Mindy Spigel’s passion is helping people create meaningful connections as a leader, a team member, and while caring for patients and families. She enjoys helping leaders build strong teams and exceptional work environments. She is committed to helping teams work together effectively. It is her desire to alleviate patient fears, build trust, and create an exceptional experience for all. Mindy Spigel is proud to be a nurse with experience working in both inpatient and outpatient settings. As an educator, Mindy has taught in both academic and clinical settings. She has both a Bachelor’s and Master’s degree in Nursing. Mindy has been honored to have presented at numerous National, State and local conferences and provided consultation and coaching to various organizations.

In this episode, we interview Mindy Spigel, author of “There’s a Snake on My Head,” about patient experience and how clinicians can alleviate patient’s fear and anxiety when seeking healthcare. Based on her research, she shares three things patient’s must feel in order to be fully present and engaged during their visit because everyone enters the doors of healthcare with fear.   

1. So there is clearly a lot to unpack and discuss about communication, but lets start out by talking more about your background. Can you share with our listeners more about your experience as a patient experience leader, like what that means and what sparked the research you did?
2. What were the major findings of your research?
3. What were some surprising findings from your research?
4. The title of your book is called, There’s a Snake on My Head! What does it mean to have a snake on your head?
5. Our podcast is all about communication, and we love to give our listeners tips and tricks related to communication. You mentioned that patients need 3 things to help manage fear and anxiety-lets unpack and give our listeners tips and tools for each one starting with how can clinicians make patients feel informed?
6. How can clinicians make patients feel comfortable?
7. How can clinicians make patients feel safe?
8. In your experience, what do you think clinicians struggle the most with?
9. What is the one thing you would want all listeners to know about communicating with patients?
10. Where can folks go to learn more about the work you are doing and how can they find your book?

Mindy Spigel 

There’s a Snake on My Head

Colleen Sweeney 

Patient Experience

Nicole: [00:00:00] hi everybody, and welcome to the Woman-Centered Health Podcast. Today we are speaking with Mindy Spigel, a nurse, speaker and author of, there’s a snake on my head about our favorite thing, communication, and specifically how clinicians can help patients overcome fear and anxiety when seeking healthcare.

Nicole: But before we start our interview, we wanna thank all of you for listening and let you know that you, especially nurses, can earn CCEs and get key takeaways, resources, and transcripts by visiting our website, woman-centered health.com. Also, Stephanie and I put this podcast together in our free time and often use our personal funds.

Nicole: So please consider supporting us. You can support us by subscribing and giving us a five star rating on iTunes or wherever you are listening to us. And if you’re able to offer a financial donation, visit our website and click the support us tab. All right, let’s meet our guest.

Stephanie: Hi, Mindy. Thank you so much for being a guest on our podcast today. First. We always like to [00:01:00] ask our guest if you could provide a little bit of details about your background.

Mindy Spigel: Absolutely. Thank you so much for having me here. I am excited and honored and really appreciate this opportunity. I am a nurse and I have my master’s in pediatrics. Started my career working with children with cancer and blood diseases and their families. Moved on for a while working with adolescents in an outpatient setting and adolescents in a hospital setting teenagers with concomitant emotional or behavioral problems as well as a chronic illness.

Mindy Spigel: And if you think about the connection and all of those things, my passion has really always been about communication and alleviating fears because you have to, both with children, with cancer and adolescents, you have to real quickly build trust, right? And, and so that’s what my passion has been.

Stephanie: I love that, and obviously Nicole and I are all about improving communication with [00:02:00] patients. So the other question that we always ask our guests, and I think you alluded to it in your last answer, but what informs your perspective? So in other words, why do you do what you do and what is most valuable to you?

Mindy Spigel: Yeah, I would have to say my keyword is passion. Like people who know me always go, you’re just so passionate about this. But I really, really am. And I would have to say my passion around patient experience and I have served what I left out of my introduction really is, my last formal position was for many years I served as the director of patient and associate experience because I don’t think you can speak about one without the other.

Mindy Spigel: The team has to be working well together and feeling good about what they’re doing in order to create a great patient experience. So they go hand in hand. And I actually, if I think back, it started early on in my career with my very first job at all of about 21 years old. And I worked in a general pediatric unit of a general hospital and realized we weren’t doing things very.[00:03:00]

Mindy Spigel: Pediatric friendly. The art on the, it was white walls, no artwork for children, but most of all we called their parents a visitor, and they had visiting hours. And I thought, how do you say a parent is this child’s visitor and not me? And so I kept commenting on it and finally my, my head nurse threw our hands up and said, if you wanna make all these changes, you’ll have to talk to the chief nurse.

Mindy Spigel: And I said, oh, could I? And I didn’t know back then in the seventies, that wasn’t really something you did. And she said, okay. So I did. I went and shared all my thoughts and slowly I saw those changes happening. And at the time I didn’t realize that was setting the foundation for my entire career. But I have had this passion for advocating for the patient experience and making it as, as positive of an experience as we can in very scary times.

Stephanie: Thank you that

Nicole: always love the answer to that

Stephanie: I do too. And that you’re, so we just had a, or we just interviewed Claire Phillips of nursing the [00:04:00] system about, oh, what was it?

Nicole: service design.

Stephanie: design, that’s what it was. And she talked a, she talked a little bit about you know, getting to know the chief nurse or the other nurse leaders and, and just talking to them like regular people.

Stephanie: And so you, that kind of reminded me like, you’re not supposed to talk to the chief nurse. No. Go talk to the chief nurse. They wanna talk to you.

Mindy Spigel: I think things are different today. I do think most chief nurses not only are open to it, but most of them round on associates and ask their opinions, and we’ve come a long way in that respect.

Stephanie: That’s great.

Nicole: All right, so like we said, today, we are going to talk about communication and how clinicians can help patients overcome fear and anxiety. So let’s jump right in. So clearly there is a lot to unpack and discuss about communication, but let’s start out talking more about your background. Can you share with our listeners more about your experience as a patient experience leader, what that means, and what [00:05:00] sparked the research that you did in that position?

Mindy Spigel: Thanks. So I was the director of pa as I said, director of patient experience for multiple hospitals in San Antonio all within the same system. And so really all I felt I could really do is give people tools and more importantly, the inspiration to change their experience. So I, I kind of would go and plant seeds and water them and hope that they would grow.

Mindy Spigel: And I really always believed that you had a touch. The clinician’s heart and remind them about why they’re doing what they’re doing in the first place. That if all of the tactics and strategies really doesn’t do anything, if they don’t connect to the why. And, and you’ve touched their heart and reached out to it to them.

Mindy Spigel: And cuz I think most people went into healthcare in the first place to make a difference. They wanted to ease fears, they wanted to reach their patients. I just had to remind them that that’s what they were doing and why. And then as you see later, as we begin to [00:06:00] talk about strategies you’ll see that really my research just reinforces the why for the strategies.

