Communication Communication

Essential Skills for Health Care Essential Skills for Health Care ProfessionalsProfessionals

ObjectivesObjectives

• Students will:Students will:– Demonstrate the use of positive communication techniques. Demonstrate the use of positive communication techniques. – Utilize two types of communication. Utilize two types of communication. – Explore possible barriers to communication Explore possible barriers to communication – Relate and communicate multicultural and multilingual needs. Relate and communicate multicultural and multilingual needs. – Differentiate between subjective and objective information. Differentiate between subjective and objective information. – Maintain confidentiality. Maintain confidentiality. – Evaluate technological threats to confidentiality. Evaluate technological threats to confidentiality. – Discuss patient/client confidentiality. Discuss patient/client confidentiality. – Analyze legal ethical aspects of confidentiality.Analyze legal ethical aspects of confidentiality.

CommunicationCommunication

• The exchange of informationThe exchange of information

• Two types:Two types:– VerbalVerbal - written or spoken language - written or spoken language– NonverbalNonverbal - message spread through body - message spread through body

language, gestures, expressionlanguage, gestures, expression

Effective CommunicationEffective Communication

For communication to be effective:For communication to be effective:• Use words that mean the same thing to you and Use words that mean the same thing to you and

the receiver of the message.the receiver of the message.• Use familiar words.Use familiar words.• Be brief and concise.Be brief and concise.• Give information in a logical and orderly manner.Give information in a logical and orderly manner.• Give facts and be specificGive facts and be specific

Components of CommunicationComponents of Communication

• SenderSender - person sending the message - person sending the message

• MessageMessage - information to be conveyed - information to be conveyed

• ReceiverReceiver - person the information is - person the information is intended for intended for

• Problems in either component can lead to Problems in either component can lead to miscommunication and/or miscommunication and/or misunderstandingsmisunderstandings

Barriers to CommunicationBarriers to Communication

• Communication barrierCommunication barrier – Anything that – Anything that gets in the way of clear communication. gets in the way of clear communication.

• May be in sender, message, or receiver May be in sender, message, or receiver

• Common Barriers include:Common Barriers include:– Psychological attitudes and prejudicePsychological attitudes and prejudice– Cultural diversityCultural diversity– Physical disabilitiesPhysical disabilities

Psychological BarriersPsychological Barriers

• Psychological barriers are often caused by:Psychological barriers are often caused by:– PrejudicePrejudice– AttitudesAttitudes– PersonalityPersonality

• Stereotypes such as “dumb blonde” or “fat slob” Stereotypes such as “dumb blonde” or “fat slob” cause us to make snap judgments about others cause us to make snap judgments about others that affect the communication process. that affect the communication process.

• Health care workers must learn to put prejudice Health care workers must learn to put prejudice aside and show respect for all aside and show respect for all individuals. individuals.

Guidelines Guidelines

• Health care workers must examine any Health care workers must examine any prejudices they may have and learn to put prejudices they may have and learn to put these aside these aside

• Never use language that others may view Never use language that others may view as offensiveas offensive

• Learning to “read” others body language Learning to “read” others body language can help to prevent can help to prevent misunderstanding misunderstanding

Cultural BarriersCultural Barriers

• All cultural beliefs must be respected.All cultural beliefs must be respected.• Every culture has beliefs and practices Every culture has beliefs and practices

regarding health and illness such as:regarding health and illness such as:– the body needs balance – if the body is cold, they eat the body needs balance – if the body is cold, they eat

hot foods.hot foods.– illness is due to demons and evil spiritsillness is due to demons and evil spirits– illness is punishment from Godillness is punishment from God

• Patients may practice their cultural remedies in Patients may practice their cultural remedies in addition to modern healthcare techniques.addition to modern healthcare techniques.

Guidelines for Cultural DiversityGuidelines for Cultural Diversity

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

• Eye contactEye contact – in some cultures, it’s not – in some cultures, it’s not acceptable, and looking down is a sign of acceptable, and looking down is a sign of respectrespect

• Terminal illnessTerminal illness – in some cultures, the patient – in some cultures, the patient is NOT told his/her prognosis, and family is NOT told his/her prognosis, and family members are responsible for making care members are responsible for making care decisionsdecisions

• TouchTouch – in some cultures, it is wrong to touch – in some cultures, it is wrong to touch someone on the head. Others may limit touch someone on the head. Others may limit touch between male and femalebetween male and female

• Personal carePersonal care – in some cultures, only family – in some cultures, only family members provide personal caremembers provide personal care

Guidelines for Cultural DifferencesGuidelines for Cultural Differences

• Respect and acceptance of cultural Respect and acceptance of cultural diversity is essential for any health care diversity is essential for any health care worker.worker.

