Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Connections Accelerated


Some clinical encounters require establishing a patient-doctor connection quickly. Providing emotional support may improve your ability to create trusting relationships. 

The OR is the only place a parent can’t accompany their child. In all other environments parents are the chief caregivers and guardians from danger: where their child goes, what he wears and eats are in their control. In the OR, the pediatric anesthesiologist becomes the parental surrogate: my job is to protect children, keep them warm, relieve pain, support them through a difficult experience, and then return them to their parents safely.  


In most cases I meet the parents and child for the first time in the preoperative area. In a brief 10–15-minute interaction, I must do the required education and paperwork of consent, and equally importantly, create a trusting relationship that will facilitate this sacred transition of responsibility. Accelerated connection with patients requires intention and skill.   


How can you create a relationship with your patient when the stakes are high, and time is short? 


1. Speak to them personally. 

Before you walk in, know how to pronounce their name and key specifics such as pronouns, medical conditions, and likely concerns. Show that you value them by greeting both parent and child warmly and directly. Introduce yourself, explain your role, and speak slowly. Use the child’s name frequently to show your concern and create connection. 


2. How are they feeling emotionally? 

Many clues tell you how they are feeling. Body language, facial expression, and speech pattern reveal parents who may be nervous or intimidated. Knowing where patients are emotionally and what their concerns are informs how to best communicate with them. It is also ok to directly ask “How are you feeling about today?”   


3. What’s the best way for me to support them? 

Meet the parents and child where they are and tailor your response. For some parents, light heartedness is helpful. For others, a calm and confident affect is necessary. A connection with the child is necessary to create a relationship and demonstrate your care for her to the parent. Talk directly to her and play at a developmentally appropriate level. 


4. Demonstrate that you understand the import. 

Ultimately, I’m asking parents to give me responsibility for the care and safety of the most precious person in their life. All clinical; interactions have an equivalent ask: for permission to know, touch, care, and treat. Even patients with a seemingly casual affect appreciate acknowledgement of the obligation. As I leave the preoperative area with their child in my arms or holding my hand, I look into the parents’ eyes and say, “I will treat her like she is my own.”  And I mean it.  









This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.