Mindy Spigel: So probably about maybe eight or nine years ago, my chief nurse said to me one day, Mindy, I want you to create a class on empathy. And I thought, I don’t know how to teach empathy. Like how do you create a class on empathy? And I said, you know, Patty, let me think about that for a while. And I have this little guardian angel that sits on my shoulder and seems in my whole career to make the right things happen for me.

Mindy Spigel: Right after that, I went to a conference, and the day before the conference I went down to register early so I didn’t have to show up so early and wait in the long lines in the morning. And I met Colleen Sweeney, and I don’t know if you’ve had the opportunity to hear her speak about patient sphere.

Mindy Spigel: She’s amazing. And Sweeney Spiegel, we were standing next to each other in line and we started talking and it was one of those relationships that we bonded on. Hello. And at the end she said, I hope you’ll come to my keynote and [00:07:00] breakout tomorrow. And I said, absolutely. Well, what she began to talk about was her work around patient spheres and what she learned about patient spheres.

Mindy Spigel: And I went, That’s it. If we could talk about the fact that that person sitting there with you is really very scared and you just don’t know what they’re scared about. Our response as clinicians is empathy, right? And there’s my empathy class. All I have to do is help them connect with ears. So I came back and I started sharing this with all, and what hap, what Colleen did was one day she was walking through her hospital, she’s a nurse, and she saw somebody who was very distraught and she went over and said, you seem like you’re very upset.

Mindy Spigel: Is there something I can do to help you? And the woman said, oh, it’s nothing. I’m just here for an x-ray. But I realized the last time I walked into your doors, it was because my mother had died here. And all those feelings came back up over me. And at that moment she realized we have no idea how people are feeling when they walk in the [00:08:00] door.

Mindy Spigel: This woman was just here for an X-ray. Nobody would’ve expected her to be afraid, right? And yet her fear was really just because of her experience, her last experience there. So she started asking people everywhere she went about their fears and it, but it could have been like at a lunch table with a group of people.

Mindy Spigel: And she just goes, what do you worry about when you come into healthcare? She didn’t really mean for it to be a formalized research study, but she spoke to over a thousand people in the course of a couple years and learned that pretty much everyone’s afraid when they walk in our doors. So I’d come back and I’d share that with my hospitals, one of which was a children’s hospital.

Mindy Spigel: And remember I’m a pediatric nurse, and they would always say to me, Mindy, is it the same in pediatrics? So I was like, Hmm, gosh darn, I need to find out. And that’s what started my study. So in 2018, I got four nurses. I’m in San Antonio, a lot of people here. Spanish is their first language, and I don’t speak Spanish, so I found four bilingual nurses to interview over 200 families about their fears when they walked in the [00:09:00] doors and inpatient, outpatient ambulatory surgery.

Mindy Spigel: And er, the fears were pretty much the same and they were pretty much the same order, a little bit different, but pretty much the same what Colleen had learned. And and so we realized that pretty much everybody walks in whatever door of our organization afraid. And that’s how I got into doing my, my study and really talking now about patient fears with whenever I have a chance to share that.

Stephanie: That sounds really interesting. And Mindy, are, did you publish those results outside of your book that we’ll get into

Mindy Spigel: I did, and I probably should have backed up and said this, the research study was done with the assistance of a grant from the Barrel Institute and my research study is published with Barrel at the moment. It’s the only place I have it at the moment. There’s a few other places I’m looking at publishing it.

Mindy Spigel: And part of the reason I wrote the book was because the distribution. So I [00:10:00] published it there, spoke a few times about it, and then Covid came and I thought, I have to find a way to get this out better to really disseminate this research. And so that’s why I wrote the book and I’ve been doing some more speaking about it and podcasts like with you, the Wonderful Ladies.

Mindy Spigel: So,

Stephanie: Well, thank you. So I wanted to ask you about the, you know, more specifically unpacking the findings. What did. What were those fears that you learned about?

Mindy Spigel: So the top fears were diagnosis and prognosis. And I think about your population that you’re particularly interested in, in reproductive health. And think those ladies who come into you, they’re really scared about what you’re gonna find, right? And they’re wondering, are the results of what you find today gonna change my life forever?

Mindy Spigel: Right? And so that’s what we found people were worried about diagnosis and prognosis. Communication was number two. And again, I, I’m in San Antonio, where’s. We did separate out our results between English as a primary language, and then those that they had to [00:11:00] speak to in Spanish.

Mindy Spigel: But everybody was concerned about communication, right? And if you think about it, in healthcare, we kind of have our own English, even for people that English is their first language. We speak another language in, in healthcare and people are wondering, am I gonna understand what they’re saying to me? And this isn’t their very best moment.

Mindy Spigel: They’re in a scary place in healthcare. And it a scary moment. That’s what we found with the research, that everybody walks in our doors afraid and they’re not processing as well as they might. If they were outside of healthcare. Infection was number three. Incompetence. Are they good here? Do they know what they’re doing?

Mindy Spigel: Did I make a good decision? Did I pick the right place to go cost? What is this gonna cost to me? And this is very, very real. Death. Maybe not with reproductive health, I don’t know. But you know, that’s something people do worry about safety. The one that breaks my heart, and Colleen found it too, is people were worried about the staff being nice to them.

Mindy Spigel: They were worried about rude staff and then needles. [00:12:00] Those were the top fears that that we found out about. So in, in, as we, in, in the research in all areas, in inpatient, outpatient, whatever,

Stephanie: So and you might not know the answer to the. This, but I wanted to ask one question related to that. Staff being nice to you piece. Because I think Nicole and I talk a lot about this with other guests, and we both do work and like bias and implicit bias in healthcare. I was wondering if you saw a difference in the results between those primary English speakers and Spanish speakers?

Stephanie: As far as the fear there,

Mindy Spigel: You know, I, I don’t know. We didn’t, we took the top three fears and we looked at ’em by location and we looked at them by by the site that they came into in patient app. We looked at them by language. We looked at them by age of the child. We, we really focused on that with the top three fears and to see if the top three fears were the same [00:13:00] with all.

Mindy Spigel: But I don’t know that my statistician really dug down into that question. It’s a great question. But it, it’s a, unfortunately, a lot of people walk in and go, people are gonna be nice to me here, and what does that mean to them? Like, are they gonna listen to me? Are they gonna, and a lot of people are afraid of upsetting the staff because they want you to be nice to them because they’re.

Mindy Spigel: Kind of at our mercy. Right. So yeah, I that’s a really good question and I don’t have a great answer.

Stephanie: that’s okay. I just wanted to throw it out there.

Mindy Spigel: Yeah,

Nicole: What are some other surprising findings from your research?

Mindy Spigel: yeah. Well, interest for me, the most important part of the research really wasn’t even what the fears were because they’re different for everybody. And bottom line, I believe we have to ask. And, and I need to just say as I talk about that, that Colleen says, don’t ask people about their fear, because that’s something they hold close to their chest.

Mindy Spigel: Ask them about their greatest concern or worry. And when you [00:14:00] ask about what is your greatest concern today, they’re gonna tell you what they’re afraid of. But if you ask about their fear, that’s really like most of us don’t walk around sharing our fear, right? But our concern or worry, we might tell you what, and I oftentimes say that too with with staff.

