crisis management for paramedics week 1 fundamentals of communication & therapeutic approach...
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Crisis Management Crisis Management for Paramedicsfor Paramedics
Week 1Week 1Fundamentals of Communication & Fundamentals of Communication & Therapeutic ApproachTherapeutic ApproachConcepts of Crisis & StressConcepts of Crisis & Stress
ServiceService
You all stated you want to help people You all stated you want to help people and that you are people persons...so and that you are people persons...so here is your chance to “shine”here is your chance to “shine”
Patients deserve our best efforts at Patients deserve our best efforts at service – service – they are the reason we existthey are the reason we exist
What the “S” in EMS stands forWhat the “S” in EMS stands for
What makes a good What makes a good communicator?communicator?
Internal FactorsInternal Factors– not about younot about you– ““natural” desire to helpnatural” desire to help
Defecate in our ambulanceDefecate in our ambulance Vomit on our shoesVomit on our shoes Bleed on our uniformsBleed on our uniforms
Heads up – if these feelings are not Heads up – if these feelings are not sincere your patients will sense it sincere your patients will sense it and you will have a short careerand you will have a short career
Effective Effective CommunicationCommunication External FactorsExternal Factors
– Look the part of a professionalLook the part of a professional– Pay attention to you appearancePay attention to you appearance– Inspire respectInspire respect– Consider it an honour to be asked Consider it an honour to be asked
into a patient’s homeinto a patient’s home
Consider the following:Consider the following: How does communication occur?How does communication occur?
What are the components of What are the components of communicationcommunication
How do we as care givers attempt How do we as care givers attempt to communicate with people in to communicate with people in crisis and what can hinder the crisis and what can hinder the communicationcommunication
CommunicationCommunicationTherapeutic ApproachTherapeutic Approach
What is communication?What is communication? The exchange of common symbolsThe exchange of common symbols Written, spoken, signing and body Written, spoken, signing and body
languagelanguage Basic elements: the sender, the Basic elements: the sender, the
message and the receivermessage and the receiver
VerbalVerbalVoice quality, diction, pitch, rate of Voice quality, diction, pitch, rate of
speech and volumespeech and volume Body languageBody language Provide your undivided attentionProvide your undivided attention
LISTEN – don’t just talkLISTEN – don’t just talk
Successful communication Successful communication occurs if, by way of the occurs if, by way of the response, the sender response, the sender believes that the message believes that the message was received accuratelywas received accurately
Effective listeningEffective listening
An active skillAn active skill Requires complete attentionRequires complete attention Focus on the messengerFocus on the messenger Never finish the other person’s Never finish the other person’s
sentencesentence Do not consider your response until Do not consider your response until
the other person has finished speakingthe other person has finished speaking Requires practice!! **Requires practice!! **
Remember:Remember:
A good communicator needs A good communicator needs patience and flexibility!patience and flexibility!
Trust and RapportTrust and Rapport
There is a certain amount of trust There is a certain amount of trust implied in being a paramedicimplied in being a paramedic
You need to earn the trustYou need to earn the trust First you establish the trust, then First you establish the trust, then
the rapport follows.the rapport follows. With good rapport the person you With good rapport the person you
are helping will follow your leadare helping will follow your lead
Developing RapportDeveloping Rapport
Introduce yourself and your partnerIntroduce yourself and your partner Address the patient formally – Mr., Address the patient formally – Mr.,
Mrs., etc.Mrs., etc. Use the patient’s name **Use the patient’s name ** Get to the level of the patientGet to the level of the patient Use a professional but Use a professional but
compassionate tone of voicecompassionate tone of voice Explain what you are doing and whyExplain what you are doing and why
Patient should believe they are your priority
Nonverbal Nonverbal communication skillscommunication skills
Eye contactEye contact Touch and GentlenessTouch and Gentleness PosturePosture Demeanour/SmileDemeanour/Smile Important to look at your Important to look at your
patient’s body languagepatient’s body language
Eye contactEye contact
Can be a very powerful source of Can be a very powerful source of effective communicationeffective communication– Take your sunglasses off!!Take your sunglasses off!!
