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The Gift of Gab

The Gift of Gab. What people say about us. Most common complaints: Rude Heartless Impersonal Isn’t it surprising how many things, if not said immediately, seem not worth saying ten minutes from now? Arnot L. Sheppard, Jr. Three components of communication. Sending messages

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The Gift of Gab

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  1. The Gift of Gab

  2. What people say about us • Most common complaints: • Rude • Heartless • Impersonal Isn’t it surprising how many things, if not said immediately, seem not worth saying ten minutes from now? Arnot L. Sheppard, Jr.

  3. Three components of communication • Sending messages • Receiving messages • Barriers to effective communication

  4. Sending messages • Verbal • What we say • Paraverbal • How we say it • Nonverbal • How we look when we say it

  5. Verbal • Trust • Get them talking • Listen, Listen, Listen • Stay neutral • Choose words carefully • Reflection

  6. Paraverbal • How we say it • “I didn’t say you were stupid” • “I didn’t say you were stupid” • “I didn’t say you were stupid”

  7. Non-Verbal Intentional or non-intentional messages that can be interpreted from somebody’s actions or decisions

  8. Non-Verbal Emotional impact of a message • Words = 7% • Voice tones = 38% • Facial expressions = 55%

  9. Kinesics • The study of communication that occurs through body movements, positions and facial expression

  10. Appearance • Well groomed • Proper uniform • Proper equipment • Look the part!

  11. Posture • Positive (open) • Confident • At ease • Attentive • Professional • Negative (closed) • Discomfort • Anger • Disgust • Fear

  12. Facial expressions • The most important conveyor of emotional information

  13. Relative level • Eye contact • Above or over • Authority • Intimidating • Below • Best for elderly and children • Patient fells in control • Even • equality

  14. Distance • Intimate zone – 0 to 1.5’ • Visual distortion • Assessing breath and body odors • Personal distance – 1.5’ to 4’ • Perceived as extension of self • Common assessment distance • Social distance – 4’ to 12’ • Impersonal

  15. The touch • Shows compassion • Concern • Support • Not accepted in all cultures

  16. Receiving messages • Requires concentration and energy • Involves a psychological connection • Includes a willingness to see their side • Requires that we suspend judgement LISTEN

  17. Physical attention • Gently lean towards the speaker • Face the person squarely • Maintain open posture • Maintain appropriate distance • Appropriate facial expressions and nodding

  18. Reflective listening • Paraphrasing • A brief statement reflecting the speakers message • Use your own words • Reflecting feeling • A statement of the feeling that you heard • “You’re worried that…….” • Summarizing • A statement of main ideas and feelings to show understanding

  19. Barriers

  20. Verbal Barriers • Attacking • “You wouldn’t be sick if you would take your medicine.” • “Did you do what the doctor told you to do?” • If you stopped getting drunk everyday you would probably feel better.”

  21. Showing power • “If you don’t go to the hospital with me, I’ll have you arrested.” • “Once you get in my ambulance, you follow MY rules.” • “You’re getting an IV if you ride with me.”

  22. “You messages” • “You don’t understand medicine, I do.” • “You don’t realize that if you don’t give your child the medicine on time, he’ll stay sick.” • “You have a mental problem.”

  23. Nonverbal barriers • Rolling your eyes • Yawning • Closed stance • Avoiding eye contact • Poor personal care • Slow movements • Slouching • Aggressive stance

  24. The Angry Patient • Usually a defense mechanism • Fear of loss of control • Fear of dying • Fear of meaning of illness • Fear of disability

  25. Strategies • Active listening • Position • Posture • Eye contact • Silence Listen and paraphrase what you’ve heard

  26. Empathy • Cognitive – enter patients’ perspective but don’t loose your own • Affective – put yourself in patient’s place • Action – verify emotion so patient can correct and/or feel listened to. Empathy is not the same as agreeing with patient. Empathizing is expressing understanding of how the patient feels.

  27. “I’m sorry” • If you made a mistake that lead to anger, admit it and apologize. • Do not try to excuse, explain or discuss specifics at first… the patient will need to have his or her feelings validated first before they are willing to listen if they are angry. Trying to excuse the problem may lead him or her to feel as if their feeling is not valid and lead to more anger.

  28. Questioning techniques • Leading questions • Guides the patient’s answer • “are you having chest pain?” • Open-ended questions • Spontaneous answers • “what seem to be the problem?” • Closed questions • “did you eat lunch today?”

  29. Questioning techniques • Continue to ask open-ended questions • Keeps them talking • May reveal important facts • Use closed questions when necessary • May help control ‘talkative’ patients • Useful when time is limited • Ask only one question at a time

  30. Questioning techniques • Allow for complete response • Use language they can understand • Never tell a child you are going to “take” their blood pressure • Avoid medical terminology • Avoid terms of endearment • Honey, sweetheart, baby

  31. Effective listening techniques • Silence • Give the patient time to answer • Reflection • Echo his/her message back in your own words • Facilitation • Encourage the patient to provide more information • Clarification • Eliminate confusion

  32. Effective listening techniques • Confrontation • Focus the patient on one particular factor of the interview • Interpretation • State your interpretation of the information • Explanation • Share factual or objective information • Summarization • Briefly review the interview

  33. Traps • Providing false assurances • “Everything will be alright” • Giving advice • Acceptable • “my opinion is that you should be evaluated at the hospital” • Not acceptable • “I think you’re crazy not to be seen by a doctor”

  34. Traps • Authority • It’s not a power trip • Avoidance language • Changing the subject to avoid something difficult • Distancing • Standing too close or too far • Using “why” questions • “why didn’t you call for help 3 hours ago?”

  35. Children • Three types • Oblivious (infants) • Uninformed (child) • Invincible (teenager)

  36. Elderly • Decreased hearing • Decreased vision • Slow to respond • Fear of hospitals • Do not use terms of endearment

  37. Do’s and Don’ts • Maintain eye contact • Show interest • Proper tone • Nod • Lean forward • Positive body language • Minimal or no eye contact • Tense facial muscles • Speaking too fast or too slow • Yawning • Negative body language

  38. Blocks • Giving personal opinions • False reassurance • Defensive responses • Arguing • Asking for explanations • Changing the subject

  39. Summary • Establish trust • Body language • Choose words carefully • Tone of voice • Be attentive • Look the part • LISTEN!! LISTEN!! LISTEN!!

  40. Remember …… It’s their emergency, not yours!

  41. QUESTIONS?? Julie Williams, NREMT-P, NCEE Training Coordinator Beaufort County EMS j_williams01@hargray.com

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