Communicating with Confidence

Communicatingwith Confidence Authored by Sally Phillips and Jane Hamilton

CommunicatingwithConfidence Authored by Sally Phillips & Jane Hamilton

Aims of the Session Delegates should leave feeling confident to: • Manage challenging conversations • Take away a tangible “toolbox” of communication skills • Acknowledge and understand own fears and how to overcome them • Share information with and support other team members • Recognise your own limitations and that within your work role

COMMUNICATE What do you understand by this word?

CONFIDENCE What is your perception of confidence?

Group work/role play Each group will be given 2 different scenarios to discuss: • What are your immediate feelings about these situations? • What are the main areas you need to consider? • How will you handle this? • What types of communication might you use in each case?

Group work/role play • Look at each scenario • Discuss each scenario as group • In the group, practise playing out each scenario • Each person should take it in turns to be “patient”, “relative” or “care worker” • Decide which scenario to present to main group.

Presentation to Main Group Each sub group will decide: • Which scenario to present • Who will record group’s ideas • Who will present these to whole group • Who will role play chosen scenario to main group

Scenario 1 Mr Harris, attending day care, is unusually rude to the driver, ignores the receptionist on his way in and throws the cushion out of the chair before he sits down. Everyone nearby is alarmed at his behaviour. As you approach him he says: “And you can “**** off too” How would you handle this?

Scenario 2 Mrs Khan was successfully treated for ovarian cancer several years ago. She has recently become unwell and is undergoing investigations for abdominal pain and vaginal discharge. Mrs Khan only speaks a little English. Her husband died last year. Through her teenage grandson, her main interpreter, she asks what is happening?. How would you deal with this situation?

Scenario 3 Tim is aged 42yrs but has a learning age of 9yrs. He has been unwell for the past 12 months and has been diagnosed with prostate cancer with spread to his bones. He lives with his elderly parents who are both becoming very frail. He experiences significant mood changes with aggressive behaviour due to hormonal treatment and is now needing radiotherapy to control bone pain. How would you explain the changes happening to him and the treatment needed?

Scenario 4 You have been visiting Mrs Smith at home for several weeks, keeping her company whilst her daughter, with whom she lives, goes shopping. Mrs Smith has become gradually more frail both physically and mentally. On this occasion, she seems quite agitated and tells you “that woman has been horrible to me. She shouts at me, hasn’t given me anything to eat and won’t let me have a bath.” How do you respond?

Scenario 5 You have been asked to work with Anne, recently diagnosed with breast cancer and now in the middle of treatment. She has Downs Syndrome and lives in a home with other adults with learning difficulties. Her carers are worried that Anne does not seem upset by her diagnosis and may not understand its possible implications. You are asked to find out what she does know.

Scenario 6 You visit a young woman at her home. Sarah has advanced cancer and knows that this is going to be her last Christmas. She asks you to help her wrap presents for her children and to write out cards for all her family and friends. How do you respond?

Scenario 7 Mark, who is currently in hospital with end stage liver disease, wants to go to the football match with his partner, Chris who is happy to take him. His mother and sisters are adamant that this will not do him any good and insist he stays put. You are in charge of his care in hospital. What do you say to Mark?

Scenario 8 You go to see Mr Kear at home. He is single with no immediate family and few friends. He has a history of schizophrenia. He was told 13 months ago that he only had 12 months to live. He gave up his job, sold most of his possessions to raise money and has spent time travelling. Medically he has remained unchanged. Yesterday Mr Kear was told he had been mis-diagnosed and that he is not dying. You have been asked to discuss this new situation with him.

Scenario 9 It’s late on a Friday afternoon and most staff have left the building. Reception has put this call through to you as an enquiry about referring a new patient. Paul, a 50 year old gentleman is ringing to enquire about referring his wife to your service. He explains that his 45yr old wife has recently been diagnosed with cancer and is having difficulty coming to terms with the news. He has heard from a friend that the hospice may be able to help. He stops and there is silence ………he starts to cry.

