OPINION


communication skills


I VISItED lonDon rEcEntlY to SIt on a pharmacY aDVISorY panEl. on mY WaY homE, I foUnD mYSElf on a frIDaY nIght aEr lIngUS flIght oUt of hEathroW - WhIch I normallY DESpISE, SIncE paSSEngErS arE gEnErallY mEan anD rUDE aftEr thEIr WorKIng WEEK In lonDon anD, aS a rESUlt, arE prEttY UnSocIablE...


by terry maguire I


was pleasantly surprised to find that my travelling companion on this occasion was an affable german


who, when he finished a long and intense telephone conversation in german, was keen to know about belfast since this was his first visit. I ably complied and hoped I didn’t bore him too much.


leaving the plane, our hostess in green, wished us a good evening over the pa and suggested we put on our coats as it was ‘lashing out there’. my new germanic friend looked quizzically at me. ‘lashing?’ he said. ah, communication skills, I thought, a topic we had discussed at length during the pharmacy advisory panel.


It was, I think, the late gerry Shulman, frpharms who, in 1979, while addressing the QUb South lecture theatre, which was bulging with pharmacists and pharmacy students, said that pharmacists needed not only to talk to patients but, he proposed, we ‘needed to have intercourse with them’! I was quite impressed with this assertion as it was not what I’d expected when I signed up to study pharmacy!


gerry Shulman was one of the first to advocate a more patient-centred community pharmacy service, and who demanded that we get out of our dispensaries and communicate. Yet, in this enthusiasm that evening, ironically, his own communication skills failed him!


nevertheless, we knew what he meant - even if he didn’t!


communication skills quickly became a core skill in pharmacy practice and a young and enthusiastic norman morrow, later to become our chief pharmacist, led that development. In conjunction with owen hargie from Ulster Univerrsity, norman did ground-breaking research and published extensively on the subject; becoming an internationally- respected expert.


today, communication skills are a core element of good practice and we are a more effective profession for it. one of norman’s most impressive findings was that, in practice, ninety-four per cent of questions pharmacists asked were ‘closed’ questions: a fact which greatly restricts the information flow in the pharmacist-client interaction. twenty years later, I hope we have improved.


most of my problems in practice - indeed in life - have been as a result of poor communication. I failed to apply the correct skills and I paid the price, so I studied the theory on open and closed questioning, explaining skills and the verbal and non-verbal aspects and, hopefully, have attained a reasonable level of competence.


In recent years, the challenge has come from non-English speaking patients and this has reminded me regularly about how vital good communication is. a chinese lady


with no English - unusual in this ethnic group - was deeply annoyed because I couldn’t understand her request and, through sheer frustration, she ended up exploding; raging loudly in fluent cantonese or mandarin - I couldn’t tell which.


So, with the lady in a full pyretic meltdown, I telephoned by my good friend, colin Wong, who runs a local chinese restaurant, since I knew that he spoke most of the languages of mainland china.


I put the lady onto the phone to speak to colin, but she simply raged at him. When I asked him what she wanted he had no idea. I put her back on the phone to him. this time she listened and was able to establish that her child had a severe congenital cardiac condition.


the hospital had prescribed a medicine and we were getting it into stock. finding the lady’s daughter’s name, I found her scrip already made up. her anger abated and she finally left the pharmacy relatively happy.


more recently, a middle Eastern refugee family moved close to the pharmacy. on the first occasion when they visited the pharmacy, they were accompanied by an interpreter, who explained to them that we could help with minor conditions and health advice.


the wife arrived on her own a few days later and, following many hand gestures - mainly centred around her


not inconsiderable stomach, I guessed she might be suffering from nausea, vomiting or indigestion. I therefore suggested a range of antacids, which she dismissed.


clearly unhappy, she produced her iphone, opened up an app and began typing on a keyboard with arabic letters. When she’d finished typing, she hit a button and then held the screen up to me.


the translation app said ‘gas-testing system’. It was a long shot, but my able pharmacy assistant, who has an insight into such things, led her over to the pregnancy tests and it was there that this particular communication problem was solved.


a week later, however, her husband came in. again it was the wild hand gestures around his abdomen, this time pushing down and then around his back. Diarrhoea? I wondered. constipation? cramps?


as there were other customers in the pharmacy, he signalled me over to a quiet corner and pulled out his iphone. an app was opened; he spoke into it quietly and it shouted back loudly - in a female voice - ‘haemorrhoids!’


as I sold this customer some anusol cream, holding up four fingers to indicate the number of daily applications, I couldn’t help but hope that the great gerry Shulman was looking down on me with avuncular pride! •


pharmacY In focUS - 41


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