I said “chairs move”.
Dr. Anthony Orsini (23m 7s):
You might not know that but they move and everyone laughed because that’s exactly what happens in the hospital, right? The doctor walks in and he or she will probably look around, they’re not a chair right there, they’re not gonna go get one. Yeah,
Mindy Spigel (23m 22s):
It’s really funny you say that because I, one of the things I did a lot was shadowed hospitalists. Very honored that people would let me do that because they wanted to improve their connections they were making with their patients. And So I would go with them in observing then give ’em a couple ideas of things they might be able to do. That’s one of the big things I talk about is sitting down. And this one doctor said it’s hard, there’s not always an available seat and I said, well what could we do about that? Well you know what? He started taking a chair with him into all. And I’m hoping to this day he still does. But I used to have staff say to me, Dr. So-and-So’s always pushing one of the chairs from the nurse’s station into the patient’s room.
Mindy Spigel (24m 3s):
Go, well he’s sitting down then obviously because why come with the chair if you’re not gonna use it? So
Dr. Anthony Orsini (24m 7s):
One message you’re sending to someone, a patient that’s say, I wanna speak to you and get to know you so much that I’m willing to walk 10 feet, go chair and it back. We always think of doctors are being so busy, et cetera. So it sends a great message. So there’s five of these Relieving strategies. One is build a relationship, two is choose your words carefully. Three, manage the first impression. Four, it takes the team and five is technology and the relationship So. I want to talk about choose your words carefully, that’s number two. And I don’t know if we’ll be able with hit on every single one of ’em. That’s okay. But I’m a big proponent of that. So tell us about that real quickly.
Mindy Spigel (24m 45s):
Yeah, I think words matter. I mean I have to tell this story really fast cuz it was a big aha for me about how important words were in that. I’m the Southwest Airlines flyer and one day was flying somewhere to do a presentation and Southwest Airlines didn’t go there. So I had a fly another airline and I arrived at the airport and I had to pay to check my bag. And now I knew I was gonna have to, but it didn’t keep me from thinking to myself, Southwest doesn’t make me pay to check my bag. And I got to the gate and they had a rick carpet laid out and they were saying boarding group one down the red carpet boarding group two down the red carpet. By the time they got to my boarding group, they said against the wall and it was like the red carpet was empty.
Mindy Spigel (25m 31s):
And okay, So I might be a little bit, I may have walked down the red carpet just outta spite, but it was like Southwest You don’t have to pay extra to be treated like a first class passenger. Everybody’s treated that way. The flight attendant didn’t do the announcements the same way that Southwest does. And by the time they didn’t do the drink order the same way. And I’m going, they don’t do it like Southwest does. I said to myself, Stop it, stop it. Did they take off on time? Has the flight been pretty smooth so far? And at that moment I realized, I woke up that morning and I thought to myself, Ugh, this isn’t gonna be a Southwest experience. And my brain heard me and it wanted me to be right. And So I kept finding examples.
Mindy Spigel (26m 13s):
If you think about if you wake up and you go, this is gonna be a Monday or I have to go into that difficult patient’s room, it’s gonna be a difficult patient and it’s gonna be a Monday because your brain is gonna look for those things. Now let’s put it into the patient experience. If we know what patients are looking from us is to keep them informed, keep them safe, keep them comfortable, use those words. Just say things like, You know what? I’m going to do everything I can to keep you just as comfortable as I can while you’re here. We are gonna work as a team to keep you safe while you’re here. And they’re gonna start looking for everything you do that keeps them comfortable and safe.
Mindy Spigel (26m 53s):
And then of course informed. We’re gonna keep you informed. We’re going to use this communication board up here to make sure you know everything that’s going on. We’re gonna tell you what’s gonna happen before it happens. We can use that example and the brain’s gonna start looking for everything we do to keep them safe, informed and comfortable. One of my big things is be careful about how we talk about time. Because when we say to people, we’re gonna be back in a minute, what do we usually mean soon? Yeah, what do they hear? 60 seconds. So we just have to be careful about how we say things because that’s what they’re hearing. And we have to try to use words that they’re gonna understand because words are, again, we speak a foreign language in healthcare,
Dr. Anthony Orsini (27m 33s):
You know it’s a big deal now we’re doing bedside rounds and I sign out, which we’re big old big advocates for it. It’s great with, for those of You don know what that is cause we’re not all in healthcare in this audience. When the nurses change shift they change shift in in front of the patient. So they tell each other. In typical teaching hospitals, the doctor will round the, the residents will present, the doctor will teach. We do that in front of the patient often. But what we don’t realize is especially in the United States, we use more communication than any other country in the world. And then we use a lot of different kind of slang in non-medical terms. And it’s important. Sometimes I’ll say, Listen, I’m gonna speak to the residents now cause I’m gonna teach them and I come, you know, we’ll talk afterwards or I’ll come back afterwards.
