AMA 101 Communications in Health Care

1. AMA 101 Communications in Health Care

2. Message Encodes Sender Receiver Decodes Feedback Clarification Communication Cycle

3. Health Care Employee Role in Communication • Communicates effectively, accurately and appropriately with physicians, staff members and patients • Use proper grammar • Be professional • MA often is the first person the patient meets, you represent your physician • Positive attitude • Therapeutic communication • Clarify confusing messages • Confirm or validate patient’s perceptions • Adapt messages to patient’s level of understanding • Ask for feedback

4. Verbal & Non-Verbal Communication • Verbal – exchange of messages using words or language; most common • Polite • Professional • Proper grammar • Gear conversation to patient’s educational level • Paralanguage – tone, quality, volume, pitch and range • Non-language – laughing, sighing, sobbing, grunting, etc… • Written – clear, concise, accurate • Non-Verbal – exchange of messages without using words (body language); may reflect more accurately a person’s true feelings • Kinesics – body movements, facial expressions, gestures and eye movements • Proxemics – spatial relationships or physical proximity; personal space; 3 feet • Touch – therapeutic indicates support, concern, feeling; use good judgment, read body language first

6. Interview Techniques Active listening – give full attention, try not to interrupt, observe body language or non-verbal as well as verbal, ask appropriate questions, record answers; use the following techniques: • Reflecting – repeat what patient says using open-ended questions; allows for further comments • Paraphrasing – repeat what you hear, using your own words or phrases; allows for clarification • Clarification – asking patient to give an example; helps to understand what patient is saying and gives insight on perception • Open-ended questions – best way to obtain info; allows for elaboration; use questions that start with: what, when or how, do not use why. Close-ended questions are answered by yes or no, avoid these • Summarizing – review of info for clarification or organization • Allowing silence – natural and gives time for thought formulation

7. Barriers to Communication • Clichés – do not use, can be demeaning • Culture – be sensitive to differences in beliefs, body language can be misunderstood • Stereotyping – holding opinion of all members of a particular culture or race; discriminatory • Bias – personal opinions; treat all patients fairly, respectfully and with dignity regardless of who they are • Language – use an interpreter, do not shout, use simple English if possible, avoid slang, learn basic phrases in other languages • Hearing impairment – talk face to face, use interpreter, use written notes, use visual aids

8. Barriers cont… • Sight impairment – identify yourself, do not raise voice, describe what you are doing each time, offer your arm, orient patient spatially, explain sounds of machines to be used • Speech impairment – allow patients time to gather thoughts, allow time to communicate, offer note pad to write • Mental health issues – explain what to expect, keep conversation focused, do not be demanding or forceful, orient patient to reality if needed, do not confirm hearing voices or seeing nonexistent objects • Anger – remain calm, be open and honest, be supportive, do not belittle or provide false assurances, ensure your own safety • Children – be at eye-level, keep voice gentle, use slow movements, explain procedures, rephrase to ensure understanding, use play, understand if child reverts to lower developmental levels due to fear, allow expression of fear, assess situation with teens before including parent, do not judge • Grief – be empathetic, know Kubler-Ross’ stages of grief, allow time for expression, use therapeutic touch, do not show pity

9. Elizabeth Kubler-Ross

10. Defense Mechanisms Mental devices used to feel more comfortable and make behavior seem more reasonable to self and others; protect us from loss of self-esteem • Rationalization- offering a socially acceptable explanation for behavior when true reason is too painful; excuses • Projection – placing blame on someone else or attributing one’s own unfavorable characteristics or desires to someone else • Displacement – redirection of strong feelings about one person to someone else; taking feelings out on another person • Daydreaming – escape device of substituting fantasy for reality • Escape into Illness – using illness to be rewarded with attention or concern; learned behavior from childhood • Repression – forcing unpleasant memory into subconscious mind • Withdrawal – shutting off communication or removing oneself from a threatening situation

11. Roadblocks to Communication • Belittling – making light of patient’s fears • Disagreeing – indicates belief that patient is incorrect • Defending – repelling a verbal attack • Stereotypes – statements that are not sincere; are biased and discriminatory • Changing the subject – prevents talking about topic that causes anxiety or fear • Reassuring cliché – insincere statement • Giving advice – shows you think you know what is best for patient or what they should do • Agreeing – shows patient’s message is correct even if not so, may not be real concern of patient

12. Positive Relationships • Be a role model – earn trust of patients • Use professional communication – be respectful, use appropriate demeanor • Use proper forms of address – show respect, do not use pet names, use Mr. or Mrs. If applicable, use last names • Professional distance – do not become too personally involved, be objective, create therapeutic environment • Teaching patients – be knowledgeable of current medical trends, issues, etc.., be aware of special services, allow time, use quiet space, be clear, encourage questions, use open-ended questions, invite follow-up phone questions • Communicating with peers – be team player, avoid non-work related topics except on breaks, be honest • Communicating with physicians – be professional, use appropriate terms, address as Dr. unless told otherwise, use proper medical terms, be confident, admit mistakes, ask questions • Communicating with other facilities – maintain confidentiality, be professional, you represent your physician, observe legal requirements, facts only, do not judge, confirm messages are received