Unit 2: Portfolio Work
Unit 2: Portfolio Work (AS Unit F911)
A01
Oral Communication
Oral can be defined as “spoken rather than written” (2012) Oxford Dictionaries.com Oxford University Press [Online] Available from: http://oxforddictionaries.com/definition/english/oral?q=oral (Accessed 25 October 2012). Communication can be defined as “the imparting or exchanging of information by speaking, writing, or using some other medium” (2012) Oxford Dictionaries.com Oxford University Press [Online] Available from: http://oxforddictionaries.com/definition/english/communication?q=communication (Accessed 25 October 2012).
Therefore, oral communication is the conveyance or swapping of information using spoken language. Communication is fundamentally important in all settings …show more content…
but especially in care settings. Talking doesn’t cost anything; it is the easiest and the quickest way for health care professionals to exchange vital information with other health care professionals.
As health care professionals, we need to always be aware of client’s needs, both medical and personal. Our job as a practitioner is to make sure that our clients can understand what we are saying to them and that we can understand exactly what they are saying to us. Communication of any kind is a two way street. Barker (2000, p.2) states “Until you have shared information with another person, you haven’t communicated it. And until they have understood it, the way you understand it, you haven’t shared it with them”.
Information needs to be passed to clients using any method that they can understand. Health care professionals need to make sure that they can interact with their client in the best possible professional manner.
Some practitioners offer “talking therapy”. This involves listening to a client’s innermost thoughts and feelings and talking about problems. A client has to be able to share their thoughts and by talking to a practitioner, can offload any problems or worries they may have. A practitioner has to listen very carefully and has to be able to understand what is being said to them. The practitioner can then potentially offer practical, helpful solutions to the client’s problems. The client has to feel comfortable with the practitioner before they can start talking about personal issues, the practitioner’s job is to make the client feel warm and welcome and he does this by talking to the client and making them feel relaxed and totally at ease. A client would be more likely to talk about their most private worries if they felt comfortable and relaxed with the practitioner. Listening is also imperative in the whole communication process; we need to listen to information first to understand it.
Oral communication is usually the first form of contact that can be made; we usually start conversations by saying “hello”. Talking is second nature to the majority of people. We do it automatically. We do not have to even think about it, we just open our mouths, and out the information flows, for some, though, it is not so easy. This is why we have lots of other forms of communication.
When a surgeon is operating in theatre, he has a mask on and so he communicates by talking to other health professionals.
Without oral communication, he would not be able to convey important information to others. It is vital that his staff listen carefully to his words whilst he is operating on a patient, any misunderstanding could potentially result in the patient being harmed accidentally or even death. The Anaesthetist also has a vital role during an operation. They have to continually monitor their patient and relay the patient’s vital signs to the surgeon at all times. This is done by talking. It is also imperative that the rest of the theatre staff can hear properly so usually there is no background noise to allow the staff to hear the surgeon’s instructions clearly. Any misunderstanding in the operating theatre could literally be a case of life or …show more content…
death.
Oral communication is used everywhere in the health care environment, Doctors speak to other Doctors, nurses speak to other nurses, everyone involved in a multi-disciplinary team meeting has to talk at some point, information is relayed to other members of the health care team by talking. A cleaner in a ward may ask a client if they can have access to their room to clean it. A catering assistant may ask a client if they would like a cup of tea. Oral communication is absolutely everywhere. It is great for welcoming people into new environments; it can be used alongside other forms of communication to make the client feel totally at ease in their new environment. There is nothing like a friendly smile and a hello to make us feel welcome. A new client should be able to sit down with a health care worker over a cup of tea and discuss openly any concerns that they may have. It is the practitioner’s job to make the client feel important and that they are being listened to.