• If unsure of cultural practices, speak with If unsure of cultural practices, speak with the patient or family to prevent future the patient or family to prevent future misunderstandingsmisunderstandings

Guidelines for Cultural DifferencesGuidelines for Cultural Differences

Physical BarriersPhysical Barriers

Physical barriers may include:Physical barriers may include:– Deafness or hearing lossDeafness or hearing loss– Blindness or impaired visionBlindness or impaired vision– Aphasia or speech disabilitiesAphasia or speech disabilities

Communicating with the Communicating with the Hearing ImpairedHearing Impaired

• Use body language such as gestures and Use body language such as gestures and signs.signs.

• Speak clearly in short sentences.Speak clearly in short sentences.

• Face the individual to facilitate lip reading.Face the individual to facilitate lip reading.

• Write messages if necessary.Write messages if necessary.

• Make sure hearing aids are working Make sure hearing aids are working properly properly

• Use a soft tone of voice.Use a soft tone of voice.

• Describe events that are occurring.Describe events that are occurring.

• Announce your presence as you enter a Announce your presence as you enter a room.room.

• Explain sounds or noises.Explain sounds or noises.

• Use touch when appropriate.Use touch when appropriate.

Communicating with the Communicating with the Visually ImpairedVisually Impaired

These patients may have difficulty remembering the correct These patients may have difficulty remembering the correct words, may not be able to pronounce certain words, and words, may not be able to pronounce certain words, and may have slurred speech.may have slurred speech.

• The health care worker must be patientThe health care worker must be patient• Allow them to try and speakAllow them to try and speak• Encourage them to take their timeEncourage them to take their time• Repeat the message to assure accuracyRepeat the message to assure accuracy• Encourage them to use gestures or point to objectsEncourage them to use gestures or point to objects• Provide pen and paper if they can writeProvide pen and paper if they can write• Use pictures with key messages communicateUse pictures with key messages communicate

Communicating with Patients with Communicating with Patients with Aphasia or Speech ImpedimentsAphasia or Speech Impediments

Recording and ReportingRecording and Reporting

• ReportingReporting is the oral account of care and is the oral account of care and observations.observations.

• RecordingRecording (charting) is the written (charting) is the written account of care and observations. account of care and observations. – During end-of-shift report, information is During end-of-shift report, information is

shared about:shared about:• The care givenThe care given• The care that must be givenThe care that must be given• The person’s conditionThe person’s condition

Recording and ReportingRecording and Reporting

• Communication between health care workers is critical in Communication between health care workers is critical in ensuring quality patient care.ensuring quality patient care.

• Workers must listen carefully and make observations.Workers must listen carefully and make observations.• Observations must be accurate, concise, and complete.Observations must be accurate, concise, and complete.• Use facts and report only what you saw, not the reasons.Use facts and report only what you saw, not the reasons.

– NOT – “Mrs. Jones is in pain.” NOT – “Mrs. Jones is in pain.” – INSTEAD – “Mrs. Jones is holding her chest with wheezing as INSTEAD – “Mrs. Jones is holding her chest with wheezing as

she breathes.”she breathes.”

• OObjective / Signbjective / Sign – what was seen or – what was seen or OObservedbserved• SSubjective / Symptomubjective / Symptom - what the patient  - what the patient SSaidaid

ObservationsObservations

• Health care workers use their senses to:Health care workers use their senses to:

SeeSee– Color of skin, swelling or edemaColor of skin, swelling or edema– Presence of rash or sorePresence of rash or sore– Color of urine or stoolColor of urine or stool– Amount of food eatenAmount of food eaten

SmellSmell– Body odorBody odor– Unusual odors of breath, wounds, Unusual odors of breath, wounds, urine or stool (feces)urine or stool (feces)

ObservationsObservations

TouchTouch– PulsePulse– Dryness or temperature of skinDryness or temperature of skin– PerspirationPerspiration– SwellingSwelling

HearingHearing– RespirationsRespirations– Abnormal body soundsAbnormal body sounds– CoughsCoughs– SpeechSpeech

The Medical RecordThe Medical Record

• The medical record, or chart, is:The medical record, or chart, is:• A written account of a person’s condition and response to A written account of a person’s condition and response to

treatment and caretreatment and care• A permanent, legal documentA permanent, legal document

• Medical facilities have policies about:Medical facilities have policies about:• Who can see them Who can see them • Who recordsWho records• When to recordWhen to record• AbbreviationsAbbreviations• How to correcting errorsHow to correcting errors• What color of ink to useWhat color of ink to use• How to sign entriesHow to sign entries

ConfidentialityConfidentiality

• You have an ethical and legal duty to keep You have an ethical and legal duty to keep the person’s information confidential.the person’s information confidential.

