BC&A reports that the “Top Ten Threats Cited in EMS ASRA [NASA's Aviation Safety Reporting System] Reports:

Mission Preparation/Operational Pressure                    93%

Excessive Workload                                                      84%

Communication Difficulties                                            75%

. . .

Distractions                                                                  28%

Pilot                                                                              17%

Assume that EMS personnel are trained and are accustomed to working under stress.  75% of the time they consider communication difficulties a threat?  What does that mean for the rest of us that do not generally work under stress …. our stress experiences has peaks and valleys.

How many times in a typical day do we ‘visit’ the fight/flight/freeze arena?  And how long do we remain that prisoner?   When we sense that our unconscious reactions will overtake our conscious actions, we need to focus on the outcome we want, not escaping from the current situation.

How difficult is it for us to communicate clearly the first time?  And what are our consequences if we don’t.  And how do we know if our meaning and intention are clearly stated?  We can take cues from the other person/people, we can restate our communications several times in several different ways, we can ask them to repeat [not regurgitate] what you said … and you can ask for feedback.

It’s not what you said … it’s what they think they heard.

I was re-reading an article in a prior edition of Business & Commercial Aviation, entitled Cockpit Cacophony.  It states that

“The noisy cockpit environment certainly doesn’t help the communication of important information.  A review of 250 NASA ASRS …. business jet flight crews found that fully 2/3 involved communication errors as a root cause and of those a quarter involved read-back errors and an equal number involved expectation errors … High noise levels can impair concentration and cause fatigue and insomnia. “

We know how important read-back is …. very much like summarizing a discussion.  Can the noisy cockpit environment be compared to the noisy work environment?  Do phone ringing, other people talking, emails dinging and music playing equate to a noisy work environment?  Does your preoccupation add to the ‘noise’?

We know that the brain cannot multi-task …. your mind can focus on only one attention-needing activity at a time.  We can walk and talk …. only if we don’t have to watch our step.  If so, then our minds will focus on the rough terrain and not be able to maintain a sane train of thought.  If your mind is sifting through the background noise, it is not able to concentrate on the words that are being directed towards you.

How about the expectation errors?  How many times have you begun listening to someone and were sure you knew what they were going to say, so you complete their sentence?  Or you expect something to happen so you disregard the signs contradicting your expectation?

It’s not what they said, it’s what you think you heard.

Yes there really is a sickness called “Hurry Up Syndrome”!  I knew this disease existed, I was surprised that it had a real scientific name!  According to University of Manchester’s Dr. James Reason, this time crunch that we operate under increases the chance that we will make a mistake by 11 times.*

When we are operating with this malady, we tend to make decisions based more on emotion than relying on fact, or on a combination of facts and emotion.  Our perspective changes, and our natural cautious checkpoints are crushed.  We are focused on completing the task, resolving the uncomfortable or threatening situation, or wanting the offending person to leave us alone!  In other words, our amygdala [Amy, as my clients know it] hijacks and takes control of our thinking.  Our neo-cortex is not given the opportunity to take over.

EMS pilots are especially susceptible to this … they have a critical care patient they must fly from Point A to Point B.  Knowing this is a critical flight, can cause these pilots to take risks they may not have taken otherwise.

Think of how your communication changes when you are experiencing “hurry up syndrome”.

It isn’t what they said, it’s what you think you heard!

*B&CA magazine, October 2008, p. 44