Another example of oral communication; a member of staff finds Mrs Smith lying on the floor unconscious, the staff member immediately shouts for help, thus communicating the urgency of the situation. Of course, there are times when people cannot talk and it is up to us, as health care workers to find other alternative forms to enable us to communicate as effectively as is possible. Oral communication is the absolute heart and soul of any communication. Barker (2000, p.6) concludes that “conversation is the stock exchange where we trade ideas. It’s the most important means of communication you possess. It is flexible and dynamic. Your organisation – any organisation – is, in essence, a network of conversations. In fact, that’s all it is. Without effective conversations, it cannot operate”.
Written Communication Written communication is the writing down of information, whether it is by the listener, or the person trying to convey the information. “Written communication in care settings has many purposes, it ensures the client’s medical information is clear and available to everyone in the health care profession. It is the means of “giving and obtaining information and the exchanging of ideas”. (Fisher et al 2012).
Everyone should have a personal record or paperwork of some kind, this starts when we are born, we receive a birth certificate, a legal piece of paper that states our name and when and where we were born. We then have a personal medical file that all health care professionals use to record any illness or medication that we may receive at any time. This file accompanies us throughout our life and any practitioner can read our file when they need to know anything about our past illnesses, care etc. This file is usually kept in a health care environment and can be easily transferred to another health care environment, i.e. Hospital, when required. As well as having past health information on it, a client’s personal file also should include current care or health needs, as prescribed by the relevant practitioner. We need to make sure that we document a client’s personal information. “There are lots of advantages to written communication: * It serves as evidence of events and proceedings. * It provides a permanency of record for future references. * It reduces the possibility of misunderstanding and misinterpretation. * It can save time when many persons must be contacted. * It is reliable for transmitting lengthy statistical data. * It appears formal and authoritative for action”.
(2012) Preservearticles.com. [Online] Available from: http://www.preservearticles.com/2012051932619/6-important-advantages-of-written-communication.html. (Accessed 20 November 2012).
There can be no confusion if a practitioner reads important information about a client, whereas verbal information could be misheard or misunderstood. Of course, practitioners need to make sure that their writing is clear and legible and can be understood by others in the health care profession. The content of the communication should be easily understood.
In a health care setting, all types of communication are imperative, health care workers need to interact, listen and read information as effectively as they can, a client’s life may depend on this, if health care workers misinterpret a number for example, and give 100 mgs of a medicine and the correct dosage was 10mgs, the client’s life may be in danger, therefore it is critically vital that health care workers are one hundred per cent positive that they have the correct information. Medication and care requirements need by law, to be written down. There should be absolutely and categorically no margin of error for staff to give the wrong medicine or even dosage if it is written down and they can see it in black and white. Health care professionals spend a large amount of time writing about their clients. They must document everything, even if there is no change. For example, “Mrs Smith sat and dozed in her room all morning after being assisted with washing and dressing”. Of course, this is just one example; health care workers need to liaise at all times with other health care workers and professionals to ensure that the correct medical and nursing care is always given to their clients. This is also done in a handover at the end and start of every shift. Key health care workers and professional staff will have a meeting in private to discuss if there has been any changes at all with their clients, it is imperative that all changes, no matter how small, are divulged.
“Shift handover should be: * Conducted face-to-face; * Two-way, with both participants taking joint responsibility; * Done using both verbal and written communication;
Based on an analysis of the information needs of incoming staff; given as much time and resource as necessary.”
(2012) Safe Communication at Shift Handover-setting and implementing standards - Health and Safety Executive. Contains public sector information published by the Health and Safety Executive and licensed under the Open Government Licence v1.0’. Available from: http://www.hse.gov.uk/humanfactors/topics/shift-handover.htm (Accessed 25 October 2012).
When a shift handover occurs, oral and written communication both play a pivotal role; the on duty shift talks and the new shift writes down the information, it is vital that they do this as they need to make ensure that the clients get the correct care, as prescribed by senior health care professionals.
When clients are brought into a new health care setting, their previous medical and care prescription needs to be divulged to the new staff. Usually, a new client is designated a named nurse. “A nurse designated as being responsible for a patient's nursing care during a hospital stay and who is identified by name as such to the patient. The concept of the named nurse stresses the importance of continuity of care”. (2008) A Dictionary of Nursing. [Online] Encyclopedia.com. Available from: http://www.encyclopedia.com/doc/1O62-namednurse.html (Accessed 25 October 2012).
