1. Healthcare Communication Skills
Rehab Careers Standard 8: Communications

2. Bell Work
1. Write down an example of how you know someone is not listening to you.
2. Write down an example of how you know someone is listening to you.

3. Standard 8
Evaluate factors that contribute to effective patient/client communication, demonstrating sensitivity to barriers, cultural differences, and special needs individuals. Apply effective practices within a lab/clinical setting.

4. Elements of Communication
Sender Receiver Feedback
Message
Teacher Notes:
Describe the elements of the communication model.

5. Communication Model Questions
What could happen to block any of the elements of communication?
Is the message always verbal?
Is the feedback always verbal?
What interruptions or distractions could interfere with communication?
Teacher Notes:
First question – have students give examples of situations that would block any of the elements of communication. Pages in Diversified Health Occupations, 7th edition, contains a number of examples.

6. Healthcare Communication
Remember that in a healthcare setting, nonverbal cues are important elements of the communication model.
Identify the elements of communication in this illustration.
Teacher Notes:
The sender is likely a home health nurse or hospice volunteer.
The receive is the patient.
The message includes an element of caring and encouragement – evidenced by the touch and smile.
The feedback is acceptance and/or agreement by the patient, who appears to be smiling at the healthcare worker.

7. Nonverbal Communication
Need five volunteers. Going to give each of you an emotion to act out without using words. Class must guess that emotion

8. Rules for Effective Communication
Message must be clear
Sender must deliver message clearly and concisely
Receiver must be able to hear and receive the message
Receiver must be able to understand the message
Interruption or distractions must be avoided
Teacher notes:
This slide summarizes the key points of the communication model.

9. Feedback Methods
Paraphrasing – reword the sender’s message and ask for confirmation.
Dr. Smith: “I think Mrs. Jones needs more aggressive treatment for her anxiety.”
Dr. Shevlin: “So you think we should order an antidepressant?”
Teacher Notes:
Show the example.
Ask students to think of another way of paraphrasing Dr. Smith’s statement.

10. Feedback Methods
Reflecting – prompts the sender to add more detail to the original message.
Dr. Smith: “I think Mrs. Jones needs more aggressive treatment for her anxiety.”
Dr. Shevlin: “So you think we should order her medication, such as…?”
Teacher Notes:
Show the example.
Ask students to think of another way of paraphrasing Dr. Smith’s statement.

11. Feedback Methods
Asking Questions – request clarification or more additional information.
Dr. Smith: “I think Mrs. Jones needs more aggressive treatment for her anxiety.”
Dr. Shevlin: “Why? Is her current treatment not controlling her anxiety?”
Teacher Notes:
Show the example.
Ask students to think of another way of paraphrasing Dr. Smith’s statement.

12. Feedback Methods
Requesting examples – examples can help explain or clarify meaning.
Dr. Smith: “I think Mrs. Jones needs more aggressive treatment for her anxiety.”
Dr. Shevlin: “What kind of treatment are you thinking about?”
Teacher Notes:
Show the example.
Ask students to think of another way of paraphrasing Dr. Smith’s statement.

13. Obtaining Feedback
Respond to this call to a veterinary office from a pet owner.
Paraphrasing
Reflecting
Asking questions
Requesting examples
I need to make an appointment for my dog. She’s not doing very well.
Teacher notes;
Ask students to imagine themselves as a receptionist at a Veterinary office. Have them give examples of each type of feedback.

14. Healthcare Information can be Subjective or Objective
Cannot be seen or felt
Often called symptoms
Usually statements or complaints from the patient
Use the patient’s exact words
Teacher Notes:
The next 5 slides will help students learn the difference between objective and subjective information.

15. Healthcare Information can be Subjective or Objective
Can be seen or measured
Often called signs
Information collected by the senses

16. Subjective Symptoms I think I’m gonna throw up. My tummy hurts.
It’s really sore on my chest.
I don’t feel very good.

17. Objective Signs of Illness
Pulse rapid, irregular and thready
Skin cold and clammy
No respirations
Lips cyanotic

18. Subjective or Objective?
Coughing
Fatigue
Headache
Foul smelling breath
Did not eat anything
Speech slurred
Joints ache
Nervousness
Objective
Subjective
Teacher Notes:
This slide gives you the opportunity to determine if students know the difference between objective and subjective information. You can have them write their answers on scratch paper before revealing the correct response. Recognize those students who answer all 8 correctly.

19. Speaking Skills
Speak appropriately to the age or status of the receiver.
Use appropriate terminology or words.
Ask open-ended questions.
Speak slowly and clearly.
Try to be eye-level with the receiver.
Make sure your non-verbal is consistent with your words.
Teacher Notes:
Call on a student to explain “why” for each point.
Explain the difference between open-ended and closed-ended questions.

20. Listening Skills Show interest and concern.
Stay alert and maintain eye contact.
Avoid interrupting.
Pay attention to what the speaker is saying.
Avoid planning your response while the speaker is talking.
Teacher Notes:
Stress the importance of active listening in the healthcare professions.

