Transcript Communication

Communication
Essential Skills for Health Care Professionals
Objectives
 Students will:
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Demonstrate the use of positive communication techniques.
Utilize two types of communication.
Explore possible barriers to communication
Relate and communicate multicultural and multilingual needs.
Differentiate between subjective and objective information.
Maintain confidentiality.
Evaluate technological threats to confidentiality.
Discuss patient/client confidentiality.
Analyze legal ethical aspects of confidentiality.
Communication
 The exchange of information
 Two types:
 Verbal - written or spoken language
 Nonverbal - message spread through body language,
gestures, expression
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
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
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
Barriers to Communication
 Barriers to transmitting the message
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Terms patient unable to understand
Incorrect grammar & punctuation
Meaningless terms- dog
Phrasing & emphasis of words
Tone & pitch of voice
Speed of speaking
Use of slang or w/ more than one meaning
Barriers to receiving the message
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Background noise or interruptions
Ability to read
Medications
Age
Level of education
Limited English
Visual, hearing, hearing impairment
Attitudes & prejudices
Trust in sender
Understanding the message
 A shared understanding of a message
– 7% of a message is conveyed by words
– 38% by the tone of voice
– 55% by nonverbal behavior
 Body language, facial expressions &
inappropriate responses may suggest lack of
understanding
 Rephrasing message will clarify for receiver
 Receivers’ attitude & prejudices may interfere
 Utilize active listening: reflective statements &
clarification
 Maintain eye contact, open mind
Tie Your Shoes Activity
Answer in complete sentences and give details!
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What problems did you encounter?
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Why is it so hard to give verbal directions only?
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.
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
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.
Guidelines for Cultural Diversity
 Language differences – people who don’t speak
English may have a difficult time communicating. You
should:
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Speak slowly
Use nonverbal communication (smile)
Avoid tendency to speak louder
Find an interpreter
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
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
Physical Barriers
Physical barriers may include:
 Deafness or hearing loss
 Blindness or impaired vision
 Aphasia or speech disabilities
Communicating with the
Hearing Impaired
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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
Communicating with the
Visually Impaired
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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.
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.
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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
Mobile Manners
 Cell phone usage is increasing dramatically
 a. Cell phone usage has been soaring for the past 15
years
 i. 1991: 7.6 million cell phone subscribers in the US
 ii. 2001: 120 million cell phone subscribers in the US
 iii. 2009: 308 million cell phone subscribers in US
 b. 89% of the US population uses cell phones
Uses
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Buisness
Emergencies
Answering machines
Internet link
Music
Camera
social
Hazards
 3% of drivers are talking on hand-held cell phones at
any given time
 Drivers using phones are four times as likely to get
into crashes serious enough to cause injury.
 Studies are being done to determine potential health
hazards associated with the use of cell phones.
Hazards
 Accidents nonrelated to driving
 Watch where you are going.
Tripping and falling
Walking into objects or other people
Stay alert.
Not paying attention to your surroundings can
put you at risk of being mugged
Technological change leads to social
change
 a. New technologies are often first adopted by younger
segments of
 a society.
 b. Rapid adoption of cell phone usage by all generations is
 reshaping the entire communication landscape.
c. Connected 24/7/365
 d. Has extended the work day
 e. Cell phone “jammers” have been developed due to new
cell phone technology.
Etiquette
 a. A set of rules we all agree to follow in order to be
considerate
 toward others
 b. It is a question of awareness of how your actions affect
others.
 c. Simple guidelines of common courtesy
 d. Contribute to a more polite society
 e. Just a matter of being considerate of others
 f. With so many cell phone users, it is necessary to have a
few guidelines regarding cell phone use.
The Simple Rules
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Modulate your voice.
i. Use your “inside voice”: a quiet conversational tone.
ii. There is no need to shout into or at a phone.
iii. Cell phones have sensitive microphones that can
pick up a
 very soft voice while blocking out ambient noise.
10-foot Proximity Rule
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i. Maintain a distance of at least 10 feet from the nearest
person when taking on a cell phone.
ii. Don’t force others to overhear your personal business.
Bystanders can hear the steady streams of
shocking and confidential revelations that are
blurted out by cell phone users.
Private issues should be kept private.
Forcing others to hear your phone conversations is
an intrusion on their thoughts.
Imposes, infringes, intrudes
iii. Keep your conversation private.
Love the One You’re With.
 Avoid taking calls when you’re already engaged in a facetoface
 conversation.
 Gives the impression that you do not value the
 person in front of you
 ii. It is inconsiderate to take a call in the middle of a
 conversation.
 iii. Never take a personal call during a business meeting.
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This includes interviews and meetings with coworkers
or subordinates
If you must take a call, ask permission of the people with
you.
The same principle applies when you are ordering food.
Give the waiter your attention.
Don’t just point to a menu item and shake your
head.
The same set of rules for texting during face-to-face
conversations – it is rude
Ear plugs
Many are near invisible
People cannot tell if you are talking to them,
someone on the cell, or your invisible friend
Lights Out, Phones Off
 Put your phone’s ringer on “silent” in theaters, courtrooms,
places of worship, and restaurants.
 Don’t light up your phone’s screen in a dark theater.
 If you forget to turn your phone off or set it to silent, don’t
answer it if it rings – turn it off immediately.
 You can leave the room and return the call.
 Just let the caller leave you a message, and get back to them
later.
 iv. No Talking Zones
 Elevators, libraries, museums, restaurants, cemeteries, theaters,
medical offices, and enclosed public spaces
Hang up and drive.
 Multitasking isn’t always a good thing.
 Most calls can wait until you’ve reached your
destination.
 if the call is upsetting, it will affect your ability to drive
safely.
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
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
Observations
 Health care workers use their senses to:
See
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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)
Observations
Touch
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Pulse
Dryness or temperature of skin
Perspiration
Swelling
Hearing
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Respirations
Abnormal body sounds
Coughs
Speech
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:
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Who can see them
Who records
When to record
Abbreviations
How to correcting errors
What color of ink to use
How to sign entries
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.
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.
Recording Time
 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
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.
Phone communications
 Good communication skills are needed when
answering phones.
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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.
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.
Dealing with Conflict
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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.
Problem - Solving
Use the following steps to help resolve
conflict.
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Define the problem.
Collect information.
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The information must be about the problem.
Identify possible solutions.
Select the best solution.
Carry out the solution.
Evaluate the results