Communication

1. Communication Essential Skills for Health Care Professionals

2. Communication • The exchange of information • Two types: • Verbal - written or spoken language • Nonverbal - message spread through body language, gestures, expression

3. Effective Communication For communication to be effective: • Use words that mean the same thing to you and the receiver of the message. • Use familiar words. • Be brief and concise. • Give information in a logical and orderly manner. • Give facts and be specific

4. Components of Communication • Sender - person sending the message • Message - information to be conveyed • Receiver - person the information is intended for • Problems in either component can lead to miscommunication and/or misunderstandings

5. Communication Model Sender Receiver Feedback

6. Communication Model Questions • What could happen to block any of the elements of communication? • Is the message always verbal? • Is the feedback always verbal? • What interruptions or distractions could interfere with communication?

7. Healthcare Communication • Remember that in a healthcare setting, nonverbal cues are important elements of the communication model. • Identify the elements of communication in this illustration.

8. Rules for Effective Communication

9. Speaking Skills • Speak appropriately to the age or status of the receiver. • Use appropriate terminology or words. • Ask open-ended questions. • Speak slowly and clearly. • Try to be eye-level with the receiver. • Make sure your non-verbal is consistent with your words.

10. Barriers to Communication • Communication barrier – Anything that gets in the way of clear communication. • May be in sender, message, or receiver • Common Barriers include: • Psychological attitudes and prejudice • Cultural diversity • Physical disabilities

11. Psychological Barriers • Psychological barriers are often caused by: • Prejudice • Attitudes • Personality • Stereotypes such as “dumb blonde” or “fat slob” cause us to make snap judgments about others that affect the communication process. • Health care workers must learn to put prejudice aside and show respect for all individuals.

12. Guidelines • Health care workers must examine any prejudices they may have and learn to put these aside • Never use language that others may view as offensive • Learning to “read” others body language can help to prevent misunderstanding

13. Cultural Barriers How do you communicate with patients who don’t speak English? • Let's watch the news....in Chinese!

14. Cultural Barriers • All cultural beliefs must be respected. • Every culture has beliefs and practices regarding health and illness such as: • the body needs balance – if the body is cold, they eat hot foods. • illness is due to demons and evil spirits • illness is punishment from God • Patients may practice their cultural remedies in addition to modern healthcare techniques.

15. Guidelines for Cultural Diversity • Language differences – people who don’t speak English may have a difficult time communicating. You should: • Speak slowly • Use nonverbal communication (smile) • Avoid tendency to speak louder • Find an interpreter

16. Guidelines for Cultural Differences • Eye contact – in some cultures, it’s not acceptable, and looking down is a sign of respect • Terminal illness – in some cultures, the patient is NOT told his/her prognosis, and family members are responsible for making care decisions • Touch – in some cultures, it is wrong to touch someone on the head. Others may limit touch between male and female • Personal care – in some cultures, only family members provide personal care

17. Guidelines for Cultural Differences • Respect and acceptance of cultural diversity is essential for any health care worker. • If unsure of cultural practices, speak with the patient or family to prevent future misunderstandings

18. Physical Barriers Physical barriers may include: • Deafness or hearing loss • Blindness or impaired vision • Aphasia or speech disabilities

19. Hearing Impairment Simulation • Make an Origami Frog

20. Communicating with the Hearing Impaired • Use body language such as gestures and signs. • Speak clearly in short sentences. • Face the individual to facilitate lip reading. • Write messages if necessary. • Make sure hearing aids are working properly

21. Vision Impairment Simulation • Verbal directions on how to make an origami frog

22. Communicating with the Visually Impaired • Use a soft tone of voice. • Describe events that are occurring. • Announce your presence as you enter a room. • Explain sounds or noises. • Use touch when appropriate.

23. Compare Making Origami Frog with Impairments vs. without Impairments • How to Make an Origami Frog (using audio and visual)

24. Communicating with Patients with Aphasia or Speech Impediments These patients may have difficulty remembering the correct words, may not be able to pronounce certain words, and may have slurred speech. • The health care worker must be patient • Allow them to try and speak • Encourage them to take their time • Repeat the message to assure accuracy • Encourage them to use gestures or point to objects • Provide pen and paper if they can write • Use pictures with key messages communicate

25. Recording and Reporting • Reporting is the oral account of care and observations. • Recording (charting) is the written account of care and observations. • During end-of-shift report, information is shared about: • The care given • The care that must be given • The person’s condition

