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RTEC-ARTEC-AWK – 12 2011WK – 12 2011

Patient Skills & Patient Skills & CommunicationCommunication

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Patient CommunicationPatient Communication

1.1. Interacting with the patientInteracting with the patient

2.2. Interacting with family and friendsInteracting with family and friends

3.3. Methods of Effective CommunicationMethods of Effective Communication

4.4. Age as a factor in Patient InteractionsAge as a factor in Patient Interactions

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Radiologic TechnologistRadiologic Technologist

1.1. Helping othersHelping others

2.2. Working with peopleWorking with people

3.3. Making a differenceMaking a difference

4.4. Thinking criticallyThinking critically

5.5. Demonstrating creativity Demonstrating creativity

6.6. Achieving resultsAchieving results

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Abraham Maslow’s Abraham Maslow’s Hierarchy of NeedsHierarchy of Needs

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Patient DignityPatient Dignity

1.1. Patients are usually in the lower levels of Patients are usually in the lower levels of Maslow’s Hierarchy Maslow’s Hierarchy

2.2. Must always be remembered and Must always be remembered and respectedrespected

3.3. Difficult to maintain dignity when illDifficult to maintain dignity when ill

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Why is this important?Why is this important?PATIENT NEEDSPATIENT NEEDS

1.1. Altered states of consciousnessAltered states of consciousness

2.2. EnvironmentEnvironment

3.3. Fear of unknownFear of unknown

4.4. VulnerableVulnerable

5.5. Coping MechanismsCoping Mechanisms

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No No’s…..No No’s…..

Referring to a patient as: Referring to a patient as:

“ “the chest in room 2”the chest in room 2”

Always use the patients name!Always use the patients name!

HIPAA Laws - Only discuss what you must HIPAA Laws - Only discuss what you must know to do your job. know to do your job.

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Classification of PatientsClassification of Patients

1.1. InpatientsInpatients

2.2. OutpatientsOutpatients

– Family Family

– FriendsFriends

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Methods of Communication Methods of Communication (Slide 9)(Slide 9)

1.1. VerbalVerbal

2.2. HumorHumor

3.3. ParalanguageParalanguage

4.4. Body LanguageBody Language

5.5. TouchTouch

1.1. PalpationPalpation

1.1. Professional Professional AppearanceAppearance

2.2. Physical PresencePhysical Presence

3.3. Visual ContactVisual Contact

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Verbal Communication (Slide 10)Verbal Communication (Slide 10)

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Communication thru Humor Communication thru Humor (Slide 11)(Slide 11)

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ParalanguageParalanguage

Defines all of the audio information in a Defines all of the audio information in a conversation beyond word choice conversation beyond word choice

Simply listening to someone’s voice, even Simply listening to someone’s voice, even if you can’t make out the words, conveys if you can’t make out the words, conveys their emotional state their emotional state

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Body LanguageBody Language

You could be talking to someone and your You could be talking to someone and your body language will will convey something else entirely. convey something else entirely.

Make eye contact occasionally you show an interest in that person Make eye contact occasionally you show an interest in that person and in what he or she is saying. and in what he or she is saying.

A smile sends a positive message. Smiling adds warmth and A smile sends a positive message. Smiling adds warmth and confidence about you. confidence about you.

Arms crossed or folded over your chest say that you have shut other Arms crossed or folded over your chest say that you have shut other people out and have no interest in them or what they are saying. people out and have no interest in them or what they are saying.

Placing your arms at your side can make you look and feel confident Placing your arms at your side can make you look and feel confident and relaxed to other people around you. and relaxed to other people around you.