Can be very important in tense or Can be very important in tense or difficult situationsdifficult situations
Remember, eye contact means the Remember, eye contact means the patient is looking at you!patient is looking at you!
Compassionate touchCompassionate touch
The holding of a hand, touch of an The holding of a hand, touch of an arm or shoulderarm or shoulder
May be awkward at first – watch for May be awkward at first – watch for responseresponse
May help to calm the patientMay help to calm the patient Be careful to touch appropriately – Be careful to touch appropriately –
consider the patient’s age, gender, consider the patient’s age, gender, cultural background and current cultural background and current settingsetting
PosturePosture
Gestures, mannerisms and Gestures, mannerisms and postures by which a person postures by which a person communicates with otherscommunicates with others
Includes distance between you Includes distance between you and the patient, whether you are and the patient, whether you are at eye level or not and your at eye level or not and your stancestance
Demeanour & Demeanour & Therapeutic SmileTherapeutic Smile
Pleasant demeanour absolutely Pleasant demeanour absolutely necessary when you are dealing necessary when you are dealing with people in crisis – they need with people in crisis – they need to feel safe and assured that you to feel safe and assured that you can helpcan help
Smile – can send the message Smile – can send the message that all will be well but consider that all will be well but consider the crisisthe crisis
QuestioningQuestioning
Use open-ended questionsUse open-ended questions Use closed questions only when Use closed questions only when
necessarynecessary Ask only one question at a timeAsk only one question at a time Listen to the patient’s complete response Listen to the patient’s complete response
before asking the next questionbefore asking the next question Use language the patient can understandUse language the patient can understand Do not ask leading questionsDo not ask leading questions
Payoff QuestionsPayoff Questions Have you felt like this before?Have you felt like this before? Have you been upset about anything Have you been upset about anything
lately?lately? Are you afraid of someone? [save this Are you afraid of someone? [save this
one for the privacy of the ambulance]one for the privacy of the ambulance] Have you been thinking about hurting Have you been thinking about hurting
yourself?yourself? What happened the last time you felt What happened the last time you felt
this way?this way?
Strategies to Elicit Strategies to Elicit Useful Responses to Useful Responses to QuestionsQuestions Facilitate the responseFacilitate the response Be quiet - Be quiet - never miss a good never miss a good
opportunity to shut up opportunity to shut up Clarify the responseClarify the response Redirect the responseRedirect the response Interpret the responseInterpret the response Simplify and summarize the Simplify and summarize the
responseresponse
Common Interviewing Common Interviewing ErrorsErrors
Assume NothingAssume Nothing Giving Medical adviceGiving Medical advice Providing false hopeProviding false hope Assuming excessive authorityAssuming excessive authority Sidestepping the truthSidestepping the truth Distancing yourself from patients Distancing yourself from patients
as peopleas people
Assessing Mental StatusAssessing Mental StatusObserving the patientObserving the patient
Appropriate HumourAppropriate Humour Timing of Responses to QuestionsTiming of Responses to Questions MemoryMemory Ability to obey simple CommandsAbility to obey simple Commands
Unique interview Unique interview situationssituations
People who are unmotivated to talkPeople who are unmotivated to talk People who are hostilePeople who are hostile People who are very old OR very People who are very old OR very
youngyoung People who live with special People who live with special
challengeschallenges Cross cultural communicationsCross cultural communications
– Manners, gestures and body languageManners, gestures and body language– Cultural sensitivity and cultural Cultural sensitivity and cultural
diversitydiversity
How does failure to How does failure to communicate occur?communicate occur?
Prejudice – do not paint all with Prejudice – do not paint all with the same brushthe same brush
Lack of empathyLack of empathy Lack of PrivacyLack of Privacy External distractionsExternal distractions Internal DistractionsInternal Distractions
Remember to bring closure to the Remember to bring closure to the callcall
Say “good bye”Say “good bye”