communications in health care health care core curriculum
TRANSCRIPT
Communications in Health Care
Health Care Core Curriculum
Ernest Hemingway: When people talk, listen completely. Most people never listen.
Franklin Delano Roosevelt: Be sincere; be brief; be seated.
George Eliot: It is very hard to say the exact truth, even about your own immediate feelings – much harder than to say something fine about them which is not the exact truth.
Hubert H. Humphrey: The right to be heard does not automatically include the right to be taken seriously.
Jonathan Swift: Argument is the worst sort of conversation.
Anne Morrow Lindbergh: Good communication is as stimulating as black coffee, and just as hard to sleep after.
Clarence Darrow: Even if you do learn to speak correct English, whom are you going to speak it to?
Edward R. Murrow: People say conversation is a lost art; how often I have wished it were.
I remember……. 10% of what I read. 20% of what I hear. 30% of what I see. 50% of what I see & hear. 70% of what I discuss with others. 80% of what I experience by doing. 95% of what you teach others
MYOB OBO AWCSICS HAK ASAPTGIF GAL FITBSWL HOYEW LOLIOW JAM KITKMA L8R YGLTTSR TTYL TNTL
True or FalseSomeone who is as cool as a cucumber, doesn’t get
worried or upset.If someone tells you to keep your hair on, they want
you to show more emotion.If you work like a dog, you work very hard.If something has down in the pan, it has failed.If you take to something like a duck takes to water,
you have a natural talent for it.
Components of Communication
1. Sender2. Message3. Receiver4. Feedback
All 4 steps are required for effective communication.Steps must be in order.
Communication Methods
Composed of different methods Words Voice Tone Non-verbal clues
Words = 7% effective Tone = 38% effective
Non-verbal clues = 55% effective
Verbal Communication
Care with: choice of wordstone of speechspeed of speechvolume of speech
BE AWARE OF ABILITY TO UNDERSTAND
Verbal Communication Techniques
Slow/clear speech Receiver is attentive Focus on client’s feelings Repeat message Re-send if necessary
DON’T PRETEND
Non-verbal Communication Body Language Facial expression Touch Posture Gesture Silence Emotion of sender Other connections
Non – Verbal Communication Techniques Face speaker Good posture Good facial expression Non-verbal supports verbal
WHAT you say is not nearly as important as HOW you say it
A dull message delivered by a charismatic person filled with energy and enthusiasm will be accepted as brilliant.
An excellent message delivered by someone who is dull will lack enthusiasm of its audience.
The Communication Process – Six Steps
1. Set Communication Goals – Gather info Instruct Inform Report
2. Create the Message Receiver must be able to understand Organize messages Asking Questions –
Closed-ended Open-ended Probing Questions Leading Questions
3. Deliver the Message To whom is the message being delivered to Understand family cultures and dynamics
4. Listen to Response Concentration Attention Observation
5. Offer Feedback & Seek Clarification Paraphrasing Reflecting Request clarification & additional information Request examples
6. Evaluate the Encounter Were communication goals met? If goal was not met
Messages clearly stated? Appropriate level? Active listening? Which part was misunderstood?
Techniques for Effective Communication Decrease background noise Listen Pace speech Allow time for response Show interest Eye contact – if appropriate Clear speech Volume as needed
Barriers Decrease hearing Decrease vision Different language Belittle someone Negativity In a hurry False reassurance Inappropriate environment
YouTube-Four Weddings and a Funeral
Communication with Elderly Clients
If hearing is decreased: Face them Be clear Hands not at mouth Stand near Assist with hearing aid Decrease background noise Do not chew gum
If vision is decreased Identify self, give name Knock Reduce glare Assist with glasses Do not move furniture or articles Explain Assist in walking – offer arm Understand potential anger of client
Roadblocks to Communication
Threatening, Warning
You better or else… If you don’t
Preaching You should….. You ought…..
Ordering You must….. You will…. You have to…
Lecturing You always…. You never…. Do you realize…
Turning “You” into “I” You really don’t understand because if you did
you’d let me go to the party. We always have to do what you want to do. I
never get to suggest anything. You are the one who bought the Wii, now how
are we going to pay for it? You wanted me to take the job and now I hate it. You never listen to me.
