Transcript AEMT Transition - Unit 3 Therapeutic Communications

TRANSITION SERIES
Topics for the Advanced EMT
CHAPTER
3
Therapeutic
Communication
Objectives
• Understand communication from a
process perspective.
• Identify useful techniques to facilitate
communication between individuals.
• Discuss how to improve communication
with differing cultural backgrounds.
• Describe strategies on how to
communicate with difficult patients.
Introduction
• Communication is a must in most
patient situations the Advanced EMT
will encounter.
• As an active process, communication
uses both verbal and nonverbal
expressions.
• At all times, you must remain
competent, confident, and
compassionate.
Process of Communication
• Communication begins with the sender
encoding the message.
• The receiver must then decode the
message for interpretation.
Communication consists of a sender, a message, a receiver, and feedback.
Techniques That May Facilitate Communication
Guidelines for Initial Contact
• Establish a positive rapport
– Speak and act professionally.
– Make introductions and learn the
patient's name.
– Always gain consent.
– Limit interruptions and control
surrounding noise.
– Be courteous, compassionate, and
respectful.
Conducting the Interview
• A mutually beneficial process
• The interview is used to gain valuable
information
– Use all types of communication,
including nonverbal.
Nonverbal Communications
A sincere touch can provide comfort to a patient.
Interviewing the Patient
• Consider age and mental capability.
• One question at a time; start with
open-ended questions.
• Avoid leading or biased questions.
• Do not interrupt or talk too much.
• Do not give false reassurances or
inappropriate advice.
Transcultural Considerations
• Understand that cultural differences
exist.
• Try to learn basic tenets of other
cultures.
• Seek exposure to cross-cultural
interactions.
An AEMT should try to achieve cultural competence to facilitate communication.
Challenges in Communication
• These situations can challenge normal
communication:
– Family preference issues
– Unmotivated or hostile patients
– Communicating with age extremes
– Patients with disabilities
– Non-English-speaking patients
Case Study
• You are called to a residence for an
elderly patient with respiratory distress.
You are met at the door by the
patient's daughter who is also her
primary care provider. You enter the
living room where you see the patient
lying on a hospital bed with
medications on a nearby stand.
Case Study (cont’d)
• What are some communication
difficulties that may arise based on the
information provided thus far?
Case Study (cont’d)
• Scene Size-Up
– Elderly female, 80+ years of age
– No sign of struggle or trauma
– Found in bed in high-Fowler position
– Patient looks very dyspneic
Case Study (cont’d)
• Primary Assessment Findings:
– Patient is responsive to verbal stimuli.
– The patient cannot speak well due to
the dyspnea, and when she does, it is in
broken English.
– Breathing is labored, but presently
intact.
– Peripheral perfusion is present.
Case Study (cont’d)
• How should you approach and
communicate with this patient?
• How can you enlist the help of family
members in communicating with this
patient?
• What nonverbal skills could you use to
help enhance communication?
Case Study (cont’d)
• Secondary Assessment:
– Patient is found to have a history of
COPD, and is on home oxygen.
– SAMPLE and OPQRST are completed.
– Breath sounds are uniformly distant.
– Balance of the secondary exam is noncontributory to the current situation.
– Vitals are within normal limits.
– The patient is prepared for transport.
Case Study (cont’d)
• What techniques will you use to
communicate with the patient while en
route to the hospital?
• Why should you inform the hospital
about the communication barrier before
your arrival?
Summary
• Communication, both verbal and
nonverbal, is integral to properly
assessing your patient.
• The Advanced EMT will be presented
with communication challenges rather
often with the diversity of patients seen
by EMS.
Summary (cont’d)
• The use of techniques discussed in this
chapter will greatly enhance the
Advanced EMT's ability to communicate
when difficulties arise.
Transfer of Care
• Physical and verbal “handing off” of
care from one healthcare provider to
another.
• Continuum of care helps to ensure that
care is consistent and appropriate.
Transfer of Care (cont’d)
• Patient's name, age, DOB, address
• Chief complaint
• History of present illness or injury
(Brief account of patient's current
condition)
• Past pertinent medical history
• Medications and Allergies
• Vital signs
Transfer of Care (cont’d)
• Pertinent findings from physical exam
• Overview of care provided and patient's
response to that care
• Ambulance Service identifying info
• Date and time of response
• Other information that may be
important to the initial management of
the patient at the hospital or other
receiving facility
Summary
Required Info for Transfer of Care
• Elements included in PCR or Drop Form
–
–
–
–
–
–
–
–
–
Patient's name, age, DOB, address
Chief complaint
History of present illness or injury
Past medical history/medications/allergies
Vital signs
Pertinent findings from physical exam
Overview of care provided and response
Ambulance ID/Date and time of response
Other important information for pt care
Review Questions
1. What elements are included in the
verbal transfer of care?
2. You respond to a 65 year old male
with chest pain. Practice giving a
verbal transfer report for such a
patient.