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Touch and Palpation (slide 14)Touch and Palpation (slide 14)

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Cycle of CommunicationCycle of Communication

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Radiographer’s ResponsibilityRadiographer’s Responsibility

1.1. IntroductionIntroduction

2.2. Explanation of exam Explanation of exam

3.3. Inform patient how they will receive Inform patient how they will receive their resultstheir results

4.4. Risks of examination Risks of examination

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Rad Tech’s Role in Clinical HxRad Tech’s Role in Clinical Hx

1.1. Extract as much history as possible Extract as much history as possible

2.2. Radiologists often do not even speak Radiologists often do not even speak with the patient.with the patient.

3.3. Radiologist can be focus on anatomy of Radiologist can be focus on anatomy of interestinterest

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Desirable Qualities for Establishing Desirable Qualities for Establishing Open Dialogue (Slide 19)Open Dialogue (Slide 19)

1.1. RespectRespect

2.2. GenuinenessGenuineness

3.3. EmpathyEmpathy

4.4. PolitePolite

5.5. Professional Professional demeanordemeanor

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Data Collection (Slide 20)Data Collection (Slide 20)

1.1. ObjectiveObjective: Signs that can be seen: Signs that can be seen

2.2. SubjectiveSubjective: Perceived by the affected : Perceived by the affected individualindividual

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Questioning SkillsQuestioning Skills

1.1. Open-ended questionsOpen-ended questions

2.2. Facilitation – encourages pt to elaborateFacilitation – encourages pt to elaborate

3.3. Silence – give pt time to rememberSilence – give pt time to remember

4.4. Probing questions – focus interview, provide more Probing questions – focus interview, provide more informationinformation

5.5. Repetition – rewording, clarifies infoRepetition – rewording, clarifies info

6.6. Summarization – verifies accuracySummarization – verifies accuracy

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Leading QuestionsLeading Questions

This is an This is an UNDESIRABLEUNDESIRABLE method of method of questioning. questioning.

– Introduces bias to historyIntroduces bias to history

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Chief ComplaintChief Complaint

1.1. Focuses attention to the single most Focuses attention to the single most important issue.important issue.

2.2. Patients often have many complaintsPatients often have many complaints– Focus on primary reason for examFocus on primary reason for exam

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Clinical IndicationClinical Indication

1.1. Tech must collect a focused history.Tech must collect a focused history.

2.2. Several elements comprise a “complete Several elements comprise a “complete history”.history”.

1.1. Sacred SevenSacred Seven

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Sacred Seven (slide 25)Sacred Seven (slide 25)1.1. LocalizationLocalization

2.2. ChronologyChronology

3.3. QualityQuality

4.4. SeveritySeverity

5.5. OnsetOnset

6.6. Aggravating or Alleviating FactorsAggravating or Alleviating Factors

7.7. Associated ManifestationsAssociated Manifestations

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LocalizationLocalization (slide 26) (slide 26)

Defining exact area of Defining exact area of patient complaintpatient complaint

Carefully worded Carefully worded questionsquestions

Palpation as neededPalpation as needed

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ChronologyChronology (slide 27) (slide 27)

DurationDuration

FrequencyFrequency

Course of symptomsCourse of symptoms

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Quality (slide 28)Quality (slide 28)

Color and consistency Color and consistency of fluidsof fluids

Size of bumps and Size of bumps and lesionslesions

Type of painType of pain– Burning, throbbing, Burning, throbbing,

dull, sharp, cutting, dull, sharp, cutting, aching, radiationg, aching, radiationg, pressure or crushingpressure or crushing

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Severity (slide 29)Severity (slide 29)Number of bumps or Number of bumps or lesionslesions

Pain on number scale Pain on number scale (1-10)(1-10)

The degree of a burnThe degree of a burn

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OnsetOnset

What was PT doing when illness began?What was PT doing when illness began?

Was there an aura before the migraine?Was there an aura before the migraine?

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Aggravation or Alleviating FactorsAggravation or Alleviating Factors

For exampleFor example– Lying down headache goes awayLying down headache goes away

Putting ice on it reduces swellingPutting ice on it reduces swelling

Pain intensifies when walkingPain intensifies when walking

Pain stops when sittingPain stops when sitting

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Associated ManifestationsAssociated Manifestations

Other symptoms that happen with this Other symptoms that happen with this illnessillness

May describe loss of feeling in fingers as a May describe loss of feeling in fingers as a part of diabetespart of diabetes

May describe an aura as part of a seizureMay describe an aura as part of a seizure

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You never know what you are You never know what you are going to get?going to get?