Reframing Exercise If you have something so interesting to say
maybe everyone would like to hear it. Pick up the mess you left behind. I always hear the same old complaints. I don’t want any talking when I’m talking. Sit down and keep quiet.
Offensive Language vs.Acceptable Language
Disabled person vs A person with a disabilityBlind person vs A person who is visually impairedDeaf person vs A person who is hearing impaired
S/he is crippled vs S/he has a disabilityS/he is nuts vs S/he has an emotional illness
Fit vs SeizureRetarded vs A person who is developmentally
disabled
Special Needs Clients
Words to avoid:Abnormal Defect NormalAfflicted Defective PalsiedBurden Deformity PoorDiseased Stricken with GimpCourageous Invalid Suffers withCrippled Unfortunate Victim
LISTENING
History repeats itself because no one listens the first time. — Anonymous
Conversation: a vocal competition in which the one who is catching his breath is called the listener. — Anonymous
The most basic of all human needs is the need to understand and be understood. The best way to understand people is to listen to them. — Ralph Nichols
Active Listening = Effective Listening
We retain half of what we hear and forget about half of that within 48 hours.
We listen at 125-250 words per minute but think at 1,000-3,000 words per minute.
Active Listening
1. Effective listening isn’t easy Active listening = high blood pressure, higher pulse rate, more
perspiration
2. Information overload is rampant Screen out things that SHOULD be important to us
3. We think faster than we speak Speak = 135-175 words/minute Listen = 400-500 words/minute
4. Listening isn’t something that we teach Lack of training = poor listening skills & habits FOCUS
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Effective Listening Do’s Build atmosphere of trust Lean forward, make eye contact Have enough time & energy to listen Restate, clarify & sum up what you’ve heard Practice Get feedback
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3 or more of the following
Culprit of non-active listening if: Finish others thoughts Tolerate or create distractions Fake paying attention Create early assumptions without keeping an open mind Call the subject uninteresting Criticize the speaker or the topic being discussed
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T = Think before you speakA = Apologize quicklyC = Converse, don’t competeT = Time your commentsF = Focus on behaviorU = Uncover hidden feelingsL = Listen for feedback
Is technology killing the art of conversation?
I am one of those people who still puts pen to paper.
Talking to more people from different countries, cultures, backgrounds
Next time you are in a café, watch how many people are on their phones instead of talking to the person opposite them.
Many people live away from their friends and would prefer to have instant conversation with them.
Conversation vs. Communication
Basic Phone Usage Name of facility Your name Soft/friendly voice Clear Moderate speed No gum chewing No personal calls
Message Taking Date – 01/25/11 Time – 24 hour clock Who for Who from Phone number Reason for call
Documentation
1. Accurate & Appropriate Documentation Accurate Legible Date Time Full signature Title Correct spelling Only the fact
2. Accurate & Appropriate Reporting Facts not opinions Clear Specific Follow chain of command
Patient’s Chart/Medical Record Legal Document Can be subpoenaed Patient’s true condition “If it’s not charted, it was not done.” Must be objective – chart the facts. Know the meaning and spelling of the words you
use.
NEVER chart in advance Use permanent ink not pencil Chart exact time Do not leave blank lines or spaces Mistake? Cross out with single line, write “error” Sign first initial, last name and title.
Sign – Observation about the patient that can be observed by others.
Symptom – Something the patient reports about his/her condition.
Objective Observation – Factual observations that you make by seeing, hearing, touching, smelling.
Subjective Observation – Observations based on what you think or what the patient tells you; may or may not be factual.
Electronic Communication Computer Fax Pager Phone
“The inability to share….to communicate – that’s the biggest
problem in the world…that’s how people get themselves in
all these troubles.”
