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Excellence in Human Understanding—A social worker’s perspective on listening and compassion

Everyone in healthcare strives to serve the patient. But a select few go even further, embodying a spirit of care and compassion that defines high-quality patient experiences.

It’s these individuals that NRC Health seeks to recognize with its Excellence in Human Understanding Award. This article is one of a series celebrating the remarkable stories of healthcare workers who make a meaningful difference in patients’ lives.

One of this year’s nominees is Luis Santos, LSCW, a behavioral-health manager at University Health (UH), based in San Antonio, Texas. Santos is on the front lines and never have his qualities been more apparent than during the COVID-19 pandemic.  Additionally, his example demonstrates the trauma-informed approach, which is a priority for University Health.  This article explores three qualities that Santos brings to his work, and how they guide his patients to a more fulfilling encounter.

Self-awareness

Managing ones’ emotions is a critical part of care delivery. But offering objective, compassionate care—even in the face of a patients’ intense emotional swings—can be an enormous challenge. Many providers struggle not to internalize the piqued reactions of their patients.

It’s here, however, where Santos excels. According to Sally Taylor, MD, UH’s SVP and chief of behavioral medicine, Santos’s awareness of his own distress is part of what makes his work so distinctive.

“Especially in behavioral health, when you’re talking with these patients, you have to realize that what they’re going through also affects us,” Dr. Taylor says. “We all have these fears and frustrations. You have to get in touch with them in order to deal with them and offer effective care. It’s that kind of self-awareness that Luis brings to every interaction.”

Santos’s emotional self-awareness allows him to be adaptable and flexible with his patients. He can adjust his approach as he goes, redirecting the encounter to be more productive for both the patient and himself.

As Santos himself will concede, this is a hard skill to describe—let alone to teach. “It’s not something I can write up on a blackboard,” he says. “But without that self-awareness, without understanding your own emotions and what’s motivating you, I think it’s very difficult to make a real connection with patients.”

Empowering patients

For Santos, “empowerment” is the watchword for almost every decision he makes.

“Patients do have choices,” Santos says. “Sometimes they make choices we may not agree with. And we have to respect that they do have that right.”

This is a particularly incisive observation for Santos’s particular field of healthcare.

The issue of autonomy is somewhat fraught for behavioral-health patients. Because of their conditions, patients with mental-health issues frequently do not enjoy the autonomy of their counterparts in other units.

While such restrictions can be a clinical necessity, it’s also incumbent on behavioral healthcare workers to strike the right balance between delivering effective care and respecting patient independence.

When patients’ preferences clash with his own, Santos actively resists laying the blame at the patient’s feet.

“When a patient doesn’t comply with something, rather than seeing it as their failure, we have to ask ourselves what our system does to make the situation happen,” Santos says. “How have we failed to support the patient, to push them toward not complying?”

This broad-minded perspective is appreciated by both Santos’s colleagues and his patients. With characteristic modesty, however, Santos insists that he doesn’t deserve all the credit.

“It’s not just me, it’s University Health as a whole,” he says. “We’ve intentionally adopted a trauma-informed care perspective, where we make these intelligent efforts at creating safe spaces for our patients, and encourage an empowering course for their hospitalization.”

Real understanding

Finally, in his day-to-day work, Santos cannot emphasize enough the importance of understanding his patients.  Much of Santos’s role, in fact, revolves around cultivating a strong awareness of the patient’s feelings and motivations.

Fortunately, Santos exhibits a remarkable talent for building a quick rapport, and for creating authentic relationships with patients as he helps to guide their care.

On this point, Dr. Taylor again sings Santos’s praises.

“Luis has this remarkable way of being attentive to patients’ internal barriers and hesitations, and helping patients move past them, so we can form an effective partnership in their care,” Dr. Taylor says.

As Santos himself says, bringing this skill to bear in a fast-paced health system is far from easy.

“We have to bring a multidimensional view to the work we do,” he says. “Our customer, always, is somebody who’s very complex. We have to understand that the patient experience isn’t always black and white; sometimes it’s gray. It’s up to us, in spite of that, to serve our patients and honor their dignity.”

The process of discovery

Appropriately enough, Santos recognizes that the work of understanding is never quite complete. Instead, it’s a continuous process, and one that healthcare workers and their organizations must embark on together, if they’re to create the kinds of experiences that patients are looking for.

“What it comes down to is, you have to have a willingness to learn,” Santos says. “It’s not what you see when the patient’s admitted. It’s what you discover in the dialogue with them, in the discourse that you have. It’s not always obvious, but the exploration can teach you so much about what it means to do this work.”

Santos’s winning spirit, that willingness to do the hard work of exploration, is precisely what NRC Health celebrates with its Excellence in Human Understanding Awards.

Congratulations to Luis Santos, and to his colleagues at University Health, on building a culture of care—premised on authentic human understanding.