The named nurse will introduce herself to the client and answer any questions that the client may have, the named nurse will go through the clients care plan with the client. “A care plan is an agreement between you and your health professional (and/or social services) to help you manage your health day-to-day. It can be a written document or something recorded in your patient notes”. (2011) NHS Choices. [Online] NHS Choices UK. Available from: http://www.nhs.uk/Planners/Yourhealth/Pages/Careplan.aspx (Accessed 25 October 2012).
The named nurse needs to communicate to the client and she does this in a way that the client can understand.
On the opposite side of the spectrum, if health care workers did not communicate with one another, there would be potentially life threatening predicaments, care staff have a legal and moral obligation to alert other carers and health professionals to any problems, for example, if a client was allergic to something, this very important information has to be passed on to all members of the care team, the allergen must not be given to the client at all costs. This information would be written down and highlighted. Health professionals need to know about past medical histories, they need this information to be able to treat a client as effectively as possible. Clients have to sign consent forms to allow treatment. Clients have to read written menus to decide what they would like to eat. For example, Mrs Smith may be given a menu on a Monday and she has to tick the boxes to pick what she would like to eat on Tuesday.
Written communication is everywhere in the health care setting, clients may receive information from other health care environments, i.e. meeting times, appointments and test results. Health care staff would not be able to do their job at all without information. Communication, in any way, shape or form, is absolutely vital to a health care setting, the implications for not communicating to others is literally life threatening.
Computerised communication
“Computerised communication is when communication takes place electronically. It is also a very quick form of interacting with people”. (2012) Wiki.answers.com. [Online] Available from: http://wiki.answers.com/Q/What_is_the_importance_of_computerised_communication_in_health_care_settings (Accessed 27 October 2012).
Since the invention of email, messages can be passed on in an instant; we no longer have to rely on “snail mail”. We now have the capability of speaking to someone online instantly, be it they are in the same health care facility, or even in a different country. Health care professionals can email other colleagues and receive an instant response to their query; they can have an online multi-disciplinary team meeting when all the team members are in different places. Staff rotas can be emailed, we can use the Internet for research, and we can find the answer to our question in a heartbeat. A client’s information would be kept on an electronic file, therefore every health care professional involved in that client’s care would have easy access to the information, this could be a G.P, Pharmacist, Physiotherapist, Occupational Therapist or staff nurse. We have a duty to protect this very private, personal information about a client; therefore we have a law in place known as “The Data Protection Act.
The Act: * Creates new obligations for those keeping personal information. * Requires that any individual using services can be given a copy of any information that is kept about them. This is known as your “right of access”. * Requires that any inaccurate information about a person is corrected or deleted. * Gives a person the right to complain to the Data Protection Commissioner if they think someone is keeping data and is not complying with the act.
* Allows individuals to claim compensation through the Courts if they suffer damage through mishandling of information about themselves. * Permits an individual who uses services to find out from any person or organisation whether information is being kept about them, and if they do, to be told the type of information kept and the purposes for which it is kept”.
(Fisher et al 2012)
A client is allowed access to their personal records, should they wish to see them. They have a legal and moral right to see what has been written about them.
Most prescriptions are now printed electronically by the prescribing practitioner; this ensures that the Pharmacist can read it and also the prescription is impossible to alter.
Sign language
Sign Language is a visual means of communicating using gestures, facial expression, and body language. Sign Language is used mainly by people who are deaf or have hearing impairments”. (2012) British-sign.co.uk. [Online] Available from: http://www.british-sign.co.uk/british-sign-language-bsl/what-is-british-sign-language-bsl/ (Accessed 29 October
2012).