Dr. Anthony Orsini (28m 16s):
But somewhat wrote an article in Neonatologist and I can’t remember who. And it was a fun article about the day that we study neonatology. That, you don’t realize it. So for instance, if you’re not a neonatology, sometimes the baby’s abdomen gets distended and the baby gets some gas or distention and sometimes that can mean an infection. And so we’ll do some blood work or an x-ray for that. The weight it’s often around is, well last night the baby’s belly blew up and
Mindy Spigel (28m 50s):
I got yes
Dr. Anthony Orsini (28m 51s):
And we got an x-ray, right? And so there were a whole bunch of those where the parents go, blew up like what was this? And so we have to be careful what we say in front of the family and then make sure that we interpret them because there’s so many different things. That, you say that are misinterpreted.
Mindy Spigel (29m 10s):
Yes. And I wanna take it one step further, particularly like when the nurses are changing shift, I ask them to go right up there to the patient’s bedside and have them be part of the conversation. Because then first of all, you tend to use words That. You would say to them like, I don’t think anyone would’ve looked at a patient and said, Well your stomach blew up last night. We wouldn’t have said that. And then the second piece is that they get to fill in the gaps in the story and it makes them feel comfortable when that happens. I actually had that experience on the other side as a patient when the nurse that was coming on to duty literally stood next to me and looked at me while the other nurse was giving a report and got my feedback on what she was saying.
Mindy Spigel (29m 54s):
And I felt like we were a team. She and I were the team hearing how to take care of me on this next shift. So I think yes in the room is a good thing, but we have to remember the patient is there as well that they’re a part of that conversation.
Dr. Anthony Orsini (30m 9s):
I wanna skip over, we’ve done a lot more than I really anticipate a lot of episodes on physician burnout in addition to suicide. Yeah, it wasn’t planned, but it’s the other hot topic in patient experience and it’s been in the news a lot and we just had some wonderful guests on that. But you do have in your part two of your book healthcare team members are people too. So I’m gonna skip over to that because that’s so important. So tell us about that.
Mindy Spigel (30m 37s):
And that part of the book really started by again a conversation. Conversation that ends up being everything, right? Yeah. So one day in March of 2020, 1 of my very favorite nurses said to me one day, Mindy, I am so concerned I’m gonna make a mistake because I can’t focus, I can’t concentrate. And I took a breath and I went, Oh my gosh Rachel, you have a snake on your head. And because I taught this and to all of our staff, she knew exactly what I meant. And she said, you’re right, I do. And at that moment I thought to myself, what did Rachel need? Keep me informed, keep me safe, keep me comfortable. And if you think about what we did in March of 2020, we didn’t know anything.
Mindy Spigel (31m 20s):
We’re flying by the seat of our pants with this whole covid thing, right? And we’d come in and we’d say, Here’s what you have to do to be safe. And the next day or maybe an hour later, we came in and we said, Wait, that’s all wrong. Here’s what you have to do to be safe. And then the next day or an hour later, we came in and we went, Wait a minute, we don’t have enough PPE for that. So here’s And what was she worried about? Am I gonna take this to my next patient and make that patient who doesn’t have covid? Are they gonna get it from me? Am I going to get it myself? Am I gonna bring it home to my family? Right? Because we were learning as we went and we had to keep people safe. We had to help them feel comfortable in the situation and give them as much information as we could as we were learning it.
Mindy Spigel (32m 2s):
And one of the things that I saw was that the, I worked with six hospitals and talked with people across the country and what I saw was that the leaders who passed out information as fast as they bought it, their team seemed to do better because at least they knew we were trying to get ’em as much information as we could as we were learning. But it also connected for me that there were a lot of what, remember I said my role was round associate experience first and then the patient experience. So a lot of the things I had done that one conversation connected the dots as to why they needed those same things at scary times for the healthcare team. And that is like when you get a new leader, I saw over and over again teams that did really well.
Mindy Spigel (32m 46s):
When a new leader came in, their results fell until they were comfortable because they were worried about things like, well who is this new person and what are they gonna change and how do they do things? And I then while they were worried about that, they couldn’t really focus on their job as well and the results began to fall. And so the sooner you can build that relationship again, it gets right back to relationships, right? As soon as you can build that relationship between that leader and their team, the results went back. When you get a new job, even if you’re very, since then you just changed laws and you went to a new place, right? Even That, you know what you’re doing and
Dr. Anthony Orsini (33m 23s):
I’m the new leader. So it’s the same thing,
Mindy Spigel (33m 26s):
Right? You had to figure out, well how do they do things here and what are those unwritten rules here that I don’t know and are they gonna be nice to me here? Are they gonna welcome me? Am I gonna be an outsider or an insider? And how do we help that person feel safe and comfortable and know what they need to know with us? And then during times of major change, people need those same things. So yeah, second half of the book looks at those same things related to the healthcare team.
Dr. Anthony Orsini (33m 54s):
Yeah. The analogy is when you have the airplane and it starting to go down, right? Put your own mask on first and then you help the person next to you. And if you’re not taking care of yourself, then you’re not gonna do a very good job care of others.
Mindy Spigel (34m 5s):
Yes. And it’s okay to take care of yourself first. It’s important.
