Elements of Effective Communication

Communication

Communicating Effectively with others is important

Health care workers must be able to relate to patients, family, co-workers, and other professionals

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

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

Factors Interfering with Communication ProcessMessage 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

Factors Interfering with Communication ProcessSender 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

Factors Interfering with Communication ProcessReceiver must be able to hear and receive

the messagePatients 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

Factors Interfering with Communication ProcessReceiver 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

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

Factors Interfering with Communication ProcessInterruptions or distractions must be avoided

Can interfere with any communicationTalking with others while answering the phone or writing can

decrease effectiveness of communicationLoud 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

ListeningImportant 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

Listening TechniquesShow interest an concern for what the speaker is sayingBe alert and maintain eye contact with speakerAvoid interrupting the speakerPay attention to what the speaker is sayingAvoid thinking about how you are going to respondTry to eliminate your own prejudices and see the other person’s

point of viewEliminate distractions by moving to a quiet area for the

conversationWatch the speaker closely to observe actions that may contradict

what the person is sayingReflect statements back to the speaker to let the speaker know the

statements are being heardAsk questions if you do not understand part of a messageKeep your temper under control and maintain positive attitude

Non-Verbal CommunicationUse 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

Non-Verbal CommunicationImportant 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

Barriers to Communication

Physical Disability

Psychological Barriers

Cultural Diversity

Physical DisabilityDeafness 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

Physical DisabilityAphasia 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 wordsMay have slurred speechIt is very important to patient while working with these

individualsLet 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

Psychological BarriersOften 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

Psychological BarriersAt 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

Cultural DiversityCulture 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

Cultural DiversityIn 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

Recording and ReportingReporting 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

Recording and ReportingAll 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

ObservationsShould be reported immediately

Subjective Observations (symptoms)Cannot be seen or felt by health care workerUsually statements or complaints made by the patientMust be reported in the exact words of the patient

Objective Observation (Signs)Can be seen or measured by the health care workerExamples include a bruise, cut, rash, or swellingBlood pressure and temperature are measureable

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***

Charting on a PatientWriting should be neat and legibleSpelling and grammar should be correctIf 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 lineRecord “error by them”Show the initials of the person making the error

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