Children are taught Sign Language using their hands to communicate; they form pre-determined words and letters with their fingers, almost like spelling out. They take to it almost instantly as it is great fun and easy to learn. Sign Language is commonly learned by health care workers, for some it is the only way of communicating with deaf or hard of hearing clients. Hearing loss can be caused by age, it is one of the processes associated with getting older, and therefore it stands to reason that the majority of older persons will have hearing difficulties. Some manage perfectly well with a hearing aid, others may lip read and some may hear by the carer speaking louder, but clearly. Others, perhaps, born deaf or becoming deaf at an early age, may use Sign Language, they may have their “own version”, just as we have local dialects in different parts of the UK, deaf or hard of hearing have different versions of sign language, British Sign Language, however, is a universally recognised language in its own rights in the UK, it has been officially recognised by the British Government as a minority language. Some hard of hearing persons communicate through written information, a health care professional may write down important information for them. Many people who have Deaf relatives also use Sign Language to communicate with their Deaf relative, when they may not have any hearing issues themselves. We could say that Sign Language is a visual way of communicating. Fire-fighters who learn Sign Language can actually communicate with their colleagues in a room full of smoke, as can Scuba divers underwater. Sign Language is hugely beneficial not only to the Deaf or hard of hearing community, it also has other uses. “Many Deaf children nowadays, got to main-stream schools, there is no need for them to go to a Special school, and many schools have persons who can sign and therefore interpret things to and for the children.” (2012) Squidoo. Using Sign Language to Communicate. [Online] Available from: http://www.squidoo.com/using-sign-language (Accessed 31 October 2012)
An example of health care workers using Sign Language; Mrs Smith comes into Hospital after falling and breaking her hip. She is very upset. Staff are immediately suspicious that Mrs Smith may have a potential broken hip. Mrs Smith cannot speak but can convey immediately to staff that she is in a lot of pain. The Doctor overseeing Mrs Smith in the Accident and Emergency department of the Hospital sees that Mrs Smith’s daughter has accompanied her in the ambulance and speaks to her; Mrs Smith’s daughter knows Sign Language and can translate and interpret for the Doctor and relay this information back to Mrs Smith. Mrs Smith is therefore informed at all times as to what is happening. Sign Language is undoubtedly an extremely useful tool, both for Deaf and hard of hearing but also for others who may not be able to communicate either orally or indeed any other way due to their environment.
Makaton
Makaton is “a language programme using signs and symbols to help people to communicate. It is designed to support spoken language and the signs and symbols are used with speech, in spoken word order”. (2012) The Makaton Charity. [Online] Available from: http://www.makaton.org/aboutMakaton/default. (Accessed 01 November 2012)
Signs, speech and symbols can all used in Makaton to help communicate.
“Makaton was developed in the early 1970s in the UK for communication with residents of a large hospital who were both deaf and intellectually disabled. The name is a blend of the names of the three people who devised it: Margaret Walker, Kathy Johnston and Tony Cornforth”. (2012) Wikianswers.com. [Online] Available from: http://wiki.answers.com/Q/Who_invented_makaton. (Accessed 2nd November 2012).
Makaton is used primarily by persons with learning and communication difficulties as their main form of communication. Relatives and carers of persons with learning and communication difficulties also use Makaton. Makaton is an internationally recognised language in its own right. “Makaton was first developed by identifying the words that are used most frequently in everyday conversation. After this, signs from British Sign Language ("BSL") were matched to these words, so that a person is able to speak and sign at the same time. Makaton users are first encouraged to communicate using signs, but then as a link is made between the word and the sign, the signs can be dropped and the speech is allowed to take over. (2005-2010) Douglas Silas Solicitors. [Online] Available from: http://www.specialeducationalneeds.co.uk/UsefulInformation/SEN-EducationInfo/Makaton.html (Accessed 2nd November 2012).
If you had a child with a learning or communication difficulty and therefore couldn’t tell you what he or she wanted, they could point to a symbol, i.e. food or drink of water. These same symbols could be pinned up around the child’s environment to allow the child to point at and therefore communicate their needs or wants. Of course, the child needs to have a basic understanding of what they are pointing at, this could be taught with the aid of pictures and signing Makaton. Some people may use Makaton for a short period of time until they grasp how to speak but others may have to use Makaton for the rest of their lives.