Dr. Anthony Orsini (34m 10s):
Yes. So we’re running outta time and I wanna ask two more questions. One is, so right now clarify what are you doing? How are you helping people with this great idea? That you had?
Mindy Spigel (34m 22s):
Well, writing the book was one of the first things I had done the research with the Beryl grant, I was very fortunate to get this grant and they allowed me to present this with Beryl. I had that opportunity and so I did some presentations, a couple of them. And the research study itself is published on Beryl’swebsite. But I felt like I wanted to reach a broader audience. And so that’s what encouraged me that in a lot of my colleagues who said, You gotta write a book, I semi-retired, I stepped out of my role in the healthcare system and they said, You’ve gotta write a book. You’ve gotta write a book. So I wrote this book. And my dream and my hope now is that the book will help people see patients a little bit differently.
Mindy Spigel (35m 2s):
And then secondly, I’ve been doing some consultations, some coaching, some presentations about the book and about other things about creating strong teams. So really the second half of the book as well. And that’s what I hope to be doing more of in the months to come. At this point in my career, I still wanna make a difference for patient experience and that’s really where my heart is.
Dr. Anthony Orsini (35m 26s):
And we’re gonna get all your contact information goes on the notes and I’ll ask you about it later, but we always end with the last question That you a very short warning for, you’ve had a lot of patient interactions in your life, you’ve had a lot of team interactions and you’ve had some personal interactions. But the title of this podcast is Difficult Conversations, lessons I learned, so think about either It can be a specific conversation or It can be a type of conversation that you think are is the most difficult one to have. And give us some advice on how you were able to navigate through that or you weren’t able to navigate but you learn from it.
Mindy Spigel (36m 4s):
I’d have to say for me, I like everybody to be happy if you haven’t picked that up for me in the last half hours, I really want everybody to be happy. And so complaining patients are sometimes difficult for me because they’re upset, they’re angry. Angry patients. And I think one of the things that’s helped me is to try really hard to see that snake on their head. You know, when people are angry, what usually sits right under that anger is fear. And we are wired for fight or flight. If someone comes out as angry, we’re either gonna push back or flee neither, which is gonna help them, right? But if we can stop and go, Ooh, I wonder what they’re afraid of or I wonder what they’re worried about or wonder what they’re scared of and can sit and listen to them.
Mindy Spigel (36m 46s):
And sometimes it’s hard because like I wanted to send, cuz they’re talking about my team and my people and things that, and sometimes it’s not always exactly the way they saw it, but I realize pushing back doesn’t help. They just need me to listen. To just listen. And if you can realize you’re dealing with someone who’s very, very frightened, they’re not at their best selves. They have a snake on their head. I don’t know what it is, but there’s something. And if I can just listen to them until they finish telling me their whole story, let it all out and then when they’re all done, I go, that’s a lot. And it sounds like you’re really pretty frustrated or pretty angry or pretty, whatever emotion it is.
Mindy Spigel (37m 27s):
But I’m so glad you told me cuz I wanna help you and then begin to talk about how is it that I can help you? What is the most important thing I could do right now that could help that. Sometimes I can’t do what they want me to do. And again, that’s also really hard for me because I can’t necessarily make their loved one better or I can’t. But what could I do right now that would help make you all more comfortable or help you or thank you at least for sharing that with me. I’m hearing that. Is that always easy? Did I always do it right? Did I get caught up sometimes when they pushed my buttons about the organization that I worked for for 30 years? So. I was very proud of, I would lie to you, I’d said they didn’t sometimes get to me, but it’s something I worked at and I just kept working at trying to see that Snake
Dr. Anthony Orsini (38m 14s):
My sound advice. That’s really, really great. Mindy, this has been really great. The book, there’s Snake on my head and it will be out by the time this airs has been a great interview. I think our audience is really gonna learn a lot from you and that’s wonderful that you’re doing this work. We’re gonna put it in the show notes, but for those people who are, listen, what is the best way to get in touch with you?
Mindy Spigel (38m 34s):
You could email me at MG Spigel and Spigel is spelled S P IG E L @gmail.com. I also have a website that is Mindy Spigelcom. So you could reach me on my website and I’d love for you to purchase my book on Amazon and I would love to hear what you’ve thought about it, if there’s anything I can do to help you.
Dr. Anthony Orsini (38m 60s):
Thank you so much. If you enjoyed this podcast, please go ahead, follow or subscribe depending on your podcast platform. We’re available on all podcasts. If you wanna learn more about Mindy, put this all in the show notes. If you need to get in touch with me or you have a guest, that you think would be perfect to be on the podcast, we are very proud that we and I got this very strange number. We’re in the concrete oh 1% of all podcasts around the world, which sounds better than it is because there’s a lot of podcasts that there are small, but we’re very, very proud that we are been in the Apple top 100. But you could reach me at info@The Orsini Way.com. Please go ahead and tell your friends to hit subscribe.
Dr. Anthony Orsini (39m 40s):
The more downloads that we get, the better guests that we get, like Mindy and other very famous people that we’ve had on. So thank you so much and please go ahead and listen to the next podcast. Have a great day.
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