1. Hospital Practice 4 Communicating with patients

2. Communication with patients The RT has to give messages/information to patient and to receive messages/information from the patient. The RT has to give messages/information to patient and to receive messages/information from the patient. If this is to be effective it is essential that the RT has a good understanding about the state of mind of the patient. If this is to be effective it is essential that the RT has a good understanding about the state of mind of the patient. When a person becomes ill his mental process becomes different from that of a normal person. When a person becomes ill his mental process becomes different from that of a normal person. This is because his needs will be different. This is because his needs will be different. It is important to assess the patient’s needs correctly. It is important to assess the patient’s needs correctly.

3. Health & Needs How to assess Patient’s needs? What is Health? What is Health? Health is a perceptual state of being. All persons have a unique way of defining their own state of being healthy. Health is a perceptual state of being. All persons have a unique way of defining their own state of being healthy. Health is often seen as being on a continuum. Health is often seen as being on a continuum. Best health Illness / State of despair (close to death) People with Normal health 100%0%

4. At the positive end of the continuum, all body organs are in top working order with one’s mental faculties working at their best. At the positive end of the continuum, all body organs are in top working order with one’s mental faculties working at their best. At the negative end, a person is close to death or in a state of despair. At the negative end, a person is close to death or in a state of despair. In the middle are persons in all states of mental an physical well- being ranging from good health to illness and death. In the middle are persons in all states of mental an physical well- being ranging from good health to illness and death.

5. People’s Needs All persons have basic needs that govern their lives. All persons have basic needs that govern their lives. When their basic needs are met, other needs emerge that are called higher needs. When their basic needs are met, other needs emerge that are called higher needs. Abraham Maslow, a recognized psychologist, placed the needs of man in the following order Abraham Maslow, a recognized psychologist, placed the needs of man in the following order

6. Hierarchy of needs 3. Need for Love & Belongingnes s 2. Safety & Security Needs 1. Physiologic Needs (Basic needs) :-food, shelter, air, water, sleep, sexual fulfillment 4. Esteem needs ( Self esteem & esteem of others ) 5. Self actualization (spiritual Needs)

7. I llness & needs Persons whose state of mental and physical health are at the most positive end of the health-illness continuum have their basic needs met and are pursuing self- actualization. Persons whose state of mental and physical health are at the most positive end of the health-illness continuum have their basic needs met and are pursuing self- actualization. When illness, whether it be physical or emotional, overtakes an individual, he losses his state of well being. When illness, whether it be physical or emotional, overtakes an individual, he losses his state of well being.

8. He no longer perceives himself as one whose basic needs for food, water, air, love, belonging, and self-esteem are being met. He no longer perceives himself as one whose basic needs for food, water, air, love, belonging, and self-esteem are being met. Illness may mean the loss of one’s ability to maintain social and economic status. Illness may mean the loss of one’s ability to maintain social and economic status. One’s place in his social group is threatened. One’s place in his social group is threatened. As illness progresses, the realization of unmet basic needs increases, and feelings of great anxiety overwhelm the ill person. As illness progresses, the realization of unmet basic needs increases, and feelings of great anxiety overwhelm the ill person.

9. When one’s level of wellness has been compromised and the satisfaction of his basic needs is threatened, what ever the cause, regressive behaviour may result. When one’s level of wellness has been compromised and the satisfaction of his basic needs is threatened, what ever the cause, regressive behaviour may result. A person in such a state has difficulty in communicating effectively. A person in such a state has difficulty in communicating effectively. He may resort to aggressive demands or may withdraw in silence and not be able to make his needs known at all. He may resort to aggressive demands or may withdraw in silence and not be able to make his needs known at all. It will be the RT’s first obligation to assess his patient’s needs and be able to communicate with him in a therapeutic manner. It will be the RT’s first obligation to assess his patient’s needs and be able to communicate with him in a therapeutic manner. I llness & communication

10. Important RT must remember that his patient is feeling threatened and is not functioning at his best. RT must remember that his patient is feeling threatened and is not functioning at his best. He must do everything possible to reassure and comfort the patient while providing care. He must do everything possible to reassure and comfort the patient while providing care.

11. Communication Definition Communication is a constantly changing process made up of both spoken and unspoken messages that go from the sender to the receiver. Communication is a constantly changing process made up of both spoken and unspoken messages that go from the sender to the receiver.

12. Components of communication Sender (source) Message Media(Channel) Receiver Feedback Context

13. RT-Patient Communication Health care is centered around communication. Health care is centered around communication. All members of the health-care team must learn to communicate clearly, effectively, and therapeutically with their patients. All members of the health-care team must learn to communicate clearly, effectively, and therapeutically with their patients. In order to become a successful communicator, one must develop skills in listening, observing, speaking, and writing. In order to become a successful communicator, one must develop skills in listening, observing, speaking, and writing.

