Quick Guide to Using Narrative Medicine in a Busy Practice

Clinicians of all kinds are indisputably pressed for ample time with their patients.  Despite the time crunch, there are simple and effective ways to incorporate narrative medicine into practice:

1. With Patients in a One-on-One Encounter

Generous listening

Commit to listening with your entire awareness to your patient for the first 3-5 minutes of the clinical encounter.  Introduce yourself by saying, “I will be your doctor, and so I must learn a great deal about your body, your health, and your life.  Please tell me what you think I should know about your situation.”

Close looking

Refrain from taking notes for 2-3 minutes during a clinical encounter.  Look into your patient’s eyes, observe their body language, and notice how they hold themselves.  Perceive them with your full attention.

Parallel chart

When writing your patient’s chart, include two to three sentences of “narrative.”  Use full sentences to describe aspects of their situation and refrain from using numbers or medical abbreviations.  Feel free to include your personal impressions and feelings.

2. With Yourself after Patient Encounters

Reflective writing exercise:  Allow yourself to be an “I”

For 2-3 minutes after an encounter with a patient, during a meal or bathroom break, or before going to sleep, write about your subjective experience of interacting with that patient.  What did you feel?  Did you feel drawn to them or repelled?  Did their story resonate with any of your own life experiences?

Creative writing exercise:  “Portrait of a patient”

For 2-3 minutes after an encounter with a patient, during a meal or bathroom break, or before going to sleep, describe one of your patients in as much detail as you can recall.  What did they look like physically?  What did you see when you looked into their eyes? What did their voice sound like?  What emotions did you sense were present?  How did they walk, sit, or stand?  What did they do with their hands?

3. With Colleagues

Collegial storytelling

Arrange to share a meal with a fellow clinician or a small group of clinicians.  During the meal, go around in a circle allowing everyone to share, uninterrupted for 2-3 minutes, one story of a memorable patient, a frustration, or a victory.

Narrative medicine group

Arrange a monthly narrative medicine gathering with colleagues.  Meet during the lunch hour or another mutually convenient time to read a poem or short piece of prose together, discuss it, respond to a related writing prompt, and share the writing you created.  Refer to the “Exercises and Readings for Narrative Medicine Groups” tool.

Author(s)

“A Quick Guide to Using Narrative Medicine in a Busy Practice” was written by Annie Robinson, M.S, (2014, updated 2018).

This Whole Health tool was made possible through a collaborative effort between the University of Wisconsin Integrative Health Program, VA Office of Patient Centered Care and Cultural Transformation, and Pacific Institute for Research and Evaluation.


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