1. 1 RTEC-A WK – 12 2011 Patient Skills & Communication

2. 2 Patient Communication 1. Interacting with the patient 2. Interacting with family and friends 3. Methods of Effective Communication 4. Age as a factor in Patient Interactions

3. 3 Radiologic Technologist 1. Helping others 2. Working with people 3. Making a difference 4. Thinking critically 5. Demonstrating creativity 6. Achieving results

4. 4 Abraham Maslow’s Hierarchy of Needs

5. 5 Patient Dignity 1. Patients are usually in the lower levels of Maslow’s Hierarchy 2. Must always be remembered and respected 3. Difficult to maintain dignity when ill

6. 6 Why is this important? PATIENT NEEDS 1. Altered states of consciousness 2. Environment 3. Fear of unknown 4. Vulnerable 5. Coping Mechanisms

7. 7 No No’s….. Referring to a patient as: “the chest in room 2” “the chest in room 2” Always use the patients name! HIPAA Laws - Only discuss what you must know to do your job.

8. 8 Classification of Patients 1. Inpatients 2. Outpatients –Family –Friends

9. 9 Methods of Communication (Slide 9) 1. Verbal 2. Humor 3. Paralanguage 4. Body Language 5. Touch 1.Palpation 1. Professional Appearance 2. Physical Presence 3. Visual Contact

10. 10 Verbal Communication (Slide 10)

11. 11 Communication thru Humor (Slide 11)

12. 12 Paralanguage Defines all of the audio information in a conversation beyond word choice Simply listening to someone’s voice, even if you can’t make out the words, conveys their emotional state

13. 13 Body Language You could be talking to someone and your body language will convey something else entirely. body language body language Make eye contact occasionally you show an interest in that person and in what he or she is saying. A smile sends a positive message. Smiling adds warmth and confidence about you. Arms crossed or folded over your chest say that you have shut other people out and have no interest in them or what they are saying. Placing your arms at your side can make you look and feel confident and relaxed to other people around you.

14. 14 Touch and Palpation (slide 14)

15. 15 Cycle of Communication

16. 16

17. 17 Radiographer’s Responsibility 1. Introduction 2. Explanation of exam 3. Inform patient how they will receive their results 4. Risks of examination

18. 18 Rad Tech’s Role in Clinical Hx 1. Extract as much history as possible 2. Radiologists often do not even speak with the patient. 3. Radiologist can be focus on anatomy of interest

19. 19 Desirable Qualities for Establishing Open Dialogue (Slide 19) 1. Respect 2. Genuineness 3. Empathy 4. Polite 5. Professional demeanor demeanor

20. 20 Data Collection (Slide 20) 1. Objective: Signs that can be seen 2. Subjective: Perceived by the affected individual

21. 21 Questioning Skills 1. Open-ended questions 2. Facilitation – encourages pt to elaborate 3. Silence – give pt time to remember 4. Probing questions – focus interview, provide more information 5. Repetition – rewording, clarifies info 6. Summarization – verifies accuracy

22. 22 Leading Questions This is an UNDESIRABLE method of questioning. –Introduces bias to history

23. 23 Chief Complaint 1. Focuses attention to the single most important issue. 2. Patients often have many complaints –Focus on primary reason for exam

24. 24 Clinical Indication 1. Tech must collect a focused history. 2. Several elements comprise a “complete history”. 1.Sacred Seven

25. 25 Sacred Seven (slide 25) 1. Localization 2. Chronology 3. Quality 4. Severity 5. Onset 6. Aggravating or Alleviating Factors 7. Associated Manifestations

26. 26 Localization (slide 26) Defining exact area of patient complaint Carefully worded questions Palpation as needed

27. 27 Chronology (slide 27) DurationFrequency Course of symptoms

28. 28 Quality (slide 28) Color and consistency of fluids Size of bumps and lesions Type of pain –Burning, throbbing, dull, sharp, cutting, aching, radiationg, pressure or crushing

29. 29 Severity (slide 29) Number of bumps or lesions Pain on number scale (1-10) The degree of a burn

30. 30 Onset What was PT doing when illness began? Was there an aura before the migraine?

31. 31 Aggravation or Alleviating Factors For example –Lying down headache goes away Putting ice on it reduces swelling Pain intensifies when walking Pain stops when sitting

32. 32 Associated Manifestations Other symptoms that happen with this illness May describe loss of feeling in fingers as a part of diabetes May describe an aura as part of a seizure

33. 33 You never know what you are going to get?