Mindy Spigel: When, when they go, when they tell me that the patient just kept asking them the same question again or didn’t believe that what they were saying was the right answer, that the clinician’s answer was, and I say, just take a step back. Instead of getting frustrated, just say, you know, what is your greatest concern here?

Mindy Spigel: What are you worried that this might be? And that’ll explain to you why they keep going. Are you sure we don’t need antibiotics? Or are you sure we don’t need another test? Or Are you sure we don’t need whatever? If we just say, you know, what, are you worried that this is, you’ll find out really what’s going on with them?

Mindy Spigel: Most surprising findings that the very last minute in our study, we added the question right before we started, we said, let’s also find out what’s the most important thing we can do to alleviate their fear if we find out they’re afraid. And across the board, people said, [00:15:00] keep me informed. Keep me safe, keep me comfortable in that order.

Mindy Spigel: Now I don’t, I have a belief that until that we do the other two things, help them feel safe and feel comfortable. They aren’t not gonna hear the words we say that when they’re scared, they don’t feel safe, they don’t feel comfortable, they can’t hear us. And I think that’s why we say we’ve told them, but they didn’t hear what we had to say to them.

Mindy Spigel: So and I really emphasize when I teach, when I’m doing presentations, is there’s a difference between feeling safe and being safe. You know, we do everything we can to help people be safe. But they, if they’re not feeling safe and feeling safe with us and feeling comfortable with us then they don’t know that they’re safe Does that make sense?

Mindy Spigel: And so that’s why, yeah. So I think those were some of our, my my surprises. That and the fact that it sounds so simple. What do they want? Keep me informed. Keep me safe. Keep me comfortable. Well, if we think about it, that’s our why [00:16:00] behind we do we doing all those things that we know are best practices for people.

Mindy Spigel: And so it, it helps connect with clinicians why they need to do those things.

Stephanie: Awesome. So okay, so let’s get to into your book a little bit. So the title of your book is, there’s a snake on my head. So what does that mean to have a snake on your head? Why did you title it that

Mindy Spigel: Yeah. So are you afraid of snakes by any chance? Either of you. Okay. All right. So you both raised your hand. Okay.

Nicole: Oh, I’m deathly afraid of them.

Mindy Spigel: So, alright, so Nicole, you’re afraid of snakes. If there was a snake sitting on your head right now, moving around, everybody, just imagine there’s a snake moving around on Nicole’s head right now.

Mindy Spigel: And those of you listening to this, if you’re afraid of snakes, or maybe it’s a rattlesnake, I think even people that aren’t afraid of snakes go, oh, if I had a rattle snake on my head and he was shaking his rattle, yeah, I’d be afraid. And I come in and I say, Nicole, I have very important things I need to tell you so you can take great care of yourself.

Mindy Spigel: When you go home, [00:17:00] how much are you going to hear while there’s a snake, a rattlesnake rattling his rattle on top of your head, what will you hear

Nicole: None. None of it.

Mindy Spigel: day? That’s what happens in healthcare. People walk in our doors, they’re afraid. They don’t have a real snake on their head, but they have something they’re afraid of on their head, and we give them all this information and they can’t hear us, and they walk out the door and they didn’t hear us.

Mindy Spigel: What’s gonna happen? It’s gonna happen. If they go home and they didn’t hear us, they’re not gonna do what we told them. Right. And we think hopefully, we never ever say you’re a non-compliant patient if you had just done what I told you to do. But they never heard what we told them to do. And I experienced this snake myself.

Mindy Spigel: I’m a nurse and I was in one of my hospitals when my husband was diagnosed with stage three colon cancer. And I had been a nurse for close to 40 years. So I wasn’t in a strange place at one a foreign language. I didn’t hear a single thing people said to me. I started writing down things people said, and I’d read my notes [00:18:00] and I’d say, they never told me that.

Mindy Spigel: I never heard it. So my handwriting, I heard it, but I didn’t hear it. And I’m a nurse. So yeah, that snake is very, very real. And when you share that analogy with people, it clicks, they get it. Like, I hope it just, it just hit you that way. And if we can start seeing that snake on everyone’s head that we’re talking to, gotta find out what that snake is.

Nicole: Yeah, that’s a very wonderful analogy. Very, very real resonates. So obviously our podcast is all about communication, and we love to give our listeners tips and tricks related to communication. And you mentioned that the patient needs three things to help manage fear and anxiety. So let’s unpack each of those and give our listeners some tips and tricks, tools for each one.

Nicole: And let’s start with, how can clinicians make patients feel informed?

Mindy Spigel: Great, thank you. Remember, I’m just have to go back and say, [00:19:00] emphasize first. They have to feel safe and feel comfortable. I know we’re gonna get to how we do that, but I just needed to emphasize that afterwards. I think we have to choose our words carefully. So first of all, do they understand the words we’re saying to them?

Mindy Spigel: But even more importantly, if we have to, if we wanna make people feel safe and feel comfortable. Let’s use those words. I’m gonna give you a real quick story that really hit home with me about this and okay. So I’m a Southwest Airlines flyer. I, when you do customer service they, I just think they get customer service right?

Mindy Spigel: And so I know they’re. Some people may argue that, especially after this past winter, but even with that, they’re responding well. So I always fly Southwest and I was given the opportunity to speak in a place where Southwest doesn’t fly. Actually I, it’s important where, so I was going to Santa Fe and I would have to fly, fly to either fly to Albuquerque in February to fly Southwest and then drive an hour in potential snow.

Mindy Spigel: Well, I’m a [00:20:00] Florida girl who lives in South Texas. I’m not gonna drive an hour someplace, I don’t know, in the snow. So, and it did snow that day a lot. So I was glad I made the right choice and I flew another airline, but I got to the airport that day and I thought to myself, oh, I have to check my bags. I have to pay to check my bags and.

Mindy Spigel: You know, I knew I was gonna have to pay to check my bags, but it didn’t keep me from thinking about that Southwest doesn’t make me pay to check my bags. And I get to the gate and there’s a red carpet laid down and they say boarding group one down the red carpet boarding group two down the red carpet.

Mindy Spigel: By the time they got to my boarding group, they go against the wall. And I was like, oh, why? There’s nobody on the red carpet. In fact, I think I probably went down the red carpet anyhow. And I thought to myself, Southwest treats everybody like a first class passenger. So I get on the plane and, you know, the flight attendant didn’t do the announcements the same way Southwest did.

Mindy Spigel: And they didn’t take the drink orders the same way Southwest did. And at that point I said to myself, [00:21:00] stop it. Stop. Did they board the plane on time? Did they take off smoothly? Has this been a good flight so far? Safe, comfortable. Stop it. And I realized at that moment I had woken up and I said, ah, to fly another airline, this isn’t gonna be a Southwest experience.

