Professional Practice in Patient Care February 14th, 2013 Lesson 6 Professional Practice in Patient Care February 14th, 2013

Communication Communication The ability to receive, interpret, and respond appropriately and clearly to messages The foundation of successful personal and professional relationships Successful only when the sender and the receiver understand the message the same way

Communication Nonverbal communication consists of eye contact, facial expressions, body language, gestures, posture, tone of voice, and touch. The message a patient expresses verbally may be contradicted by nonverbal cues. Develop communication skills and the ability to listen and convey interest, compassion, knowledge, and information.

Communication Effective Verbal Communication Guidelines Prepare your thoughts before you speak. Analyze the intent of each message. Adapt to your physical settings whenever communicating.

Communication Effective Verbal Communication Guidelines Adequately brief the patient. Consider your tone of voice, the rate of your speech, and your body language when communicating. Follow up your communications and ask the right questions to ensure that the patient understands.

Types of Communication Social conversation Polite or friendly exchanges of factual or social information (chitchat) Does not provide significant information, identify problems, or result in solutions Important in establishing a relationship with patients and creating a climate of supportive communication

Types of Communication Supportive communication More goal oriented Important patient information is discussed—how patients feel—and any problems that concern them can be shared. Helps relieve patient anxiety, anger, or frustration and to learn about any unmet patient needs. By talking through such concerns, the sonographer often can help patients resolve their problems.

Effective Communication Skills Listening Observing Responding appropriately Maintaining silence Clarifying

Types of Communication Effective Communication Skills (see Box 3-2) Repeating Gathering information Summarizing Accepting Touching

Communication Barriers Talking too fast Using slang, medical vocabulary, or broad generalizations “Talking down” to patients Speaking in hostile or insulting tones Labeling patients as “complainers” or “disoriented” Lack of a common language

Cutting Off Communication A listener prevents a conversation from starting or continuing. Patients may cut off communication if they feel embarrassed, threatened, or distrustful. Listen—without judgment—to their concerns and feelings. Give accurate information. If you do not know the facts, or are not free to discuss them, find someone who is authorized to give that information.

Cutting Off Communication Negative Communication Traits Judgmental responses Arguing Solving Interrupting Changing the subject Distractions

Cutting Off Communication Negative Communication Traits False assurances Untruthfulness Evasion Avoidance False reassurance

Exploring Attitudes and Feelings Physical or emotional states can affect communication. In difficult situations sonographers should be careful about what they say. The same techniques of communicating with family and friends can be used with coworkers and patients.

Patients with Hearing Impairments Determine if the patient is using any hearing aids. When speaking, face the patient directly and on the same level if possible. Facial expression, body gestures, and touch enhance communication.

Patients with Hearing Impairments Learn to use a lower tone of voice. Reduce background noise. Get the patient’s attention before speaking.

Patients with Hearing Impairments Never talk from another room. If the patient can’t understand you, find another way of saying the same thing. Write things down whenever necessary.

Patients with Vision Impairments Patients with age-related macular degeneration may have no central vision. Patients with cataracts may see only blurs or distinguish only light. Promote patient independence whenever possible.

Patients with Vision Impairments When walking with patients with visual impairments, have them hold on to your arm while leading the way.

Patients Who Are Blind Approach a blind patient by saying, “Hello.” Ask patients who are blind how they are used to doing things for themselves and then allow them to continue unless their actions would interfere with their safety. Tell patients if you must leave the room, the reason why, and when you will return. Use touch and tone of voice to communicate with patients who are blind and remember to avoid nonverbal responses.

Patients with Speech Impairment With patients who have difficulty understanding communication: Stand where visible. Speak slowly and clearly in a normal tone of voice. Use common vocabulary and short, simple sentences. Give directions or requests in a simple manner, repeating or rephrasing the directions as necessary. Use simple gestures or pantomime for clarification.

Patients with Speech Impairment For patients who have difficulty speaking: Be patient and provide ample time for them to organize what they want to say. Watch for clues or gestures if the patient’s speech cannot be understood. It is all right to assist patients with words they cannot say, but do not speak for them. Do not treat patients as children. Never speak with another sonographer or staff member in front of patients as if they were not there.

Patients Who Are Confused Confusion can be the result of memory loss or an illness and can be temporary or long term. Drug-related confusion can be accompanied by behavioral changes. Use simple and direct language. Ask only one question at a time. Allow ample time for a response. Use reality techniques that are based on sensory stimulation by identifying what is happening around them and clarifying who they are.

Patients Who Are Disoriented Talk face to face with the patient and praise and encourage a patient’s abilities and attempts to cooperate with your instructions. Keep the environment calm to avoid overwhelming such patients with too many people or too much confusion. Supportive communication helps such patients when they get frustrated, anxious, or depressed.

Patients Who Are Disoriented A gentle, caring attitude helps support the patient during periods of extreme confusion. Patients in restraints may become confused if unable to interact with their surroundings. Always provide patients with correct information. Correct them gently with supportive communication, and do not argue with patients who continue to be confused.

Patients with Mental Challenges Communicate in a quiet or private area. Speak to the mental age of the patient and not his or her physical age. Be patient, flexible and supportive. Avoid talking too fast because this will only frustrate the patient. Do not mimic how the patient pronounces words.

Patients with Mental Challenges Speak in a low voice. Look them in the eye to let them know that you care about what you are saying.

Communication Triads Sonographer, patient and family member can create a triad. Is useful when patients are anxious, need support or don’t understand the sonographer’s instructions Third person forming the triad could be an interpreter who speaks the patient’s language. Triads should not be used when confidentiality is required.

Professional Communication Interviewing patients and instructing patients and their families Reporting patients’ sonographic findings to other members of the healthcare team Participating in team conferences, grand rounds, in-service training, and departmental meetings

Professional Communication Recording information in daily logs, charts, and files Accessing patients’ charts for hospitalized patients Contacting the referring doctor’s office Scheduling patients

Professional Communication Speaking with referring physicians, sonologists, and other interpreting physicians: Speak with courtesy and respect. Answer questions directly and within professional guidelines. If requested, ask your interpreting physician to provide a stat reading. Do not offer a clinical diagnosis.

Communication Our Biggest Tool

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