Suzanne Gordon: Why introductions matter

suzanne_gordonThe other day, I was invited to give a seminar on interprofessional teamwork to a group of residents and attendees at a prestigious university medical center in Europe. The first thing people did when they trooped into the room was introduce themselves to me. Since there were about 25 people in the room, no one really expected me to remember their names. But each and every one of them went through the drill.

These introductions did more than convey instrumental information about who we all were and what roles we had. At the most fundamental level, what people are doing when they acknowledge a stranger walking down a street or shake the hand of a person whom they have just met is create a psychologically—not to mention physically—safe environment.

Introductions are commonplace everywhere except in healthcare. In the UK there has been a concerted effort to encourage healthcare personnel to introduce themselves to patients. What I would like to see all across the globe is an equally robust effort to encourage healthcare staff to introduce themselves to one another—i.e. the physician introduces him/herself to the registered nurse, the registered nurse introduces himself to the nursing assistant or housekeeper.

Consider, for example, how the residents and attendees I spoke with responded when I asked them if they routinely introduced themselves to nurses when they went on a unit to see a patient.

One attending physician explained the routine. “I usually go up to the wards, and ask the nurse where I can find the patient.” Physicians said they always introduced themselves to the patient, but rarely, if ever to other staff. One physician said he didn’t understand why he should invest the time to introduce himself to registered nurses whom he will probably never see again. Another said registered nurses don’t introduce themselves either.

Although nurses constantly complain that physicians don’t acknowledge their presence and never know their names, they forget how rude or brusque they can be to doctors. In a teaching hospital, I have commonly heard nurses explain that there’s no point in introducing yourself to residents who rotate in and out of their units.

We’re too busy, everyone agrees. Besides, why bother.

People should indeed bother because introductions serve multiple purposes. The most important, as I said above, is to make people feel that they are no longer strangers. Introductions also convey critical information, like who you are, and what your role is. For this reason, the SBAR (situation, background, assesment, recommendations communication technique has become the I-SBAR communication technique. The I stands for introduction—with full name, and title or function. This replaces the anonymous voice on the phone announcing, “Hi, this is Four South I need an order for morphine for…” with, “Hello this is Nurse Joan Smith who is taking care of Mrs. Jones who.. .”

Introductions also link people together. When I do a workshop, I always begin with a brief introduction asking people to give their full names and to tell me why they are there and what they hope to get out of it. Again, I can’t possibly remember all their names and reasons for attending. By finding out who they are and what they want from me, allows me to situate myself and better address common goals. Plus, they feel I am interested in them. We can begin to work together. We have taken the initial step of creating a potential team.

Which is precisely why healthcare staff—even those who have never seen each other before and may never see each other again—should always introduce themselves to each other when they share the work of caring for patients. Yes it takes time—although not as much as they think. Saying “Hello, I am Suzanne Gordon and I am taking care of….” takes less than a second. When I’ve timed it with six people introducing themselves, it takes exactly 19 seconds, (or 26 seconds if someone starts griping about how long it’s taking).

Making introductions involves more than an investment in a relationship with a particular person. It involves taking the first step in the creation of an effective healthcare team.

So, if you’re a physician, introduce yourself to the nurse, unit clerk, or respiratory therapist next time you encounter them. If you’re a nurse, look up and acknowledge the person standing in front of you. Maybe even try being welcoming rather than annoyed. If you think it’s silly, try it just once. See what happens. And then maybe you can follow in the footsteps of Kate Granger and make your workplace a more welcoming, pleasant, and safer space.

Suzanne Gordon is a healthcare journalist and co-editor of  The Culture and Politics of Healthcare Work Series at Cornell University Press. Her latest book is Collaborative Caring: Stories and Reflections on Teamwork in Healthcare, which she co-edited and she is co-author of Beyond the Checklist: What Else Healthcare Can Learn from Aviation Teamwork and Safety. Most importantly she is a patient.