Mindy Spigel: And my brain wanted me to be right. And so it looked for all the ways that I was right. Our brains are always listening to us. I promise you, if you wake up and you say, ah, this is gonna be a Monday, it will be. Cuz your brain is gonna find every way it is. If you say, oh, this person is so difficult, I gotta go talk to a difficult person.

Mindy Spigel: Whether it’s a team member or whether it’s a patient, they will, you will find why they’re difficult. That’s what you’ll see. I’m gonna flip that to a more positive outlook though, because I tend to really be more positive even though that story wasn’t so positive. Let’s take that positively. You can plant those words if you want people to be safe.[00:22:00]

Mindy Spigel: To feel safe and you want them to feel comfortable, tell them or, and, and informed. Tell them, I’m gonna keep you informed. I’m gonna keep you safe while you’re here. I’m gonna keep you comfortable while you’re here. And their brain will start looking for all those things. So that’s my first word. One is words.

Mindy Spigel: Choose your words carefully. Choose words. People can understand. Use the words they don’t know that you’re doing all these things to keep them safe. We do, we work really hard to keep ’em safe. Tell them, tell them the things we’re doing. We work really hard to keep ’em informed. Tell them, I’m gonna inform you all along the way.

Mindy Spigel: I know this is new for you. I’m gonna tell you every step of the way what we’re gonna be doing for you. And notice I kept saying for you, for you are words that make people feel safe. And one last thing is you’re choosing your words carefully. There’s a big difference between the. Giving them all this information and say, do you have any questions?

Mindy Spigel: And what questions do you have? There’s a big difference when we say, do you have any [00:23:00] questions? Most of the time people just shake their head no. And then they walk out of the room. And as nurses we probably have experienced that. They look at us and say, what did they just say? Because they never heard anything, but they felt like they shouldn’t have any questions at this point.

Mindy Spigel: But if we ask them, if we say, woo, I’ve been through a lot of information, what questions do you have for me right now? People are more likely to ask you. And so words matter. Choose those words carefully and think about what is that experience that you want them to say. If I’m gonna talk about communication, I just have to also say, be careful about your body language.

Mindy Spigel: Your body language is speaking so loudly. People don’t hear the words we say. So when I, I, I mentioned that my, and I love, love, love the physician who took care of my husband and, and did his surgery. The day he gave me all the information, he came out after surgery and told us what happened. My primary care doctor wanted to know, and I looked at my son, who was in med school at the time, [00:24:00] and I said, well, what should I tell my doctor?

Mindy Spigel: And he said, tell him that whatever he said. And I go, Zachary, he didn’t say that. And my friend was sitting there, who’s not even in healthcare. And she goes, yes, he did. And I went, oh. And I said, and I go, what else? And Zachary said something else. And I go, he didn’t say that. And my friend went, and, you know, What, what I realized days later when my brain returned was he had a distressed look on his face as he was telling me all this positive information and I was waiting for the butt I was waiting for.

Mindy Spigel: But Mindy, I’m so sorry. He died in surgery and there was no butt again. Days later when my brain returned, I realized it was seven o’clock at night. He was probably tired. He may have had another patient he was worried about. He may have had to go to he may have still had a surgery to do. I don’t know what was on his face, but it wasn’t about Barry.

Mindy Spigel: But everything that you have to say and everything on your face and everything in your body language is about. That person and they think their [00:25:00] family member or themselves is the sickest, most important person in the hospital or in your office or in your clinic or in your whatever. And everything they see is about them.

Mindy Spigel: So be really careful. I’ve told staff, I, I tell staff all the time, you may walk into a patient’s room and you have this many things you’re worried about. Well, you guys can’t see that. A laundry list of things you’re worried about. And are you gonna fix any of those things while you’re in that patient’s room?

Mindy Spigel: You’re not. So imagine a basket outside the room and leave all of your other worries and concerns there while you’re in that patient’s room so you can focus just on them and they don’t read your body language being all those other things. When you get ready to leave, it’ll all still be sitting in the basket.

Mindy Spigel: You can pick it up and start worrying about it again. So those are some of my, my key tips for information.

Nicole: Well, and I think, you know what’s interesting in this conversation being informed is it’s also front and center my mind in [00:26:00] some other projects that we’re doing. But then also I had a friend recently who went and got her teeth cleaned and she came back. She’s like, oh my gosh, she’s like the first time ever, and this isn’t the first time she’s ever had her teeth cleaned.

Nicole: She’s like, the hygienist explained what she was doing the whole time and like told me what was happening and she was just like, mind blown. And I was like, yeah, this is how low the bar is. I’m like, look at this. They’re explaining to you what they’re doing to your body.

Mindy Spigel: Right.

Nicole: And like, and you know, like she was just so felt that that was such a great marker of care.

Nicole: And I was like, again, like they were doing things to your body. The bar is that low that they just explained what they were doing while they were doing it to you. And I was like, which is sad. I mean, I’m glad you had a great experience and you found that to be really positive. Right? But at the same time, like, man, just simply explaining what you are doing while you are [00:27:00] doing it to someone’s body, like

Mindy Spigel: We do it every day. We forget. They don’t experience it every day,

Nicole: Yeah.

Mindy Spigel: you know?

Nicole: Yeah. And I think that’s really important. And then, and then we’re, Stephanie and I are also working on a research project with May. I don’t know what to call her anymore. She’s my PhD advisor, but I’ve have long since gotten my PhD. But anyways, we’re working on a research of black women’s experiences seeking reproductive care in Iowa, and one of the big issues is just not feeling informed and that being a big barrier and it, how it shows up for them.

Nicole: It, or, or in this, because we’re talking about reproductive care specifically, how it is often showing up is that they’re not given all the options of birth control. Like we’re not sharing all of the information about we’re, we’re self-selecting on what we think would be the best birth control for them without giving all [00:28:00] the information on the birth control.

Nicole: And I’ve experienced this in, again, another reproductive setting. I had I have had two miscarriages and one of them, so I had to induce both of them. One was blighted, ovum, and one was the baby stopped developing, no longer had a heartbeat. And the first time around they never gave me all the options of the way that I could take the medication.

Nicole: They just gave me one option and it turned out that it was like the least effective dose, but with the most side effects. And so I had to call back and advocate. Fortunately, I have friends in the circle, so they were like, oh my gosh, that’s gonna be so awful for you to take it that way. And they’d prescribed it orally, but you could take it vaginally.

Nicole: And so I called back and I said, Hey, can I take this vaginally? And they’re like, oh, yeah. We just usually prescribe it orally because most women don’t feel comfortable doing it vaginally. But it’s like, well, but you [00:29:00] didn’t even give me the option. Like, and so I think part of that feeling informed is also making sure that we, we are truly giving and it, and, and in some situations it could be a lot of options, but it’s still important to like have that shared decision making and, and giving people all the information they need to make the best decision for themselves.

Nicole: Not you as the clinician making shortcuts or cognitive shortcuts or whatever that might look like and saying, well, most women do it this way or want it this way, or This is what I think would be the best birth control for you.