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Special Condition PatientsSpecial Condition Patients

Traumatized PatientsTraumatized Patients

Visually Impaired PatientsVisually Impaired Patients

Speech and Hearing Impaired PatientsSpeech and Hearing Impaired Patients

Non-English Speaking PatientsNon-English Speaking Patients

Mentally Impaired PatientsMentally Impaired Patients

Substance AbusersSubstance Abusers

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GerontologyGerontology

The study of aging and diseases of the The study of aging and diseases of the elderly.elderly.

By the end of the 20By the end of the 20thth century 33 century 33 million, more than 12% of total million, more than 12% of total population.population.

In 1900 only 4%, of populationIn 1900 only 4%, of population

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Key to a Successful ExamKey to a Successful Exam

Plan of actionPlan of action

Systematic problem-solving processSystematic problem-solving process– Assessment of dataAssessment of data

– Setting a goalSetting a goal

– Establishing a planEstablishing a plan

– Safety in completing assignmentSafety in completing assignment – Evaluating the work Evaluating the work

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CommunicationCommunication

The key to a successful exam for The key to a successful exam for Technologist and Patient.Technologist and Patient.

Human DiversityHuman Diversity

FALL 2011FALL 2011

What is Human Diversity?What is Human Diversity?

1.1. Is also known as cultural diversity.Is also known as cultural diversity.

2.2. It means the inherent differences among It means the inherent differences among people.people.

3.3. It addresses the entirety of the ways It addresses the entirety of the ways people are different and alike.people are different and alike.

Characteristics of Human DiversityCharacteristics of Human Diversity

AgeAge

DisabilityDisability

Economic statusEconomic status

EducationEducation

Geographic locationGeographic location

Organizational levelOrganizational level

Political affiliationPolitical affiliation

Sexual orientationSexual orientation

EthnicityEthnicity

Family statusFamily status

First languageFirst language

GenderGender

LifestyleLifestyle

Physical characteristicsPhysical characteristics

ReligionReligion

Work style or ethicWork style or ethic

GlobalizationGlobalization

People go into other countries for:People go into other countries for:

– WorkWork– SchoolSchool– Medical careMedical care– Visit / VacationVisit / Vacation– Live / RelocateLive / Relocate– Refuge / SafetyRefuge / Safety

Globalization’s Effect Globalization’s Effect

Nation, societies and businesses have become Nation, societies and businesses have become multicultural or cross culturalmulticultural or cross cultural

Strategies must be employed to understand Strategies must be employed to understand cultural differencescultural differences

Strategies needed to mediate conflictsStrategies needed to mediate conflicts

A concerted effort toward Cultural competencyA concerted effort toward Cultural competency

Taking the LeadTaking the Lead

Colleges, universities, businesses and Colleges, universities, businesses and health care providers foster cultural health care providers foster cultural diversity.diversity.

New trends and New jobsNew trends and New jobs– Offices of diversityOffices of diversity– Vice president of equity and diversityVice president of equity and diversity– Diversity programs for employeesDiversity programs for employees

Medical Imaging and DiversityMedical Imaging and Diversity

Through professional organizationThrough professional organization– American Society of R.T.American Society of R.T.– American Society of Diagnostic Medical American Society of Diagnostic Medical

SonographersSonographers– Society of Nuclear MedicineSociety of Nuclear Medicine

How:How:– Concerted push toward cultural competencyConcerted push toward cultural competency– Minority scholarshipsMinority scholarships– Mentoring programsMentoring programs

Significant Diversity TraitsSignificant Diversity Traits

AgeAge

EthnicityEthnicity

RaceRace

Gender or sexual orientationGender or sexual orientation

Mental or physical disabilityMental or physical disability

AgeAgeCultures assign different valuesCultures assign different values

Baby Boomers (1946 – 1964)Baby Boomers (1946 – 1964)– 75 million born75 million born– Overall healthy and educatedOverall healthy and educated– Will be in the work force longerWill be in the work force longer

Age biases in western societyAge biases in western society– Valuing you over ageValuing you over age– Viewing aging as a “bad” thingViewing aging as a “bad” thing– Forgetting contributions offered by the agingForgetting contributions offered by the aging– Considering seniors as mentally inferiorConsidering seniors as mentally inferior

Ethnicity and National OriginEthnicity and National Origin

Ethnicity refers to a person’s racial, national, religious, Ethnicity refers to a person’s racial, national, religious, linguistic and cultural heritage. linguistic and cultural heritage.