V. Satir
Conflict Management Conflict ………………..
is natural and normal part of everyday life. can be handled in positive or negative ways. can have either constructive & creative or
destructive results. can be a positive force for personal growth &
socail change
5 Dimensions of Conflict
1. Who or how many parties are involved? Internal Interpersonal Intragroup Intergroup Global
2. What are the sources of conflict? What is it over?
Resources Values Psychological Needs
3. Relationship between/among conflicting parties. Climate Power Balance or Imbalance Degree of Interdependence Know one another
4. What is the history of the conflict? Duration Frequency Intensity Perception
5. The Process: How do we choose to deal with the conflict? Avoidance Diffuse Engage
Communication & Conflict Needs
1. To be listened to2. To be understood3. To be loved & accepted4. To be taken seriously5. To move toward resolution6. Respect
Causes of Conflict Gender Issues Increased work Threat to safety Threat to security (job) Invasion of personal space
Communication in Conflict
4 Different ways to Communicate when in conflict1. Passive/Nonassertive2. Aggressive3. Passive-Aggressive4. Assertive
Passive/Nonassertive Behavior is when someone gives up their own rights and (directly or
indirectly) defers to the rights of another person. Passive behavior results in an "I lose; you win" outcome. Passive behavior includes violating your own rights through inaction or by failing to express your thoughts, feelings or desires.
"We can do whatever you want. Your ideas are probably better."
Aggressive Behavior is when someone stands up for their own rights without
regard for others. Aggressive behavior results in an "I win; you lose" outcome. Aggression is self-expression which demands, attacks or humiliates other people, generally in a way which shows lack of respect for others.
"Hey, I'm in a hurry. Get out of my way."
Passive-Aggressive Behavior is when someone acts out aggressive impulses in an indirect
way. When people act passive-aggressively, they attempt to get what they need or want indirectly or manipulatively. Passive-aggressive behavior is an indirect attempt to control or punish others.
"I’m sorry I'm so late. I didn’t realize this was such a big deal."
"Oh, don’t bother, I'll just have to do it myself."
Assertive Behavior includes standing up for your rights without infringing on
the rights of others. Assertive behavior results in an "I win; you win" outcome. Assertion involves expressing beliefs, feelings and preferences in a way which is direct, honest, appropriate and shows a high degree of respect for yourself and for others.
"When you talk, I can't hear the movie. Please keep it down."
"I really like it when you wear that shirt. You look great!"
Assertiveness Script: "When you __(behavior)__ , I feel / think ___________ ; So, I would like __(new behavior)__ ."
Situation
You typically get off from work at 4:30. One day your boss comes up to you in at 3:30 and says, “Oh, by the way, you need to stay at work today until 6:00.” You have other things you planned to do after work, so staying late is an imposition. What would be different ways you could respond?
Passive
Example- Stay until 6:00 and say nothing even though you need to cancel other plans.
Aggressive
Example: Yell at your boss, “I hate this! You don’t tell me until 3:30 that I need to stay until 6:00. You are always doing things like this. You don’t care about me or any of the other employees. You’re a dictator, not a boss! You are mean and inconsiderate.” - AGG
Passive/Aggressive
Example - You say, “Oh, OK, I’ll stay. I need to change a lot of plans and people will probably be really mad at me, but that’s OK - don’t worry about me. I guess what I had planned isn’t that important. I don’t mind - really (deep sigh). I hope my friends will still talk with me after canceling at the last minute.”
Assertive
Example - You say, "When you tell me I need to stay until 6:00 at 3:30 in the afternoon, I feel frustrated because I have already made plans; So, I would like us to talk about this situation so we both can get what we need.”
For each of the following situations write a 1) passive, 2) aggressive, 3) passive-aggressive, and 4) assertive response.
Situation #1 You are working and one of your clients/patients
comes in an hour late to an appointment. The client/patient insists that he be able to keep the appointment immediately because he was stuck in traffic, and it wasn’t his fault. You are not able to accommodate his request because there are already 5 people waiting for appointments.
Situation #2 You have set an important meeting for first thing in
the morning with a co-worker to discuss a project that needed to be done that day. You only have an hour for the meeting, and the project needs to be done that day. An hour should be enough time to discuss the project if you and your co-worker work fast. Your co-worker comes in 35 minutes late, and says, “I’m running late - sorry about that. I stayed up really late last night, and I just couldn’t get out of bed this morning. Are you ready to start?”
Problem Solving Identify the problem Analyze the problem Generate solutions/brainstorm Implement best solution Evaluate solution