Mindy Spigel: Powerful story. Thank you.

Stephanie: Yeah. Thank you Nicole. So let’s talk about. Comfort. So how can clinicians help patients feel more comfortable in your, in your top three things?

Mindy Spigel: Yes. So and again, I, I know I keep emphasizing this, but feeling comfortable with you. So I think that’s all about the [00:30:00] relationship. It’s all about how we build that relationship. And it starts with the first impression. It starts with the first impression when they walk in your door. I, I talk a lot about it takes a team because I actually left a practice once.

Mindy Spigel: I loved the, the clinicians in the back. But I couldn’t stand the front office staff and I left. So it starts with do we welcome people or do we just process them when they walk in the door and then we get to the clinician and whoever you are, doctor, nurse, whatever. Do you build that rel how fast and quickly do you build that relationship and trust that make people feel like they’re safe with you and feel comfortable with you?

Mindy Spigel: It’s so hard for me to separate all these. I’m sorry. So how we introduce ourselves, not just did we introduce ourselves, which we don’t even always do that well, but how did we introduce ourselves to them? Sitting down, sitting down, I know it sounds so very simple, but when you sit down, it makes people feel more comfortable and like you’re gonna stay.

Mindy Spigel: You don’t even have [00:31:00] to spend more time. There was a really there was a research study that was done with an emergency room where they asked the clinician to just go in and do what they normally did and and they. Came out and they went in, it was about a five minute encounter, and they went in and they asked the patient, how long were they there?

Mindy Spigel: And the patient said, about five minutes. And they said, now go in and do what you normally do with your next patient, but sit down this time. And it was about a five minute encounter. And they went in and asked the patient, how long were you there? And they said, 15. And so we don’t have more time, but if we can get more time, get credit for more time by sitting down, that’s a, that’s a, that’s a good thing, right?

Mindy Spigel: The other thing I encourage you to do is go, go find somebody in your home, even in your household, and ask them to talk to you while you’re sitting in there standing. And then ask them to sit down so you can feel the difference. I always do this in my workshops and one day I was doing it for an emergency room team [00:32:00] and it was an odd number.

Mindy Spigel: So I partnered with one of the nurses that didn’t have a partner and I stood up and I said, you know, hi, I’m Mindy and I’m gonna be your nurse today and here’s what we’re gonna be doing. And, and then I sat down and I got about as far as, hi, I’m Mindy and I’m gonna be your nurse. And he went, Oh my gosh.

Mindy Spigel: And I said, what? And he said, I was taught it was more professional to stand. I feel so bad. So it’s powerful. It builds a connection really quickly and helps to put people at ease. Eye contact is really important and there’s a lot of distractions in healthcare today. Not only time and rushing and doing it, but we also have that computer and that technology that can distract us.

Mindy Spigel: Eye contact is so important if you want them to feel comfortable enough to tell you what their biggest worry and concern is. You’re gonna have to make eye contact with them and connect with them and help them feel like they’re the only person that matters to you at that moment.

Mindy Spigel: I also [00:33:00] always, I always teach no one thing about a person that has nothing to do with why they walked in your door. One thing, just one thing to build that connection. Small talk before, build big talk. If you can just make that connection, then they feel more comfortable with you if you can find out that one thing about them.

Mindy Spigel: And then truly listening to them. I, Stephen Covey says, when we listen with the intent to understand, rather than the intent to reply. Then true communication and relationship building happens. Listen, with the intent to understand, not with the intent to reply. Have you ever spoken to someone that you know, they’re still looking at you, you’re still making eye contact, but you know, they’re in their head thinking of their response because there’s nobody home.

Mindy Spigel: Right? They’re looking at you, but there’s nobody really there. And and so really staying present and really listening with the intent to understand that’s how we’re gonna help them feel comfortable. Those are some of my, my Q-tips.

Nicole: I can’t remember who said it, Stephanie, maybe you can, but I [00:34:00] remember them saying, you have two ears and one mouth, so you should listen twice as much as you talk.

Mindy Spigel: Absolutely. I’ve heard that too. Yes.

Nicole: I know someone on our podcast has said that too. And Mindy, I’m kind of curious what your thoughts on this. We’ve, I, I believe these are conversations we’ve had in our podcast.

Nicole: Sometimes I forget where I take in information cause we talk to a lot of people. But when I think about comfort, especially in the ob g space, it’s always, you know, that really cute gown that you have to put on. And I’m sure you saw this with peds too. You know, they, they, you know, you gotta put on the gown and they talk about the difference even of what conversations you have and like, when does someone really need to put that gown on?

Nicole: Like, A lot of times what happens is, especially for obgyn, the nurse will come in and say, okay, you know, ask some questions. I’m gonna leave the room before the doctor comes. You change into this and then the [00:35:00] doctor, nurse practitioner comes in and you’re already changed. And I’ve heard people trying to flip the script on that and saying, no, the physician can come in and talk because you’re more comfortable when you’re in your own clothes rather than sitting on a piece of paper with a blanket and an itchy g gown.

Nicole: And so I’m curious what your take is on that with relation to the gown and how you’re setting.

Mindy Spigel: Great point, and especially that initial visit when you’re trying to build a relationship you know, we normally don’t build relationships with people dressed that way. Colleen, I, I’m pushing Colleen again, but Colleen has an amazing video that she, that she has done with the obese space. And since I’m talking to reproductive health she has made an amazing video of all those things that are going on in that patient’s mind while they’re sitting on the table in a gown, getting ready to have a not so private experience and something that [00:36:00] most women are anxious about to start with.

Mindy Spigel: Right. And not even wor, I mean, even if you put aside worrying about what might you find even for a normal pelvic exam when you don’t anticipate anything wrong, it’s not something most people look forward to having. Done. And how we build that relationship first is really important. Anyways, she has a, an amazing video that she has done about all the fears that, and what’s going through that person’s mind, sitting in that gown, sitting on that table, waiting and waiting and, and, and waiting is one of the things that is a big thing for me anyhow.

Mindy Spigel: But, you know, it, yeah. I think that if there’s a way to be able to, especially if they’re coming in and they’re gonna have a, they have a concern. They may be more comfortable talking to you about it while they’re dressed, but I think especially that first visit before you have a, I mean, like I know my doctor so well now that probably doesn’t matter so much, but when I was first meeting her, like it might have been nice to have been my professional self talking to her [00:37:00] professional self or my best self talking to her best self, you know?

Mindy Spigel: But

Stephanie: Yeah,

Mindy Spigel: just to recognize, yeah.

Stephanie: yeah. I shout out to my OBGYN because she does a lot of what you’re suggesting and whenever I go and see her, I. Yeah, she, it’s, I’m fully clothed when I first see her, and the last time I saw her, the first question she asked me, speaking of your personal, you know, the personal question, she said, what are you doing in your life that’s bringing you joy?

Stephanie: And I’m like that’s an amazing question. I’ve never had a healthcare provider ask me a question like that before. But I think it also just really can also give them a lot of information about your health and kind of where your mindset is, you know, your mental health. So or maybe even just your physical health even.