• The The Health Insurance Portability and Health Insurance Portability and Accountability Act of 1996Accountability Act of 1996 ( (HIPAAHIPAA) ) provides federal protections for personal provides federal protections for personal health information and gives patients an health information and gives patients an array of rights with respect to that information. array of rights with respect to that information.

HIPAA GuidelinesHIPAA Guidelines

• Health care workers have access to information Health care workers have access to information related to the care of their patients.related to the care of their patients.

• Any information is confidential and is only Any information is confidential and is only reported to others involved in care of the patient.reported to others involved in care of the patient.

• Care must be taken when reporting any Care must be taken when reporting any information to prevent others from hearing the information to prevent others from hearing the information.information.

• Patient information should never be discussed in Patient information should never be discussed in public areas such as hallways, cafeterias, public areas such as hallways, cafeterias, elevators, etc.elevators, etc.

Recording TimeRecording Time

• Many facilities use a 24 Many facilities use a 24 hour clock.hour clock.

• It eases the confusion of It eases the confusion of whether a time is AM or whether a time is AM or PM. PM.

• 1:00am - 01001:00am - 0100• 1:00pm - 1300 1:00pm - 1300 • 6:30am - 06306:30am - 0630• 6:30pm - 18306:30pm - 1830

Medical TerminologyMedical Terminology

– Prefixes, roots, and suffixes Prefixes, roots, and suffixes • A prefix is a word element placed before a root.A prefix is a word element placed before a root.• The root is the word element that contains the The root is the word element that contains the

basic meaning of the word.basic meaning of the word.• A suffix is a word element placed after a root.A suffix is a word element placed after a root.

– Medical terms are formed by combining word Medical terms are formed by combining word elements.elements.• Prefixes always come before roots.Prefixes always come before roots.• Suffixes always come after roots.Suffixes always come after roots.• A root can be combined with prefixes, roots, and A root can be combined with prefixes, roots, and

suffixes.suffixes.

AbbreviationsAbbreviations

– Abbreviations are used frequently in health Abbreviations are used frequently in health care facilitiescare facilities

– Use only those accepted by the center.Use only those accepted by the center.

Computers in Health CareComputers in Health Care

• Computers are routinely used in health Computers are routinely used in health care facilities to collect, send, record, and care facilities to collect, send, record, and store information.store information.

• The following guidelines apply:The following guidelines apply:– Use computers only for work purposes.Use computers only for work purposes.– Do not share your password.Do not share your password.– Employers may monitor your Employers may monitor your computer use.computer use.

Phone communicationsPhone communications

• Good communication skills are needed when Good communication skills are needed when answering phones.answering phones.– Be professional and courteous.Be professional and courteous.– Answer with a greeting, your location, name, and title.Answer with a greeting, your location, name, and title.– Take messages accurately and deliver promptly.Take messages accurately and deliver promptly.– Follow the center’s policies regarding who can answer Follow the center’s policies regarding who can answer

and take messages.and take messages.– Many facilities restrict cell phone use Many facilities restrict cell phone use

during work hours.during work hours.

ConflictConflict

• Conflict can occur in any setting.Conflict can occur in any setting.

• If problems are not worked out, the If problems are not worked out, the following can occur:following can occur:

• Unkind words or actions occur.Unkind words or actions occur.• The work setting becomes unpleasant.The work setting becomes unpleasant.• Care is affected.Care is affected.

Dealing with ConflictDealing with Conflict

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

Problem - SolvingProblem - Solving

Use the following steps to help resolveUse the following steps to help resolve

conflictconflict..1.1. Define the problem.Define the problem.

2.2. Collect information.Collect information.1.1. The information must be about the problem.The information must be about the problem.

3.3. Identify possible solutions.Identify possible solutions.

4.4. Select the best solution.Select the best solution.

5.5. Carry out the solution.Carry out the solution.

6.6. Evaluate the resultsEvaluate the results