1. Elements of Effective Communication

2. Communication Communicating Effectively with others is important
Health care workers must be able to relate to patients, family, co-workers, and other professionals

3. What is Communication?
Exchange of information, thoughts, ideas and feelings
Occur in two ways
Verbal: spoken words or written communication
Nonverbal: behavior such as facial expressions, body language and touch

4. Essential Parts of Communication
Sender: an individual who creates a message to convey information or an idea to another person
Message: information, ideas or thoughts
Receiver: the person who receives a message from the sender
Feedback: used to determine if communication was successful
Feedback occurs when receiver responds to a message
Allow the original sender to decide how message was interpreted and to make any necessary adjustments or clarification
Can be verbal or nonverbal

5. Factors Interfering with Communication Process
Message must be clear
Must be in terms that both sender and receiver understand
Terminology used by health care workers is frequently no understood by persons not in health care
Terms must be defined or substituted while talking to others
Requires constant practice and experience to learn to create a message that can be clearly understood
Example:
Health care worker needs a urine speciemen
Some patients can be told to urinate in a container
Other May be told to “pee” or do number “1”

6. Factors Interfering with Communication Process
Sender must deliver message in clear and concise manner
Correct pronunciation and the use of good grammar are very important
Avoid the use of slang words or words with double meaning
Avoid meaningless terms such as “you know”, “all that stuff”, “um”, and “OK”
Tone and Pitch are important: use a moderate level not too soft or too loud
Ex) Everyone say to your neighbor “I really like this job”
Discuss how different meanings that can be interpreted by the tone and pitch of the voice

7. Factors Interfering with Communication Process
Receiver must be able to hear and receive the message
Patients under heavy sedation may nod their head as if message was heard
Examples of people who may not be able to receive messages
Patients with hearing or visual impairments
Patients with limited English speaking abilities
Ways to allow the receiver to respond
Repeat the message
Change the form of the message
Get others to interpret the message

8. Factors Interfering with Communication Process
Receiver must be able to understand the message
Avoid using unfamiliar terminology
Many people do not admit that they do not understand because they think other will think they are dumb
Can cause a break in communication
Ask questions or repeat information in different terms
Receiver’s attitude and prejudices can interfere
If patient’s feel health care workers do not know what they are talking about, they will not accept information presented
Must have some confidence and belief in sender before they will accept and understand a message
Be willing to say “I don’t know, but I will try to find that information for you,” when asked a question about which you do not have correct knowledge

9. Factors Interfering with Communication Process
The health care worker must be aware of their own prejudices and attitudes when receiving messages from clients
If you feel patients are lazy, ignorant, or uncooperative, then you will not respond correctly to messages patients send
You must be aware of these feelings and work to overcome them so you can accept patients as they are

10. Factors Interfering with Communication Process
Interruptions or distractions must be avoided
Can interfere with any communication
Talking with others while answering the phone or writing can decrease effectiveness of communication
Loud noises, bright light or uncomfortable temperature can interrupt communications
Two people talking outside in freezing temperatures will limit conversation because of discomfort
Child jumping around or climbing up and down off a mother’s lap will distract a mother as she is getting instructions from health care worker
Loud television or radio interferes with verbal messages, because the receiver may pay more attention to radio or television that to the person speaking
Eliminate or limit distractions if meaningful communication is to take place

11. Listening Important part of communication
Means to pay attention and to make an effort to hear what the other person is saying
Good listening skill require constant practice and will allow you receive the entire message a person is trying to say

12. Listening Techniques
Show interest an concern for what the speaker is saying
Be alert and maintain eye contact with speaker
Avoid interrupting the speaker
Pay attention to what the speaker is saying
Avoid thinking about how you are going to respond
Try to eliminate your own prejudices and see the other person’s point of view
Eliminate distractions by moving to a quiet area for the conversation
Watch the speaker closely to observe actions that may contradict what the person is saying
Reflect statements back to the speaker to let the speaker know the statements are being heard
Ask questions if you do not understand part of a message
Keep your temper under control and maintain positive attitude