Stephanie: So I, I think that is a great way to [00:38:00] sort of start that, that relationship or that, you know, making a patient feel comfortable and

Mindy Spigel: Yeah,

Mindy Spigel: yeah. yeah. And that’s what I meant about small talk versus big talk. I mean, small talk before big talk is, you know, find out that one thing, you’re right as a clinician, there’s a whole lot more you’re gonna learn. But from that patient’s perspective, it’s really just, whew, Stephanie cares about me as a person, not just me as patient number 562 that she’s gonna see.

Mindy Spigel: Right. Like I love that. That’s a beautiful question. Thanks for

Stephanie: Yeah. I also am making this kind of leap between the snake on the head and that story you told us about your husband’s surgery and kind of that, the, the sequence of things. So it almost seems like making the patient feel comfortable is sort of that first step before you can even inform them. Am I understanding that correctly?

Stephanie: Because [00:39:00] they’re not gonna hear what you say if they’re not comfortable.

Mindy Spigel: right. Even though the number one thing the patients told us was keep me informed. I’m saying that until you get that snake off their head by making them feel safe and comfortable, they’re not hearing the information. So we have to focus there first and build that relationship and help them feel at ease and listen to them and what they’re saying and how they’re feeling.

Mindy Spigel: So, yeah.

Nicole: Yeah, we probably should have reversed our order and how we unpacked these

Mindy Spigel: Well, you did it based on the

Mindy Spigel: order of

Mindy Spigel: my research, but that’s okay.

Stephanie: I just wanted to make that connection.

Mindy Spigel: Totally.

Stephanie: So I was also going to your story about your husband and the doctor coming out to talk to you and kind of the body language and. I had a situation with my son when he was three. And it, it was a minor situation, but I was in nor New Orleans, and I live in Iowa at a work conference.

Stephanie: And I got a phone call from [00:40:00] my three year old son’s daycare at the time. And they told me like something had happened to him and my mind immediately went to he’s, he’s dead, or and I couldn’t hear anything else. And instead of, I, I feel like the situations are, instead of sort of alleviating, of that first fear of like, everything’s fine, everybody’s safe, we’re just doing blah, blah, blah.

Stephanie: I think that is also a really good strategy to sort of like, okay, that snake on your head. It’s not a rattlesnake, like and just so you can hear the rest of it almost, if that makes sense. Like, I don’t know if you felt like that in your situation, if that first thing was your husband is fine, he’s in recovery or whatever.

Mindy Spigel: Yeah. That the surgery went really well. Yeah. Or whatever. Yes. And he’s safe and comfortable and Yeah. Something. Yeah. [00:41:00] Totally. And maybe, you know what? I honestly don’t think I heard a word he said. So it’s very possible that, I mean, he just came out looking stressed or distressed or something, and I was reading his body language.

Mindy Spigel: It speaks really loudly. So we have to be careful about what our face is saying,

Stephanie: yeah. Totally.

Mindy Spigel: and he would’ve, he would be mortified if he knew that, because he’s not that kind of person. But I’ve never told him that.

Stephanie: Yeah.

Mindy Spigel: So hopefully he’s not listening.

Stephanie: But it’s understandable, right? Like he probably was very stressed. And, and I think that’s too, like the, the daycare teachers at my were very anxious. And so they led sort of with that. And sometimes we did, yeah. As, as clinicians, we needed to take a breath and say, okay, we’re gonna, you know, lead, not lead with maybe is our emotions as much, which is hard.

Nicole: well, and Stephanie, I think you bring up a good point too, just [00:42:00] thinking about, you know, trauma informed care and all that is, we don’t know what kind of trauma patients are coming in with. Like, I know for me, you know, based on phone calls, like I’ve received really bad news too many times over the phone, so like my trauma brain instantly goes to.

Nicole: If someone I personally know is calling me, they’re probably calling to tell me bad news even though they’re not. But instantly my brain’s like, I’m already like, oh my gosh, my brother’s calling me. You know, like, and so I think too, like we, we don’t always know what patients are coming in with and like what that kind of trauma is.

Nicole: And like that story you shared at the beginning where the woman was just coming in for an x-ray, but she had this trauma of her mother passing and that was very overwhelming. And so I think if we can, yeah, I mean that certainly requires a special level of awareness to face check ourselves, but then also maybe leading too with what’s the good news or, you know, not beating around the

Nicole: bush. And,[00:43:00]

Mindy Spigel: Yeah, start with the end first. Yes. That’s good. Good point.

Nicole: okay. So last but certainly not least, this other third piece is how can clinicians make patients feel safe?

Mindy Spigel: So and again, the the words that we use work pretty much the strategies we’ve talked about when we’ve built that relationship and we’ve built that trust and we’ve used those words that we’ve planted it helps to make people feel safe. I think your friend’s story about the dentist and the hygienist telling ’em step by step that helps people feel safe, not just comfortable, it’s both, it’s hard to separate out the two.

Mindy Spigel: I think it’s important to remember that. They experience care as a team. So it’s not only to feel safe with you, but when you have that relationship with them, what you say about other team members and what your face says about other team members helps them feel safe. So making sure that we’re managing up other people is important.[00:44:00]

Mindy Spigel: And just I, I just wanna share another story that I think and I, I honestly didn’t do this on purpose. I was in one of my hospitals again. And I, I was having surgery this time for the first time. I had been a nurse over 40 years, and it was my first surgery ever. And talking to this group, all I it, and it was a GYN surgery.

Mindy Spigel: I had a hysterectomy, and I I was. On the other side for the first time as a patient, I had never been in a hospital other than to have babies. I had never had surgery before. It was, it was a scary experience. And the pre-op nurse said she had asked to take care of me. So talk about feeling comfortable with the person who was taking care of me.

Mindy Spigel: The post-op nurse, the nurse who’s gonna take care of me in recovery. She came in into the pre-op area and said, I came in on my day off so I could take care of you. So I had the, the right team taking care of me if I was gonna feel comfortable to start with. [00:45:00] But the nurse was hanging, was getting everything together, hanging my iv, and I said to her, I know I’m a nurse, but I’m really scared.

Mindy Spigel: I’ve never had surgery before. And she stopped hanging the IV and she sat down and she took my hand and she said, Mindy, I love you and I’m going to keep you safe. She goes, I’m gonna tell you Everyth. And she had not even heard my research yet. And she goes, I’m going to tell you everything, every step of the way of what’s gonna happen.

Mindy Spigel: You’re gonna know, we have plenty of time to get you ready for surgery. We’re gonna take our time and we’re gonna make sure you know everything that’s happening. And I’m not gonna let anything happen to you. You’re gonna be okay. And ladies, I felt that snake come off my head. I literally felt that snake come off my head just by her saying those words.

Mindy Spigel: So if we, again, the most important thing we can do to help people feel safe, I think, is to tell them we’re gonna keep them safe and tell them [00:46:00] what we’re gonna do to keep them safe so that that snake comes off their head.