26. Recording and Reporting • Communication between health care workers is critical in ensuring quality patient care. • Workers must listen carefully and make observations. • Observations must be accurate, concise, and complete. • Use facts and report only what you saw, not the reasons. • NOT – “Mrs. Jones is in pain.” • INSTEAD – “Mrs. Jones is holding her chest with wheezing as she breathes.” • Objective / Sign – what was seen or Observed • Subjective / Symptom - what the patient Said

27. Healthcare Information can be Subjective or Objective • Subjective • Cannot be seen or felt • Often called symptoms • Usually statements or complaints from the patient • Use the patient’s exact words

28. Healthcare Information can be Subjective or Objective • Objective • Can be seen or measured • Often called signs • Information collected by the senses

29. Subjective Symptoms I think I’m gonna throw up. My tummy hurts. It’s really sore on my chest. I don’t feel very good.

30. Objective Signs of Illness • Pulse rapid, irregular and thready • Skin cold and clammy • No respirations • Lips cyanotic

31. Subjective or Objective? Objective Subjective Subjective Objective Objective Objective Subjective Subjective • Coughing • Fatigue • Headache • Foul smelling breath • Did not eat anything • Speech slurred • Joints ache • Nervousness

32. Observations • Health care workers use their senses to: See • Color of skin, swelling or edema • Presence of rash or sore • Color of urine or stool • Amount of food eaten Smell • Body odor • Unusual odors of breath, wounds, urine or stool (feces)

33. Observations Touch • Pulse • Dryness or temperature of skin • Perspiration • Swelling Hearing • Respirations • Abnormal body sounds • Coughs • Speech

34. Listening Skills • Show interest and concern. • Stay alert and maintain eye contact. • Avoid interrupting. • Pay attention to what the speaker is saying. • Avoid planning your response while the speaker is talking.

35. Listening Skills • Try to see the other person’s point of view. • Find a quiet or private location. • Watch the speaker’s facial expressions for consistency with words. • Ask for clarification when needed. • Maintain a positive attitude.

36. The Medical Record • The medical record, or chart, is: • A written account of a person’s condition and response to treatment and care • A permanent, legal document • Medical facilities have policies about: • Who can see them • Who records • When to record • Abbreviations • How to correcting errors • What color of ink to use • How to sign entries

37. Confidentiality • You have an ethical and legal duty to keep the person’s information confidential. • The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides federal protections for personal health information and gives patients an array of rights with respect to that information.

38. HIPAA Guidelines • Health care workers have access to information related to the care of their patients. • Any information is confidential and is only reported to others involved in care of the patient. • Care must be taken when reporting any information to prevent others from hearing the information. • Patient information should never be discussed in public areas such as hallways, cafeterias, elevators, etc.

39. Many facilities use a 24 hour clock. It eases the confusion of whether a time is AM or PM. 1:00am - 0100 1:00pm - 1300 6:30am - 0630 6:30pm - 1830 Recording Time

40. Medical Terminology • Prefixes, roots, and suffixes • A prefix is a word element placed before a root. • The root is the word element that contains the basic meaning of the word. • A suffix is a word element placed after a root. • Medical terms are formed by combining word elements. • Prefixes always come before roots. • Suffixes always come after roots. • A root can be combined with prefixes, roots, and suffixes.

41. Abbreviations • Abbreviations are used frequently in health care facilities • Use only those accepted by the center.

42. Computers in Health Care • Computers are routinely used in health care facilities to collect, send, record, and store information. • The following guidelines apply: • Use computers only for work purposes. • Do not share your password. • Employers may monitor your computer use.

43. Phone communications • Good communication skills are needed when answering phones. • Be professional and courteous. • Answer with a greeting, your location, name, and title. • Take messages accurately and deliver promptly. • Follow the center’s policies regarding who can answer and take messages. • Many facilities restrict cell phone use during work hours.

44. Conflict • Conflict can occur in any setting. • If problems are not worked out, the following can occur: • Unkind words or actions occur. • The work setting becomes unpleasant. • Care is affected.

45. Dealing with Conflict • Ask your supervisor for some time to talk privately. • Approach the person with whom you have the conflict. • Agree on a time and place to talk. • Talk in a private setting. • Explain the problem. • Listen to the person. • Identify ways to solve the problem. • Set a date and time to review the matter. • Thank the person for meeting with you. • Carry out the solution. • Review the matter as scheduled.

46. Problem - Solving Use the following steps to help resolve conflict. • Define the problem. • Collect information. • The information must be about the problem. • Identify possible solutions. • Select the best solution. • Carry out the solution. • Evaluate the results