21. Listening Skills Try to see the other person’s point of view.
Find a quiet or private location.
Watch the speaker’s facial expressions for consistency with words.
Ask for clarification when needed.
Maintain a positive attitude.

22. Barriers to Communication
Communication barrier – Anything that gets in the way of clear communication.

23. Three Common Barriers Physical disabilities
Psychological attitudes and prejudice
Cultural diversity

24. Physical Disabilities may include:
Deafness or hearing loss
Blindness or impaired vision
Aphasia or speech disabilities

25. To improve communication with the hearing impaired…..
Use body language such as gestures and signs.
Speak clearly in short sentences.
Face the individual to facilitate lip reading.
Write messages if necessary.
Make sure hearing aids are working properly.

26. To improve communication with the visually impaired…….
Use a soft tone of voice.
Describe events that are occurring.
Announce your presence as you enter a room.
Explain sounds or noises.
Use touch when appropriate.

27. What about someone with aphasia or speech impairments…..
They have difficulty remembering the correct words, may not be able to pronounce certain words, and may have slurred speech.
The health care worker must be patient.
Allow them to try and speak.
Encourage them to take their time.
Repeat message to assure accuracy.
Encourage them to use gestures or point to objects.
Provide pen and paper if they can write.
Use pictures with key messages to communicate.

28. Psychological barriers are often caused by:
Prejudice
Attitudes
Personality

29. Stereotypes such as “dumb blondes” or “fat slob” cause us to make snap judgements about others that affect the communication process.
Health care workers must learn to put prejudice aside and show respect for all individuals. Is that possible?
Do all patients have the right to quality health care?

30. Health Care workers should:
Allow patients to express their fears or anger.
Encourage them to talk about their feelings.
Avoid arguing.
Remain calm.
Talk in a non-threatening tone of voice.
Provide quality care.
Hospital chart errors (PDF)

31. Cultural Barriers
Each cultural group has beliefs and practices regarding health and illness.
Some cultures believe the body needs balance-if the body is cold, they eat hot foods.
Some cultures believe illness is due to demons and evil.
Some cultures believe health is a reward from God, and illness is punishment from God.

32. Cultural beliefs must be respected
Patients may practice their cultural remedies in addition to modern healthcare techniques.

33. Cultural diversity may interfere with communication in other ways:
Language differences-people who don’t speak English may have a difficult time communicating. You should:
a. Speak slowly.
b. Use nonverbal communication (smile).
c. Avoid tendency to speak louder.
d. Find an interpreter.

34. Cultural Barriers Cont.
Eye contact- in some cultures, it’s not acceptable , and looking down is a sign of respect.
Terminal illness- in some cultures, the patient is NOT told his/her prognosis, and family members are responsible for making care decisions.
Touch- in some cultures, it is wrong to touch someone on the head.
Personal care-in some cultures, only family members provide personal care.
Respect and acceptance of cultural diversity is essential for any health care worker.

35. Recording and Reporting…
Health care workers must listen carefully AND make observations.
They use their senses to: 
See ∆ Color of skin, swelling or edema
∆ Presence of rash or sore
∆ Color of urine or stool
∆ Amount of food eaten

36. They use their senses to:
Smell
∆ Body odor
∆ Unusual odors of: breath, wounds, urine and stool

37. Touch
Pulse
Dryness and temperature
of skin
Perspiration
Swelling

38. Hearing
∆ Respirations
∆ Abnormal body sounds
∆ Coughs
∆ Speech

39. Observations:
Observations should be reported accurately-use facts and report what you saw, not the reasons.
NOT-”Mr. Ruiz is in pain.”
INSTEAD- “Mr. Ruiz is moaning and holding his side.”
Observations on a patient’s health record (chart) should be accurate, concise, and complete.

40. Observations: Objective observations – what was seen.
DO NOT record what you feel or think.
If a patient’s statement is recorded, use the patient’s words and use quotation marks.
Sign entries with name and title of the person recording the information.
Cross out errors neatly with a straight line, write error, and initial error.

41. Hospital charting errors

42. Communication Poster Project
Each person will sign up for a different culture/religion or special needs to research.
You are responsible for finding the following:
Culture/Religion:
Brief explanation of culture/religion
Common diseases and disorders
Cultural communication considerations that must be taken if caring for a patient of this culture
Number of people of this culture living in the United States
Identify communication barriers for caring for patients within this culture
Special Needs:
Brief explanation of diagnosis
Common diseases or conditions that may result from this special need.
Communication considerations that must be taken if caring for a patient with this disability
Number of people with this special need living in the United States
Identify communication barriers for caring for patients with this special need.
Create a poster that summarizes your assigned culture/special need.
Be prepared to present it to the class.
Presentations on Monday. See Grading Rubric.

43. Topics Hispanic African American Indian (Native American) Asian LGBT
Muslim
Hindu
Catholics
Buddhism
Judaism
Visually impaired (blind)
Hearing impaired (deaf)
Autism:
Dyspraxia (DCD)
ADHD
Epilepsy