Stephanie: So we talked a lot about some things that clinicians struggle with, but in your experience, what do you think clinicians struggle the most with?

Mindy Spigel: most? we have hit a lot of those, again, we’ve already talked about, but I wanna reemphasize that we do it every day, but it’s their first time. Even as a nurse, that was my first surgery.

Mindy Spigel: For that pre-op nurse. She probably already had done 30 of them that day, but it was my first and just that day, but it was my first, right. And so I think to remember that piece, to begin to try to see the snakes on their heads. Patients don’t always walk in the door like I told her, but not everybody walks in the door and tells you they’re afraid or what they’re afraid of.

Mindy Spigel: So really to ask like, what is the most, what is your greatest concern or what is the most important thing I can do for you today? Helps. And then remember that [00:47:00] they’re not hearing you. I think clinicians think, again, we’ve told them why aren’t they doing that? Well, a, maybe they can’t, maybe we didn’t find out whether this plant works for them.

Mindy Spigel: And then B they may not have heard us, so we have to ask. I think we have to say we’ve been through a lot. tell me what you’ve heard or tell me how this plan is settling with you, or, can we, let’s just go over what’s, what, what you’re hearing is our plans going forward because you don’t know when they’ve checked out.

Mindy Spigel: And just kind of as a caution, if you’ve ever even mentioned that horrible c word of cancer, people usually stop after that, so you might as well plan that they didn’t hear anything else after that. But I think, so that’s, I guess my biggest thing that clinicians, I think, struggle with the most is we get into the routine.

Mindy Spigel: We stop seeing the snakes on people’s heads, or we didn’t know to think about the fact everybody walks in afraid and they don’t always tell us we’ve gotta ask. And then remembering that they’re not hearing us

Nicole: Mindy, I’m [00:48:00] gonna, I’m gonna ask you a weeds question. It’s okay if we need to cut this one out. And I know that Stephanie and I, this is something that we, you know, we could have a whole entire podcast episode about. what

Nicole: advice do you have for clinicians who maybe are about to diagnose and say that someone has cancer or some other big diagnosis?

Nicole: What, what tips do you have based on your research that. They should keep in mind or could help people here.

Mindy Spigel: Yes. And so I, I guess I would say pretty much all the things I’ve just talked about, how we build that connection and trust first and that relationship. And they have to feel like we’re on their team and we care about them and we’re gonna be with them every step of the way here. And and then know that they’re not gonna hear a whole lot after that.

Mindy Spigel: And so to know that you probably are gonna have to [00:49:00] follow up with them. And that might be a strategy of letting ’em know, I really, really care about you, is, you know, a phone call later, find out. You know, what have they heard and what do we need to go over again? A friend of mine just broke her ankle a few weeks ago and I, I always say to her, write down everything they say to you whenever you go wherever, right?

Mindy Spigel: So she knows that piece. And she was that night and it was just an ankle. It wasn’t cancer, but just that night she said to me, Mindy, well what do you think? Like, how long do I have to do this? And do you think I’m gonna be able to do that? And do you think I’m gonna be able to go here? And what do you think?

Mindy Spigel: And I said, you know, I’m sure they told her a lot of those things. She just didn’t hear it. She was overwhelmed at that moment. So no, that, when you’re gonna mention the the C word, people aren’t gonna hear anything else afterwards.

Stephanie: Do you have any thoughts on. Then how, the, the provider always hands us these, you know, after visit summaries or discharge instructions if we’re in the inpatient setting.[00:50:00] And do you have any thoughts on how helpful those are traditionally, and if a clinic or a hospital is, is working on revisiting and redoing those or revising those, how, what tips would you provide them?

Mindy Spigel: Well, my personal pet peeve is when they’re just pre-printed it and has nothing really to do with me. It has to do maybe with my diagnosis, but my experience and my plan might not be the same as yours, Stephanie or yours, Nicole. Like it could be different, right? So with those, I don’t think we get to just say, here, here are your instructions.

Mindy Spigel: I think a, they need, is there a way to personalize them so it works for that person. B. Is it written in a language that people understand and not medicalese? And then three, I think we still need to go hand it to them and go over them and make sure that they understand them and [00:51:00] what and what it is that you’ve given to them.

Mindy Spigel: I think just handing a piece of paper as they walk out the door, especially in a hospital, like, I’m going home from the hospital finally, and you’re gonna put this full piece of paper in a folder. Recognize I might not ever take it out. So you wanna make sure I know what’s on there. That should just be a, a summary.

Mindy Spigel: So those are my thoughts about we it’s conversations and it needs to not happen for inpatient for sure. It needs to not happen at the moment that I say, Stephanie, you’re gonna be going home now, so let me go over all your instructions. Because again, going home is a big step and not the best time to be training people, teaching people didn’t I know a few hours ago or the day before what Stephanie’s instructions were gonna look like.

Mindy Spigel: Maybe on the way out the door is not the best moment to teach her. Cuz she’s gonna go, yeah, I got that. Put the paper in my folder and I’m outta here. I’m going home.

Nicole: Yeah, that’s a good point too. The cuz you’re right, once you hear you can go home, you’re then annoyed [00:52:00] with any other step after that

Mindy Spigel: Yeah.

Nicole: and you’re not listening and you’re like, okay, then just get me outta here. Speaking from just giving birth like a year ago?

Stephanie: No, I think, and I think a lot of hospitals are going towards, like discharge planning should happen at admission, right? Discharge instructions. You know, it should be like the whole process. The whole, the whole stay and not just, right, like at the end, like you were saying like, you’re going home, here’s your instructions, here’s all the meds.

Stephanie: Bye.

Mindy Spigel: And especially with a new baby, my first baby, like, have I done all these things yet? You know,

Stephanie: Mm-hmm.

Mindy Spigel: I was just thinking about Nicole’s home with the baby.

Nicole: Well, and to be quite honest, I’m sure there was a bunch of stuff in that folder. I never took it out. I dunno like

Stephanie: have a baby and you’re sleep deprived and you’re in pain and yeah.

Nicole: Hmm. Pain. Especially at that point, [00:53:00] I didn’t really care about a folder,

Mindy Spigel: Exactly.

Nicole: it.

Mindy Spigel: Exactly.

Nicole: So obviously we have talked about lots of things, but if you had to pick one thing, I’m not gonna lie. Sometimes this becomes one to three things, but what would you want all listeners to know about communicating with patients?

Mindy Spigel: Yeah. So I, I know I’ve said this already, but they’re scared they’re not hearing you, and we really have to listen to what they’re saying to us. There was also a study done that said we give people 16 seconds to tell us their story before we jump in. I think in those first 16 seconds, oftentimes people are just trying to see if They can trust you with what’s really bothering them and what’s really scary.

Mindy Spigel: And again, especially if your audience is in reproductive health I might have to trust you before I tell you my biggest concern, like I may. So really listening is probably my biggest takeaway to take that snake off someone’s head.