Scenario 10 A patient, Molly rings you on reception at 9.30am. She is cancelling her appointment that was due at 11am today. She starts to cry and explain that she received bad news from her Consultant yesterday - has learned that her cancer has spread. ‘I really can’t face meeting anyone at the moment – I am sorry to cry. I didn’t mean to………’ She sobs and says sorry again. What do you say?

Scenario 11 Mary, a patient whom you have known for a while has phoned to cancel future transport and appointments. She explains without emotion that she knows she doesn’t have long to live and that she wants you to pass on her thanks to all the staff who have helped over the last few months. What do you say?

Scenario 12 You are assisting Miss Robinson, a 58 year old lady, to have a bath. She is a retired headmistress and now a lay preacher in her church and is living with MND (motor neurone disease). You have been working with her for many months and have seen her condition decline markedly over the last 6 weeks. She says to you: “I have had enough – I can’t go on living like this, it’s only going to get worse and it’s not fair on my family and friends. I have decided to go to Switzerland to end it all. I know you are the only one who understands how I feel. Please will you come with me?”

Scenario 13 Mrs Paterson has returned to her care home following a short stay in hospital where tests showed that her tumour has enlarged and spread. Further treatment is not likely to help and could make her feel very unwell. She has accepted her prognosis and has told staff at the home that she wants to die there, “just quietly and peacefully”. She knows her daughter will be upset, will want her to try every treatment and will not want her to “give in”. Mrs Paterson has asked you to be with her when she tells her daughter the news.

Scenario 14 Mr McClean, a single gentleman, has been a resident at your care home for several years. He has made a lot of friends and is very popular. His Parkinson’s disease has now progressed and he is becoming more and more confused and gets very agitated at times. He tells you he doesn’t like all these strangers coming into his room at night. His niece is visiting from Scotland. He has asked her to “take me home”. She asks you what you think she should do.

Scenario 15 You are visiting Mr and Mrs Wilson at their home. You see Mr Wilson sitting in the garden – he tells you that he has been diagnosed with widespread cancer and has only a short time to live. He wants you to help him make some arrangements whilst he can. He then says that his wife and family think he is just a “bit anaemic” and will get better with the new tablets. “I don’t want them all to get upset. I’ll tell them when I’m ready and I don’t want anyone else telling them either.”

Scenario 16 You have worked over your hours on your shift and are now about to go off duty. You have an important personal appointment to attend and you are running late. As you get to the door, Susan (a client) stops you and says: “I saw the consultant today and its bad news. I really need to speak to someone – have you got time?” She is looking very anxious. How do you respond?

Scenario 17 John was given his diagnosis some 6 weeks ago but does not appear to have accepted it. He does not talk about the future. He has become very “happy go lucky” and seems unperturbed. Yet, from time to time, he looks sad and a bit red eyed. What would you say to John?

Scenario 18 You work on a busy, acute medical ward. Mrs Holmes, a 46 year old single parent of 2 teenage sons, is admitted with a chest infection. She does not respond to antibiotics and tests reveal she has advanced lung condition which is not treatable. Her prognosis is short. She does not want her sons to be told – “it will be too upsetting for them”. Her elderly mother, who lives nearby, is visiting and says to you: “my daughter is very poorly, isn’t she? What is wrong with her?” How do you respond?

Scenario 19 You work in the community. You are visiting a young man who has an inoperable brain tumour and whose condition is deteriorating rapidly. He has just been discharged from hospital and returned to live with and be cared for by his parents. They all know he is dying. They think a nurse will be with them 24/7 and have asked you to confirm the arrangements. You know that this is not possible and that the care package is for a carer to come for 45 mins, 4 times a day. What will you say?

Scenario 20 You meet Mr Ramsay in your workplace. This gentleman, although physically fit and well, looks very tearful and sad. When you ask him what is the matter, you realise he is unable to speak- his tongue has been removed. What do you say and do?

Communicating with Confidence