I want to share with you a quick technique I’ve been experimenting with for the past few years. I first came up with this while working as a supervisor in the private ambulance service. At that point I did a lot more interacting with bystanders on scene and it was often a challenge to get them to hang-up their cell phones and talk to me.
It still happens. And it seems that it’s becoming a more and more frequent event. People wreak their cars or fall down the escalator and their first thought is, “Oh my gosh, who’s going to pick up the kids at day care? What will my husband say?” And by the time we arrive, three to eight minutes later, they have their cell phone planted in their ear and the conversation is just getting under way. Does this happen to you to? I imagine it does.
So we usually say something like, “Ma’am I need you to put the cell phone down so I can speak to you for a few minutes.” And they say something like, “OK, hang on. Dear I need to go. I need to go. The paramedics need to talk to me. Yes…no…ok. Well it isn’t a lot of damage…” And the conversation continues.
Here’s where I think we make a big mistake. We step away. We step back and give them a few feet of social comfort while they wrap up the conversation. And that’s almost like giving them permission to keep talking. We don’t want to be rude. We don’t want to take the phone away and hang it up. Sure, in some extreme scenario that might be necessary, but it’s pretty over the top. It also doesn’t go over well with the would-be patient.
So here’s my suggestion. Politely ask the patient to hang up the phone and then, when they say, “OK” don’t give them an inch. I mean not an inch. Don’t glance away. Don’t break eye contact. Just stare politely into their eyes with an amicable smile on your face.
They’re going to try to look away. Don’t let them do it. If they turn away, step right back in front of them. Keep your polite smile and keep staring right at them. It’s very, very awkward for the person on the phone. Have you ever tried to talk to one person while staring at another? It’s amazingly distracting, even more so when the person is inches from your face, looking at you kindly. I find most people get off the phone in one or two sentences.
You will find a few people immune to this technique. If I run into someone who just won’t put the phone down I have a few other strategies. First, I try to listen to the context of the conversation. If they have a really significant issue that they’re trying to resolve, I’ll cut them some slack and give them a little time. I don’t want to pressure someone who’s trying to arrange care for a sick relative but who’s going to pick up the client at the airport and what temperature to set the oven for tonight’s turkey can wait. So can detailed descriptions of the event.
If Chatty-Kathy shakes off my polite stare and keeps talking I’ll politely say, “If you’re unwilling to end your phone conversation, I’ll assume that you’re uninjured and don’t want an evaluation. I’ll go start the paperwork.” This tends to jar even the most adamant ramblers out of their phone conversation and back to reality, especially the word paperwork. Average Joe doesn’t know what the paperwork means and they’ll be interested to know what this paperwork is that you’re initiating. By the time you return with the clipboard they’re usually ready to talk.
If you find them still in full conversation mode when you return, take a set of vitals on the free arm and make the call. I’m serious. I’ve only had to do it once before but, after a description of the mechanism, the patient presentation, orientation, and situation, the doctor was more than understanding.
Doc, “He seriously won’t put down the phone and talk to you?”
Me, “Nope, he just keeps talking.”
Doc, ‘OK, have him sign”
And he did. Without ever once interrupting his urgent phone call. I’m sure the dude could later make a case that his refusal was not an informed refusal and I certainly wouldn’t try that on someone who I genuinely thought was sick or injured, but it’s an option worth considering in some cases.
If the dude had an injury that needed evaluation, I imagine I might have needed to take the cell phone from him. What do you think?
Now it’s your turn: Would you use the smile and stare technique? What about the mid-conversation refusal? Would you take a cell phone away from someone? How have you responded in this situation?
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