13. Non-Verbal Communication
Use of facial expressions, body language, gestures, eye contact and touch to convey messages or ideas
Two different messages are sent if the person is smiling and sitting in relaxed position while saying, “I’m very angry.”
Send messages with a smile, a frown, a wink, a shrug of the shoulders, a bored expression, a tapping of fingers or feet and other similar body gestures or actions

14. Non-Verbal Communication
Important for health care workers to be aware of both their own and patient’s nonverbal behavior
Touch of the hand, pat on the back, firm handshake, and hug can show more interest in caring than words
When verbal and nonverbal messages agree, receiver is more likely to understand message being sent

15. Barriers to Communication
Physical Disability
Psychological Barriers
Cultural Diversity

16. Physical Disability Deafness or Hearing Loss
Have difficulty receiving the message
To improve communication, use body language such as gestures and signs, speak clearly in short sentences, face the individual to allow for lip reading, write messages if needed, and make sure any hearing aids have good batteries and are inserted correctly
Blindness or Vision Impairment
Person may be able to hear what is being said but will not see body language, gestures, or facial expressions
To improve communication use a soft tone of voice, describe events that are occurring, announce your presence as you enter the room, explain sounds or noises and use touch when appropriate

17. Physical Disability Aphasia or Speech Impairment
Can have difficulty with not only the spoken word but also written communications
May know what they want to say but have difficulty remembering the correct words
May not pronounce certain words
May have slurred speech
It is very important to patient while working with these individuals
Let them try to speak, ask questions that require only short answers, speak slowly and clearly, encourage them to take their time, repeat messages to be sure they are correct, encourage the patient to use gestures or point to objects, provide writing materials if they can write messages, or use pictures with key messages to communicate

18. Psychological Barriers
Often caused by prejudice, attitudes and stereotypes
Judgment of others is too often based on appearance, lifestyle and socioeconomic status
Stereotypes such as “lazy bum”, “dumb blonde”, “fat slob” cause us to make snap judgments about an individual and affect the communication process
Health care workers must learn to put prejudice aside and show respect to all individuals

19. Psychological Barriers
At times this can be extremely difficult and patience and practice are essential
Other health care worker may be able to communicate more effectively with patients watch these workers to learn how to handle difficult situations

20. Cultural Diversity
Culture consists of the values, beliefs, and practices regarding health and illness
Some cultural groups may have beliefs and practices regarding health and illness
Language differences are another barrier to communication

21. Cultural Diversity
In come cultures eye-contact while communicating is not acceptable
Even the use of touch can create a communication barrier
Respect for and acceptance of cultural diversity are essential for any health care worker

22. Recording and Reporting
Reporting and recording all observations noted while providing care is an important part of effective communication
Must not only listen to what the patient is saying but also make observations about the patient

23. Recording and Reporting
All senses are used to make observations:
Sense of Sight
Sense of Smell
Sense of Touch
Sense of Hearing
By using all senses, health care workers can learn about a patient’s condition and report observations accurately

24. Observations Should be reported immediately
Subjective Observations (symptoms)
Cannot be seen or felt by health care worker
Usually statements or complaints made by the patient
Must be reported in the exact words of the patient
Objective Observation (Signs)
Can be seen or measured by the health care worker
Examples include a bruise, cut, rash, or swelling
Blood pressure and temperature are measureable

25. How to Record an Observation
Should not state, “I think Mr. B. has a fever.”
Should state, “Mr. B. is complaining of feeling hot. His skin is red and flushed and his temperature is 102”
***Observations recorded on the medical record must be accurate, concise and complete***

26. Charting on a Patient Writing should be neat and legible
Spelling and grammar should be correct
If patient’s statement is recorded, it should be in the patient’s own words with quotation marks around it.
Information should be signed with the name and title of the person recording it
Errors
Crossed out neatly with a straight line
Record “error by them”
Show the initials of the person making the error

27. The Health Insurance Portability and Accountability Act (HIPAA)
Established strict standards for maintaining confidentiality of health care records
Under this act Patients:
Have total control on how information in their medical record is used
Must be able to see and obtain copies of their records
Can set limits on who can obtain their information
Can prevent other family members from seeing the information
Can file a complaint that the privacy act has been violated if any health care provider allows information to be released from the medical record without the patient’s permission
Every health care provider must be aware of all parts of this act and make every effort to protect the privacy and confidentiality of the patient’s health care record