Communication in health Flashcards
Communicate and work effectively in health and community services
Benefits of effective communication:
Keeps everyone in the loop, feeling informed and like part of the team. Whenever major and minor misunderstandings arise the cause can usually be traced back to poor communication
Ties together team members, management and external agencies.
Welds together the various parts of a service or organisation into an enterprising, efficient and effective business that serves both the economy and the community as a whole
Forms of communication:
words symbols pictures graphics voice tone facial expressions clothing body language.
“Six C’s of Communication”:
Clear Complete Concise Concrete Correct Courteous
Person centred practice:
Healthcare which is tailored to individual needs, preferences and cultural diversity.
Also known as client centred practice or patient centred practice.
Universal needs:
The universal needs we all have, such as basic survival needs, must be met.
In these needs we are more similar than different.
We all need a safe place to live and we need food and clean water. We have the need for knowledge, work to support ourselves and our family and we have spiritual aspirations.
The way these needs are met is determined to some extent by the culture in which we live.
Communication types:
one- and two-way
Intrapersonal:
The internal use of language or thought.
Often used for clarifying information or analysing a situation. For example, the nurse observes that the patient is shivering and the nurse thinks to themselves ‘perhaps the client is cold, maybe I should check their temperature and get another blanket if necessary’.
The nurse observes the patient’s needs and thinks internally to address the problem
Interpersonal:
Basic to human interaction and essential for healthcare practice.
Communication is a process that requires interpretation, sensitivity, imagination and active participation.
Nurses interact with many persons in the course of their profession and effective communication assists in meeting legal, ethical, and clinical standards of care.
If communication is ineffective, there may be serious difficulty, increased liability and a threat to professional credibility.
Interpersonal communication requires sensitivity
Transpersonal:
Can be thought of as communicating spiritual sensitivity or emotional support.
Transpersonal communication may be demonstrated by the nurse as they enhance therapeutic relationships with the client by conveying acceptance, respect and non-judgemental attitudes and instilling hope in the future for the client and their family.
Transpersonal communication conveys respect and non-judgemental attitudes.
Small group:
This type of communication may be utilised by the nurse in many instances, from handover at the commencement of shift to the nurse who leads and Occupational Health and Safety Committee or to one who is participating in a support group for clients with particular health issues, such as rehabilitation.
Small groups are more effective when they have a suitable environment and all members of the group are aware of the objectives of the group and committed to working towards achieving these objectives.
Small group communication is more effective when all members are committed to a common goal.
Public:
Communication to an audience where the nurse who is presenting at a conference or leading a classroom discussion with peers must plan how to convey their message effectively.
Consideration needs to be given to the verbal information (being relevant and interesting) and the non-verbal gestures, tone and volume of voice being appropriate to the needs of the group. The presenter must consider if they require technology to support their presentation, enabling the audience to have the verbal message enhanced by the use of pictures and the written word. The size of font and the simplicity of the written communication need to be considered if the message being conveyed is to be effective.
Public communication considers verbal and non-verbal cues from the audience for effective delivery.
One-way interaction:
The sender is in control.
This form of communication generally sees the receiver give little, or no, response to the sender of the message.
Advantages:
Faster
Orderly
Authoritative
Disadvantages:
No receiver participation
Lack of feedback
Unable to assess understanding
Two-way interaction:
The message is sent, received, interpreted and response(s) given. It requires more time and energy and involves questioning, clarification and active listening.
Advantages:
More receiver participation
Open to feedback
Able to check for understanding
Disadvantages:
Slower
Can be a more challenging skill
The essence of effective communication:
Responding with meaning.
As the process of this communication is influenced by a number of significant variables, the meaning cannot be merely transferred from one human being to another, it must be mutually negotiated.
If you send communication to a colleague/supervisor and it is returned to you, the flow then becomes two-way. When communications are distributed among a department, such as a report that requires comments from other colleagues, the flow will become a two way flow as soon as the team members return their comments to the original sender.
Listening is:
One of the most important skills you can have. How well you listen has a major impact on your effectiveness, and on the quality of your relationships with others.
It is not:
Maintaining polite silence while waiting for a break in the flow of talk so you can jump in.
Mentally rehearsing what you want to say next or waiting for flaws in the information so you can pounce on them.
True listening is about trying to understand how the other person sees things, which can’t be achieved with poor listening habits like interrupting, jumping to conclusions, finishing others’ sentences and changing the subject.