Nicole: [00:54:00] So when I was writing these questions, I had this internal battle because it was a question I wanted to ask, but I didn’t know how to phrase it. So I’m going to throw something out there cuz I think it is worth bringing up. Again, this may or may not remain in the recording, but I really wanted to speak to this piece about I aro phobia and especially so like, I’m thinking specifically for folks who, when we think historically and even presently, to be quite honest about what research and medicine and how they have treated, especially for example, black women. You know, when, when we are coming, when those folks are coming into the system, what with already this kind of baseline fear, right? Because of how they’ve been historically treated. How does that fit in with your work? Or did you see that? Or how, how can we be more conscious of [00:55:00] what these bigger systems and what folks are. Fears they’re coming in with.

Mindy Spigel: Yeah. I don’t know that I’m the expert on this answer, so I’m just gonna give you Mindy opinion. I, I just think as a rule of thumb, we never know what people’s experiences are and to really just ask and listen. So if we treated everybody as our own loved one and, and approach and recognize that people walk in our doors afraid.

Mindy Spigel: And I think for some people and, and definitely people that have felt like they weren’t treated well in the past, in healthcare, whatever their reason for not having, feeling that way I, I think when they know that we really care about them as a person by doing all the things we’ve chatted about, so that we, and they feel like they can trust us, then they can share what their greatest concern really is.

Mindy Spigel: [00:56:00] so for me, I think that’s important for, you know, people that may have felt marginalized in the past is, you, Stephanie are important to me. You, Nicole, are important to me and what is the most important thing I can do for you right now? And then to be quiet and listen that we might learn and we might hear something and we may be able to change their experiences that they’ve had in healthcare before.

Mindy Spigel: But again, that’s just a Mindy opinion. I don’t have that based on anything.

Nicole: No, I appreciate that. And I, and I also appreciate that you have mentioned this a few times, you a role of trust, and that’s something that really kinda underlies, right, our entire podcast is how do we facilitate trust? And I think what you talk about is facilitating trust, because yeah, if people don’t trust you, they’re not gonna share with you.

Nicole: That, but again, we get to trust by making people feel safe and and comfortable because I think about, At Stephanie when we were speaking with Frankie about trans broken leg syndrome, and it was like, you [00:57:00] are a trans person. You come in cuz you broke your leg, but somehow it gets derailed and it’s all about you being trans.

Nicole: And suddenly we have forgotten about treating your broken leg. And so then they had talked about the importance of facilitating trust and, and maybe they’re not gonna disclose all the relevant information because they don’t trust you. That might be important to their diagnoses. Stephanie, did I just totally

Stephanie: No, I think that’s

Stephanie: totally right. Yeah.

Mindy Spigel: I like that. You know, and the other thing I think is, Being careful knowing that all of us have these unconscious biases. Always it happened to you, Nicole. You shared the story about your provider made a decision that you wouldn’t want your treatment vaginally. Well, how do you know? So if there’s options to go when you know we have options here, which one works best for you?

Mindy Spigel: And sometimes we just go, here’s your treatment plan. And we don’t stop and go, does that work for you? How does this [00:58:00] sound to you? Because there’s a variety of reasons why that might not work for people and and we need to engage them in that part.

Stephanie: All right, so I wanted to ask you more about your work and your book. So where can folks go to learn more about the work you’re doing and how to find your book?

Mindy Spigel: Thank you so much. Okay. My website is simple. It’s mindy spiegel.com. Mindy Spiegel, all one word. M i n d y s p i g e l. There’s not that extra e in there.com. And actually from there you can click a thing to order the book straight from there. Or you can go to Amazon. It’s on Amazon. It’s not very expensive because I didn’t want that to be a barrier for people to read my book.

Mindy Spigel: It’s not very long and it’s not very expensive. But I have a lot of strategies in there that are easy to, to do and to follow and more information about. My research is in the book. So thank you for [00:59:00] giving me that moment to share.

Stephanie: Yeah. Do you have any other resources aside from your website and book that you wanna share with our listeners? And you can, you can also get back to us as I popped that question in.

Mindy Spigel: Well, and I do have a lot of resources in my book. At the end of the book. I do provide a lot of resources, and like I said, especially for this population I love Colleen’s Colleen Sweeney and oh, her webs. I think if you google Colleen Sweeney, you’ll get to her website. And she’s got that great video about, particularly related to that office visit with in women’s health.

Mindy Spigel: So yeah, that’s, I, I don’t off the top of my head other than the stuff that’s in that’s in the the book for you to look at.

Stephanie: No, that’s fine. And we’ll put those in our, we always do our transcript and we’ll add those

Mindy Spigel: Okay.

Stephanie: on our website.

Mindy Spigel: Great.

Mindy Spigel: That’s awesome.

Stephanie: So Mindy, I would personally like to thank you so much for your [01:00:00] time and commitment to advancing sexual and reproductive health through communication. Do you have any last thoughts that you would like to add before we end?

Mindy Spigel: Thank you. Yes. First of all, I thank you again for letting me be here. I’ve totally enjoyed this immensely talking with both of you, and I hope it’s been helpful for the listeners. I just wanted to leave because I really firmly believe that we have to take care of ourselves first as clinicians, and sometimes that’s hard and sometimes patients are hard and situations are hard and days are hard.

Mindy Spigel: And so I just wanted to leave you with one of my favorite sayings from Mr. Rogers. And he says, if you could only sense how important you are to the lives of those you meet and how important you can be to the people you may never even dream of, there is something of yourself that you leave at every meeting with another person.

Mindy Spigel: And I think, I truly believe that as a nurse, I truly believe, I’ve always felt that I’ve been blessed to be in invited into people’s lives at their sickest, most vulnerable times, [01:01:00] at their scariest times. And I feel like. In healthcare as clinicians, we have that opportunity to make a difference for people.

Mindy Spigel: And sometimes I think we lose sight of that and forget that. That what a, what a every day you make a difference. And so one last quote to leave you with is that John Gordon said, every day, focus on your purpose. Remember why you do what you do. We don’t get burned out because of what we’re doing. We get burned out because we’ve lost our why.

Mindy Spigel: So every day, I always challenge people every day. When you drive home from work, what, wherever you work, whatever your role is, whatever you do, ask yourself, how did I make a difference today? Who did I make a difference for? Because every day we make a difference in people’s lives and we forget that piece and we beat ourselves up over all the things we didn’t do.

Mindy Spigel: And I wanna tell you to stop that and to realize that you make a difference every day.

Stephanie: I love that so much. Thank you.

Nicole: I feel like that needs to be a dinner conversation question [01:02:00] for my kids.

Stephanie: like what are you grateful for and what did you, yeah, what changed? What did you do for somebody? Or what change did you

Nicole: Yeah. How did you make a difference today?

Stephanie: Love that.

Nicole: I do. Well, and Mindy, I especially appreciate we, we threw you some extra questions that we didn’t prepare you for. So thank you for playing along with us, but we are very good at that.

Stephanie: Yeah.

Nicole: So thank you so much, Mindy.

Stephanie: you.