34. 34 Special Condition Patients Traumatized Patients Visually Impaired Patients Speech and Hearing Impaired Patients Non-English Speaking Patients Mentally Impaired Patients Substance Abusers

35. 35

36. 36 Gerontology The study of aging and diseases of the elderly. By the end of the 20 th century 33 million, more than 12% of total population. In 1900 only 4%, of population

37. 37 Key to a Successful Exam Plan of action Systematic problem-solving process –Assessment of data –Setting a goal –Establishing a plan –Safety in completing assignment –Evaluating the work

38. 38 Communication The key to a successful exam for Technologist and Patient.

39. Human Diversity FALL 2011

40. What is Human Diversity? 1. Is also known as cultural diversity. 2. It means the inherent differences among people. 3. It addresses the entirety of the ways people are different and alike.

41. Characteristics of Human Diversity AgeDisability Economic status Education Geographic location Organizational level Political affiliation Sexual orientation Ethnicity Family status First language GenderLifestyle Physical characteristics Religion Work style or ethic

42. Globalization People go into other countries for: –Work –School –Medical care –Visit / Vacation –Live / Relocate –Refuge / Safety

43. Globalization’s Effect Nation, societies and businesses have become multicultural or cross cultural Strategies must be employed to understand cultural differences Strategies needed to mediate conflicts A concerted effort toward Cultural competency

44. Taking the Lead Colleges, universities, businesses and health care providers foster cultural diversity. New trends and New jobs –Offices of diversity –Vice president of equity and diversity –Diversity programs for employees

45. Medical Imaging and Diversity Through professional organization –American Society of R.T. –American Society of Diagnostic Medical Sonographers –Society of Nuclear Medicine How: –Concerted push toward cultural competency –Minority scholarships –Mentoring programs

46. Significant Diversity Traits AgeEthnicityRace Gender or sexual orientation Mental or physical disability

47. Age Cultures assign different values Baby Boomers (1946 – 1964) –75 million born –Overall healthy and educated –Will be in the work force longer Age biases in western society –Valuing you over age –Viewing aging as a “bad” thing –Forgetting contributions offered by the aging –Considering seniors as mentally inferior

48. Ethnicity and National Origin Ethnicity refers to a person’s racial, national, religious, linguistic and cultural heritage. Overcoming Linguistic Differences –Bilingual staff –Medical interpreters –Encouraging bilingualism –Forms in different languages Many different cultures as demonstrated in everyday life and by statistical data: U.S. Census 2000.

49. 2003 Census Report 2000 Caucasian alone- 228,106 African American/ Black alone- 35,704 Native American/ Alaska native alone- 2,664 Asian alone- 10,589 Native Hawaiian/ other Pacific Islander alone- 463 Combination of two or more- 3,898 Hispanic or Latino origin- 35,306 2003 Caucasian alone- 234,196 African American/ Black alone- 37,099 Native American/ Alaska native alone- 2,787 Asian alone- 11,925 Native Hawaiian/ other Pacific Islander alone- 495 Combination of two or more- 4,308 Hispanic or Latino origin- 39,899 Adler & Carlton 2007

50. Ethnocentrism and Racism Ethnocentrism is the belief that norms and values of their culture should be standard Racism is the belief that one race or culture is superior to others

51. Gender or Sexual Orientation Male vs. Female –1900 female roles –Today's women –Glass ceiling Gender role stereotyping Gender identity Sexual orientation –Heterosexual –Homosexual –BisexualKsixHomophobia

52. Mental or Physical Disability Mental or physical ability is the capacity to perform cognitive and psychomotor tasks with average ability Those with disabilities have been shunned –Seen as objects or assistance, protection and treatment 600 million or 10% of the world have some form of disability

53. Four Core Values of Human Rights AutonomyDignityEqualitySolidarity

54. Elements of Cultural Competency Valuing Diversity Possessing the capacity for cultural self assessment Having a consciousness of the dynamics of cross cultural interaction Institutionalizing cultural knowledge Developing adaptations of service based on an understanding of multiculturalism

55. Empathetic Practices Communication Assessment and communication Negotiating

56. Areas of Cultural Diversity related to Health Care CommunicationSpaceTime Environmental control Biologic Variations Social organizations