Overcoming Linguistic DifferencesOvercoming Linguistic Differences– Bilingual staffBilingual staff– Medical interpretersMedical interpreters– Encouraging bilingualismEncouraging bilingualism– Forms in different languagesForms in different languages

Many different cultures as demonstrated in everyday life Many different cultures as demonstrated in everyday life and by statistical data: U.S. Census 2000.and by statistical data: U.S. Census 2000.

2003 Census Report2003 Census Report20002000

Caucasian alone- 228,106Caucasian alone- 228,106

African American/ Black alone- African American/ Black alone- 35,70435,704

Native American/ Alaska native Native American/ Alaska native alone- 2,664alone- 2,664

Asian alone- 10,589Asian alone- 10,589

Native Hawaiian/ other Pacific Native Hawaiian/ other Pacific Islander alone- 463Islander alone- 463

Combination of two or more- Combination of two or more- 3,8983,898

Hispanic or Latino origin- 35,306Hispanic or Latino origin- 35,306

20032003

Caucasian alone- 234,196Caucasian alone- 234,196

African American/ Black alone- African American/ Black alone- 37,09937,099

Native American/ Alaska native Native American/ Alaska native alone- 2,787alone- 2,787

Asian alone- 11,925Asian alone- 11,925

Native Hawaiian/ other Pacific Native Hawaiian/ other Pacific Islander alone- 495Islander alone- 495

Combination of two or more- Combination of two or more- 4,3084,308

Hispanic or Latino origin- 39,899Hispanic or Latino origin- 39,899

Adler & Carlton 2007

Ethnocentrism and RacismEthnocentrism and Racism

Ethnocentrism is the belief that norms and Ethnocentrism is the belief that norms and values of their culture should be standardvalues of their culture should be standard

Racism is the belief that one race or Racism is the belief that one race or culture is superior to othersculture is superior to others

Gender or Sexual OrientationGender or Sexual Orientation

Male vs. FemaleMale vs. Female– 1900 female roles1900 female roles– Today's womenToday's women– Glass ceilingGlass ceiling

Gender role Gender role stereotypingstereotyping

Gender identityGender identity

Sexual orientationSexual orientation– HeterosexualHeterosexual– HomosexualHomosexual– BisexualBisexual

KsixKsix

HomophobiaHomophobia

Mental or Physical DisabilityMental or Physical Disability

Mental or physical ability is the capacity to Mental or physical ability is the capacity to perform cognitive and psychomotor tasks perform cognitive and psychomotor tasks with average abilitywith average ability

Those with disabilities have been shunnedThose with disabilities have been shunned– Seen as objects or assistance, protection and Seen as objects or assistance, protection and

treatmenttreatment

600 million or 10% of the world have some 600 million or 10% of the world have some form of disabilityform of disability

Four Core Values of Human RightsFour Core Values of Human Rights

AutonomyAutonomy

DignityDignity

EqualityEquality

SolidaritySolidarity

Elements of Cultural CompetencyElements of Cultural Competency

Valuing DiversityValuing Diversity

Possessing the capacity for cultural self Possessing the capacity for cultural self assessmentassessment

Having a consciousness of the dynamics of Having a consciousness of the dynamics of cross cultural interactioncross cultural interaction

Institutionalizing cultural knowledgeInstitutionalizing cultural knowledge

Developing adaptations of service based on an Developing adaptations of service based on an understanding of multiculturalismunderstanding of multiculturalism

Empathetic PracticesEmpathetic Practices

CommunicationCommunication

Assessment and communicationAssessment and communication

NegotiatingNegotiating

Areas of Cultural Diversity Areas of Cultural Diversity related to Health Carerelated to Health Care

CommunicationCommunication

SpaceSpace

TimeTime

Environmental controlEnvironmental control

Biologic VariationsBiologic Variations

Social organizationsSocial organizations