Managing Difficult Conversations Without a Neuralyzer

I think I was the last lone ranger Chief Resident in Psychiatry, meaning doing the job solo. After that, there were always at least two senior residents managing that. One of the things I did was to give lectures on various topics that were not strictly related to how to work on the wards and clinics, but how to communicate with other professionals and with patients.

The other big task was fielding outside telephone calls from doctors in other hospitals trying to transfer patients to The University of Iowa Hospital psychiatric units. That’s right, that was a resident’s duty. I had some pretty difficult conversations. I couldn’t just accept every referral.

The hospital didn’t issue neuralyzers, so it was impossible to make difficult conversations go away.

I used a couple of books as guides: “Getting to Yes” by Fisher and Ury, and Difficult Conversations by Stone, Patton, and Heen. I should seriously have reread those books during my entire career and even now. Nobody’s perfect. I encountered racism from patients, so I was no stranger to a variety of difficult conversations in many different situations.

Anyhow those two books are on the short list at the University of Iowa Conflict Management web page. There’s a ton of resources there available for learning about how to manage conflict and recognize what implicit bias is and what it is not.

Implicit bias gets a lot of press. I think it can tend to set people on edge before and during seminars on equity, diversity, and inclusion. Not everybody is a racist. But our brains are wired for implicit biases. I think we all need to get busy, and I mean everybody, including me. A good place to start is understanding implicit bias.

Author: James Amos

I'm a retired consult-liaison psychiatrist. I navigated the path in a phased retirement program through the hospital where I was employed. I was fully retired as of June 30, 2020. This blog chronicles my journey.

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