Active listening:
Look at the speaker, to observe body language and listen for changes in voice tone and pitch.
Ask questions, summarise frequently and repeat in own words what you’ve understood the conversation to be about.
Don’t rush the speaker. Be poised, calm and emotionally controlled.
Respond with positive non-verbal communication such as smiles and nods.
Let people finish what they are saying before offering an opinion.
How can I be a better listener to gain more information?
PARAPHRASE the speaker’s meaning.
CLARIFY misunderstandings with phrases like ‘You feel…’ ‘You think…’ ‘It seems to you that…’ ‘You sound as though…’
WAIT OUT pauses - allow the speaker silence to gather their thoughts.
Only address the FACTS - don’t get caught up in emotions.
Remain NEUTRAL (don’t make judgements).
Don’t second guess the speaker and start adding or subtracting to their statements
Active listening prevents and minimises misunderstandings because it provides clear feedback from the receiver to the sender about what has been understood. Active listening also helps to build trust and encourages the speaker to provide you with more information.
Non-verbal communication:
Use of body language to support the transmission of a message, such as: facial expressions; gestures; touch; and appearance
The sender needs to be aware that the message may be confusing to the receiver if the non-verbal communication does not match the verbal communication.
It is important to be aware of the non-verbal messages that are sent by others or to others.
Non-verbal communication ‘speaks’ very loudly and if it is not consistent with what is said verbally, in a given set of circumstances, it can cause confusion and there are times when it may completely override the sender’s intended message.
Example:
you notice a client is agitated, going red in the face and scowling. You ask them if they are upset and they deny that they are feeling upset. This example illustrates a disparity between the feelings that are being communicated non-verbally and the verbal response from the client.
What percentage of a message is taken from body language?
What does body language include?
Over 70%
Facial expressions, gestures, eye contact, posture, body orientation and the distance you stand or sit from the person you are talking to communicate meaning. Even the way you dress makes a statement about you and your business.
Tone of voice equates to approximately 23%, with the actual words spoken being only ~7%
You have mastered the art of effective facial communication when:
You can maintain a warm, friendly facial expression even when confronted with someone who irritates or challenges you. Refraining from using negative facial expressions like rolling your eyes, scowling, or even worse, yawning, is the hallmark of a professional.
How can I use gestures to help me communicate?
Gestures can be used to:
Emphasise a point (pointing to a wrist watch to suggest time is running out);
Illustrate a point (creating a shape with your hands or miming an action);
Communicate a desired action (motioning to a chair inviting someone to sit down).
Is there any such thing as a negative gesture?
Yes, gestures can also be used negatively.
Your challenge will be to keep ‘unconscious’ gestures, like tapping your feet, in check.
At all times your facial expressions and gestures should match the meaning of your words.
So, what happens when I send mixed messages while communicating?
It risks confusing the recipient
It raises doubts about how genuine you are
It raises questions about your credibility or knowledge.
A professional image:
is not only generated from appropriate facial expressions and gestures alone. Hygiene and grooming are also very important.
is imperative and can be aided by projecting your professionalism visually.
To project a professional image you can:
Wear smart casual or corporate attire appropriate for the situation
Invest time into staying well groomed (neat hair, clean nails etc.)
Pay attention to your personal hygiene (keep deodorant at work if you sweat a lot, make sure your breath is fresh before treating clients etc.)
Verbal communication:
the spoken part of communication. It can be face to face, over the telephone, or via voice mail.
Advantages: fast; easy; natural. Disadvantages: words “disappear” once spoken; conversations are often remembered differently by different participants-if at all.
Word selection impacts not only the message that is sent but also the ability to receive and respond to that message. For example, the use of professional jargon with a client may be confusing since the interpretation of the word may be different from a medical perspective to a layperson’s understanding.
We need to tailor our communication to the person that we are speaking with and need to consider that the way we speak with clients may be different to the way we speak with colleagues, managers, friends and family.
Tips for verbal communication in a healthcare setting, when
Speaking to patient:
Speaking to nurse etc:
Speaking to patient:
You should address your patient by name unless they have specified otherwise.
You also need to explain any procedure to a client properly and then obtain consent.
Avoid unnecessary terminology.
Don’t be abrupt, it’s disrespectful.
Explain why, if you are unable to meet any requests.
