The Jug technique
A communication skills technique also effective when addressing emotionally charged conversations
Core skills of jug technique
Listening
Acknowledging
Concurrent skills of the jug technique
attending
silence
clarifying
use of questions
Listening
-The JUG represents LISTENING
-Visualise yourself bringing the jug (your Listening skills) to every consultation.
-Place the jug at the centre of the consulting space, beforehand…thus
-Transforming the area into a CONTAINING space…. therefore
-Providing CONTAINMENT during the CONSULTATION.
The HCP should avoid
Feeling pressure/pressurised to respond to the MANY questions or statements issued by the patient.
Personalising the patient’s responses.
Ignoring the emotion – and continuing from where the conversation was before, as if nothing happened.
Acknowledge
Acknowledge & Normalise emotions displayed
-After Active Listening and Silence, when Emotions subside
-Name what emotion you just witnessed and normalize it.
-BE SILENT and ATTEND
-Be silent in your mind, emotions and physically – Be present, in the moment and contain the situation
Recall
- So, after attending to the emotions, what? It’s RECALL time.
- What do you remember that the patient said? What is inside the jug?
- Pull responses/concerns individually,
- address each with the patient, share available options, promote patient involvement in decision making.
- Once exploring options for each concern is completed and nothing else in the jug,
- the HCP may ask the patient to remind them: “I know that there are other concerns which you raised, Which ones am I missing/ leaving out or forgetting?”
Contents of the jug
- Address all concerns in the same way
- At the end of the consultation, contents of the jug (which belong to the patient) are turned into a nicely packed folder (visually)
- The folder (visually) serves as a reference point for any of the concerns that were unpacked and discussed during the consultation.
- The patient takes the folder (memory) home. This is from where they will pull and share information with their loved ones.
the A, B, C and D of dignity of conserving care
A- attitude
B- behaviour
C- compassion
D- dialogue
Breaking bad news- SPIKES
S- set up
P- perception (ask)
I- invite (ask)
K- knowledge (tell)
E- emotions/ empathy
S- summary/ strategy/ support
Set up
prepare setting and information, who needs to be present
Perception (ask)
elicit the patient’s understanding
Invite (ask)
Ask the patient
- how they like to receive the information
- what they want to know and
- permission to go ahead
Knowledge (tell)
Provide information: small chunks, no jargon
Emptions/ empathy
Recognize and explore patient’s emotions (SPIKE)
Summary/ strategy/ support
Check for understanding, summarise what has been said, agree on next steps, offer support
NURSE technique
N- name the emotion
U- understand the emotion
R- respect the patient
S- support the patient
E- explore the emotion