Braille
“Braille is a series of raised dots that the blind or partially sighted feel with their fingers, Braille consists of patterns of raised dots arranged in cells of up to six dots in a 3 x 2 configuration. Each cell represents a letter, numeral or punctuation mark. Some frequently used words and letter combinations also have their own single cell patterns”. (1998-2012) Omniglot.com. [Online] Available from: http://www.omniglot.com/writing/braille.htm (Accessed 05 November 2012).
Braille gives the blind and partially sighted persons the ability to communicate with others, they can “read” Braille and in fact they can “write” in Braille. There are mechanical machines out there that blind or partially sighted persons can use. They operate in much the same way as a typewriter, i.e. there are buttons to press but they are in fact producing raised dots on paper. There are computer keyboards as well that can allow a person to type in Braille. Braille is used in everyday situations; it is used on lift buttons, medicine labels, toxic chemicals and household cleaners. There are raised dots on potentially dangerous products that partially sighted or blind people can feel and know exactly what they are touching. This promotes empowerment for the blind and partially sighted, they no longer have to rely on someone else to read out aloud to them, they can in fact, communicate for themselves.
Interpreter
“An interpreter is a person who provides an oral translation between speakers who speak different languages”. (2012) Dictionary.com. [Online] Available from: http://dictionary.reference.com/browse/interpreter?s=t (Accessed 05 November 2012).
An interpreter can act as a go-between between a client and a practitioner; they can translate the language the client is speaking and relay it back to the practitioner. The interpreter can then listen to the practitioner and relay their words back to the client. The interpreter is usually fluent in his or her chosen language. An interpreter may also converse in Sign Language and therefore can communicate to persons with hearing difficulties; they can then translate Sign Language back into verbal words for the practitioner. Interpreters are indeed fluent in multiple communication tasks and may work in all kinds of care settings as there is a platitude of multi-cultural clients in every care setting.
All the above are tools that allow communication to take place, whether it is visual, tactile, written, oral, or aural.
Values of care
A care value is an “ethical code which governs how caregivers ought to act in certain situations within a health or social care setting, to be certain that they are not discriminating, violating people's rights, or providing poor care for their clients”. (2005. pp. 42-60) Moonie, Neil; Windsor, Gwyneth.
When practitioners are communicating with clients, who use services, they have a duty to ensure that communication is made as clear as possible, i.e. that clients understand what is being communicated to them, whether it be through written or verbal, or in fact any other kind of special communication mode. Practitioners need to also make sure that they themselves understand what the client is trying to say to them. Practitioners need to read verbal and non-verbal signs from the client. They need to make sure that they know how to comfort a client who may be upset, sad or angry. They need to be supportive, reassuring and sensitive to their client’s needs at all times. All this is done by using the relevant communication skills. We need to remember that everyone is different and that we all do things in different ways, this is the same with clients, we may be able to do one thing with one client who is sad but we may find that we cannot use the same technique with another client, we need to understand that clients are all individuals. Service users may have personality traits or characteristics that may make them difficult to deal with or indeed very easy to deal with, we may indeed have our own characteristics, as health care professionals, we need to make sure that we do not allow our own personal values, beliefs or opinions to interfere with the care we give to a client. Every client deserves the right to be treated with dignity and respect. They also have the right to access services that are correct for them. A client has the right to their own beliefs, i.e. they have the right to attend their own place of worship, and they have the right to eat the food that they wish to eat. They also have the right to live at home and live an independent a life as possible, with the support of the most appropriate care package that has been tailored to their individual needs. Values of care are borrowed from Human Rights.” Values are beliefs that people hold that allow persons who use services to be in control of their own lives”. ( Fisher et al 2012).