If you are not able to do something immediately try and let your client know how long you will be.
Speaking to nurse etc:
You should always refer to a client by name rather than room number.
Explain what the problem is to help the nurse prioritise their time.
(eg: Mr Johnston wants to speak with a nurse about his sore arm. Could you take a look at him when you get a chance?)
Positive phrasing:
- tells the listener what can be done
- suggests alternatives and choices available
- sounds helpful and encouraging, not bureaucratic
- stresses positive actions and positive consequences that can be anticipated
Negative phrasing:
- tells the listener what cannot be done
- can have a subtle tone of blame
- includes words like can’t, won’t, unable to
- does not stress positive actions that would be appropriate, or positive consequences
Turning negative phrases into positive phrases:
Eliminate negative phrases and replace them with positive ways of conveying the same information.
Examples of positive phrasing.
I will do all that I can to help you
How can we make this a positive experience for you
I understand what you are saying
If you just provide us with (whatever), we can do (whatever)
Clarification:
confirms mutual understanding, by offering back to the speaker the essential meaning, as understood by the listener, of what they have just said.
Clarification involves:
Ensuring that the listener’s understanding of what the speaker has said is correct, reducing misunderstanding.
Reassuring the speaker that the listener is genuinely interested in them and is attempting to understand what they are saying.
It can involve asking questions or occasionally summarising what the speaker has said.
A listener can ask for clarification when they cannot make sense of the speaker’s responses. Sometimes, the messages that a speaker is attempting to send can be highly complex, involving many different people, issues, places and/or times. Clarifying helps you to sort these out and also to check the speaker’s priorities.
Through clarification it is possible for the speaker and the listener to make sense of these often confused and complex issues.
Clarifying involves genuineness on the listener’s part and it shows speakers that the listener is interested in them and in what they have to say.
Timely communication:
Improves the likelihood of effective communication
Assists decision making
Demonstrates respect
Improves safety
Even if we clearly communicate a message, poor timing can result in that communication being effective.
Example: trying to provide client education when a client is in severe pain would most likely render that communication ineffective.
Confidential communication:
Maintaining confidentiality is a sign of professionalism and respect.
Each client has a right to privacy and it is important for each healthcare worker to protect this privacy.
You cannot give out any information about a person without their permission.
In a health care setting, you will deal with a lot of personal and sensitive information including a person’s age, gender, address, and date of birth, as well details of health and family issues. Information of a personal or sensitive nature should only be discussed with the appropriate people when and where others cannot overhear the conversation.
Examples of breaches of confidentiality:
Client asks you how the man in the next bed is and if he is getting better. You tell him that the man is not doing well and needs to go for further tests.
Client is sat out in the chair and while you are making the bed with your colleague, you begin discussing one of the other residents.
Client has a severe leg ulcer and while you are assisting the nurse to redress the wound you take a photo and then later post it on social media.
You participate in a bedside handover of patient information and relatives of one of your patient’s overhear.
You go out to dinner after work with some colleagues and friends and openly discuss one of the clients that you have been looking after.
Confidential documents:
Documents need to remain private and confidential.
If documents of a sensitive nature are left where members of the general public or other unauthorised people may access them, the information within them could be taken out of context or made public.
There also may be information that the client does not wish their family, friends or others to know.
Records also need to be correctly stored and eventually destroyed by the correct personnel to make sure that information of a sensitive nature does not get into the wrong hands.
Confidentiality is important because:
It allows clients a safe place to talk about their health needs and any health problems they may have;
It helps clients trust your service because they know their health information will be kept private;
It lets clients know that they can decide who knows about their health issues and concerns.
Maintaining Confidentiality:
Personal or confidential information about a client should only be provided to another person if it is for the purpose of the client’s health and the client has agreed to the information being shared.
You may share certain information about a client with another health professional to help them understand and meet the client’s needs – with your client’s consent.
When you are required to provide information about a client to other people, it is important that you seek permission from the client to do so and only when it is obtained can you share the information with the consented parties.
You must not provide any information about a client in your care to the media, or allow media access to the client records.
Any client notes or records should be kept in a safe place (a lockable filing cabinet only accessible by those requiring it for treatment purposes)
Before sharing information you should always ask yourself, ‘Does this person need to know the information I am about to share and why do they want it?’ If I give this information will I be breaking the rules of confidentiality?