14. Limitations in Perceiving others All of us are limited in our abilities to perceive others because of our learned attitudes. All of us are limited in our abilities to perceive others because of our learned attitudes. In order to communicate in a therapeutic manner, the RT must first understand himself. In order to communicate in a therapeutic manner, the RT must first understand himself. He must become aware of his own limitations and understand any feelings and attitudes that might lead to bias or discrimination in interactions with others. He must become aware of his own limitations and understand any feelings and attitudes that might lead to bias or discrimination in interactions with others.

15. Attitudes & Biases Biases are brought about by attitudes. Attitudes are a set of beliefs, that a person holds toward issues or persons that cause the person to respond in a predetermined manner and may eventually affect his general behaviour. Biases are brought about by attitudes. Attitudes are a set of beliefs, that a person holds toward issues or persons that cause the person to respond in a predetermined manner and may eventually affect his general behaviour.

16. a person reacts not to a particular event, but to a personal perception of that event., a perception that is the result of learned attitudes. a person reacts not to a particular event, but to a personal perception of that event., a perception that is the result of learned attitudes. The RT must understand this and not expect patients to feel as he does in any situation. For instance, the patient who is experiencing pain will react to pain in a manner learned from his past life experience. The RT must understand this and not expect patients to feel as he does in any situation. For instance, the patient who is experiencing pain will react to pain in a manner learned from his past life experience.

17. The RT will be better be able to understand and communicate with others in a therapeutic manner if he examines his own background and considers the source of his own attitudes, beliefs, prejudices, and values. The RT will be better be able to understand and communicate with others in a therapeutic manner if he examines his own background and considers the source of his own attitudes, beliefs, prejudices, and values. Then, with a new understanding of himself, he can try to put aside his own biases and look at each patient as an individual, with needs and perceptions different from his own. Then, with a new understanding of himself, he can try to put aside his own biases and look at each patient as an individual, with needs and perceptions different from his own.

18. Nonverbal Communication The unspoken or nonverbal aspects of communication can be defined as all stimuli other than the spoken word involved in communication. The unspoken or nonverbal aspects of communication can be defined as all stimuli other than the spoken word involved in communication. E.g. facial expressions, body movements, hand signals, nodding, head shaking E.g. facial expressions, body movements, hand signals, nodding, head shaking

19. Factors that affect communication Cultural Variations Cultural Variations para-language (sound of speech) para-language (sound of speech) Age group Age group Educational & social level Educational & social level Hearing problems Hearing problems Physical condition Physical condition environment environment

20. Feedback In order to be certain that the message you are transmitting has been correctly received, feedback must be obtained. In order to be certain that the message you are transmitting has been correctly received, feedback must be obtained. If the message was misunderstood, the patient will not respond in the manner that was anticipated. If he does not, it will be the RT’s responsibility to restate that the patient will understand and will demonstrate understanding by giving the correct feedback. If the message was misunderstood, the patient will not respond in the manner that was anticipated. If he does not, it will be the RT’s responsibility to restate that the patient will understand and will demonstrate understanding by giving the correct feedback.

21. Developing a harmonious working relationship Although interactions with a patient will often be brief, the patient should be made to feel that he is a partner in the examination process, for indeed the most important member of the health team. He should be made to feel that he is sharing in the process. Although interactions with a patient will often be brief, the patient should be made to feel that he is a partner in the examination process, for indeed the most important member of the health team. He should be made to feel that he is sharing in the process.

22. Communication techniques There are a series of communication techniques that the RT student should cultivate that will help him to become a therapeutic member of the health team. They include; establishing communication guidelinesestablishing communication guidelines reducing distancereducing distance listeninglistening using therapeutic silenceusing therapeutic silence responding to the feeling and the meaning of the patient’s statementsresponding to the feeling and the meaning of the patient’s statements restating the main idearestating the main idea reflecting the main ideareflecting the main idea making observationsmaking observations exploringexploring

23. 1. introducing yourself, explanation of the examination or the treatment, what will be expected of the patient, what he can expect of the radiology staff. 2. reduce the physical distance, make eye contact, do not cross arms or legs during communication, do not perform any other tasks while attempting to communicate,

24. 3. when the patient is speaking “shut out” your own feelings and assume a totally nonjudgmental attitude. 4. related to listening is the therapeutic use of silence. Short periods of silence give the patient time to arrange his thoughts and consider what he wants to say. This will help the RT to assess the patients non verbal communication as well as his own.

25. Blocks to therapeutic communication There are several factors that actually block or destroy the possibility of crating a therapeutic atmosphere in communication. Speaking rapidly.Speaking rapidly. Using complex medical terminology.Using complex medical terminology. Distracting environment such as a noisy waiting roomDistracting environment such as a noisy waiting room Language problemLanguage problem Failing to explore the patient’s description of a problemFailing to explore the patient’s description of a problem

26. End of lesson 4 Next :- The grieving process