Therapeutic Communications

Therapeutic CommunicationsMade Simple1TopicsThe Basic Elements of CommunicationCommunication TechniquesPatients with Special Needs

Communication ComponentsCommunication is a primary function of lifeCommunication is the exchange of common symbols:WrittenSpokenSigning or body language

Oral/Verbal communicationMost prevalent style usedTerms and concepts should be presented in language the listener understandsLay language is the most satisfactory for most patients and family membersEx. Bend rather than flexTone, volume, and inflection of your voice can destruct from or add to your messageMaintaining eye contact allows both persons to relate non verbal cuesWritten CommunicationShould be brief, concise and specific and should use language the reader will be most likely to understandTyped or printed instructions are more easily read than handwrittenDiagrams, drawings and pictures are useful to show specific positions or the sequence of movements

Non verbal communicationMakes up majority of the human communication and maybe more effective than verbal communicationDone through: facial expression, posture, gestures, body movements, or changes in body responses.Use of touch by the caregiver is another form of NVC Ex. A brief hug, a hand squeeze or pat at the backCommunicationVarious barriers to communication should be recognized, documented and avoided whenever possible.Patient-caregiver rapport can be established quickly through the use of effective communication or delayed by the lack of it.

Communicating with a Person with a DisabilityCaregiver must maintain the persons self-esteem by considering the person first in your words and thoughts.The persons disability must be described accurately but it is more important to emphasize the persons abilities rather than disability. John who has a SCI , uses a wheelchair for mobility or Because he has a broken back, John is confined to a wheelchairPerson with disability rather than disabled personCommunicating with a Person with a DisabilityPerson who is visually impaired will appreciate knowing who is speakingRemember it is not necessary to increase the volume of voice when speaking with a person who is visually impairedWhen speaking with a person who is seated, stoop or squat and position yourself in front and at eye level with the personCommunicating with a Person with a DisabilityPerson who is hearing impaired will need to have a tactile and visual cueing from you before you speakBasic Elements of CommunicationCommunication consists of a sender, a message, a receiver, and feedback.

Failure to Communicate (1 of 2)Prejudice: Or lack of empathyLack of privacy:Inhibits the patients responses

Failure to Communicate (2 of 2)External distractions:Traffic, crowds, loud music, EMS radios, TVsInternal distractions:Thinking about things other than the situation

Hallmarks of a Good CommunicatorPatience Flexibility Trust and Rapport (1 of 2)Use the patients name.Address the patient properly.Modulate your voice.Be professional but compassionate.Trust and Rapport (2 of 2)Explain what you are doing and why.Keep a kind, calm expression.Use an appropriate style of communication.

Professional Behaviors (1 of 2)First impressions are crucial.Be neat and clean.Practice good hygiene.Stay physically fit.

Professional Behaviors (2 of 2)Maintain an overall demeanor that is calm, capable, and trustworthy.Be confident, not arrogant.Be considerate

19Communication TechniquesGetting down to a patients level can help improve communications on a pediatric call.

Which is better?An open stance A closed stance

Interpersonal Zones

Eye ContactUse eye contact as much as possible.Remember to remove sunglasses while working with patients.

Use an appropriate compassionate touch to show your concern and support.

Questioning Techniques (1 of 2)Use open-ended questions.Use direct questions.Do not use leading questions.

Open-ended QuestionsWhat do you plan to do immediately following graduation from college?Direct QuestionsHow has he managed to get in shape so quickly?Wheres the bathroom?Why did you move to Europe?Leading QuestionsWhere you at the Business Class on the night of June 7, 2014?Questioning Techniques (2 of 2)Ask one question at a time, and listen to the complete response before asking the next.Use language the patient can understand.Do not allow interruptions.

Observing the ClientOverall appearanceClothingJewelryMental statusSpeechMood and energy level

Effective Listening and FeedbackSilenceReflectionFacilitationEmpathyClarification

InterpretationExplanationSummarization

Interviewing ErrorsProviding false assurancesGiving adviceAuthorityUsing avoidance behavior

DistancingProfessional jargonTalking too muchInterruptingUsing why questions

Patients with Special NeedsSources of Difficult InterviewsPatients physical conditionPatients fear of talkingPatients intention to deceive

Always treat elderly clients with the respect that they deserveSensory ImpairmentBlindness:Tell them everything you are going to do.Use touch as a form of contact for reassurance.Hearing impairment:Ask patients what their preferred method of communication is.

Language and Cultural ConsiderationsUnderstand that cultures vary and ethnocentrism hinders communication.There is additional fear when a patient cannot understand your language.Avoid cultural imposition.

Interpreters (1 of 2)Speak slowly.Phrase questions carefully and clearly.Address both the patient and the interpreter.Ask one question at a time, and wait for the complete response.The information you receive may not be reliable.Have patience.

Hostile or Uncooperative Patients (1 of 2) Set limits and boundaries.Document unusual situations.Consider having a same-sex witness ride in the ambulance.If your safety is in jeopardy, keep away from the patient.

Hostile or Uncooperative Patients (2 of 2)Have an appropriate show of force if necessary.Know local policy regarding restraints and psychological medications.Use law enforcement if needed.

Transferring Patient CareBefore patient care is transferred to you, listen to the report carefully.Interact with colleagues with respect and dignity.Give a report to the receiving nurse or doctor.Introduce the patient by name, and say good-bye.

SummaryThe Basic Elements of CommunicationCommunication TechniquesPatients with Special Needs