Care settings have anti-discrimination policies in place to ensure that staff is knowledgeable in ways to communicate with service users that do not discriminate against them. There are eight individual guidelines. Support staff needs to ensure that when interacting with clients they: * Give individual help and assistance * Accept dialects or variations in language * Are aware of any religious views or spirituality * Celebrate diversity * Use a multi-cultural approach * Do not stereotype * Challenge discriminatory behaviour * Make sure there is full inclusion for all
Practitioners are bound to treat clients as above. There may be a great mixture of diversity in care settings, everyone is different and also clients come from many different cultures. We need to be aware of this when treating clients. We cannot treat everyone the same, as client’s needs are all different, but we must ensure that we apply all the above principles at all times to our interactions.
When a client is being treated, he or she has the right to say “no”. They do not have to accept any treatment or care planned for them. They can say no to any food that is offered, they can also complain if they feel like they are not being treated as they should be. We absolutely cannot enforce our own views or opinions on clients, a client has the right to be listened to, we must as health care professionals “respect” our clients as individuals, as stated in our basic Human Rights.
We also need to maintain confidentiality at all times.
“Client confidentiality is the principle that an institution or individual should not reveal information about their clients to a third party without the consent of the client or a clear legal reason. This concept is commonly provided for in law in most countries”.
(2012) Wikipedia.org [Online] Available from: http://en.wikipedia.org/wiki/Client_confidentiality. (Accessed 05 November 2012).
When a client enters a care setting, their most private and personal information is written down for health care professionals to see, it is imperative that nobody else sees this most personal record. As stated before, “The Data Protection Act” allows for complete confidentiality. Practitioners must also ensure that they do not discuss this private information with anybody, i.e. a relative of friend of the practitioner. A health care professional has a “duty of care” and this duty of care ensures that a client’s record and personal information is kept as confidential as possible. Most professional bodies have their own confidentiality policy in place. For example; if a client had a meeting with a health care professional and it was discovered that the client was suffering from a communicable disease, the health care professional would have a duty of care to report this.
“There is a clear public good in having a confidential medical service. The fact that people are encouraged to seek advice and treatment, including for communicable diseases, benefits society as a whole as well as the individual. Confidential medical care is recognised in law as being in the public interest. However, there can also be a public interest in disclosing information: to protect individuals or society from risks of serious harm, such as, serious communicable diseases or serious crime; or to enable medical research, education or other secondary uses of information that will benefit society over time”. (2009) http://www.gmc-uk.org [Online] Available from: http://www.gmc-uk.org/static/documents/content/Confidentiality_0910.pdf. (Accessed 05 November 20212).
I have used the General Medical Council confidentiality policy as an example. This is the regulatory body for General Practitioners. Doctors have a right to protect a client’s confidentiality as much as is possible, unless there are circumstances, such as above, that may require the practitioner to disclose that confidential information.
“Action must be taken quickly, for example, in the detection or control of outbreaks of some communicable diseases, and there is insufficient time to contact the patient”.
(2009) http://www.gmc-uk.org [Online] Available from: http://www.gmc-uk.org/static/documents/content/Confidentiality_0910.pdf. (Accessed 05 November 2012).
The Doctor in the example above is required “in the public’s best interest” to disclose that his patient has a communicable disease, this is to make sure that the disease is not spread to anyone else. This is a good example of a health care professional disclosing something that is told in confidence. Of course, there must be an extremely good reason for the health care professional to do so. They will be guided by their regulatory body policy and indeed their care setting may have its own confidentiality policy in situ as well.
Many practitioners in their professional lives will come across many moral dilemmas, for example, Mrs Smith aged 83 has a serious heart condition and wishes for no medical intervention, should she suffer another heart attack. Mrs Smith has had several heart attacks and every time she has been treated successfully and in time. Mrs Smith now wishes to be left to die, should she have another heart attack. This in itself provides a moral dilemma for practitioners, to leave a client to die goes against everything that they have been taught. Of course, clients must not suffer, so Mrs Smith should be given painkillers to alleviate pain and any other drug that may help settle her, but no drug should be given to promote or prolong her life. Mrs Smith should be made comfortable and kept as pain free as possible. Practitioners have to accept Mrs Smith’s opinion; it is the client’s wish that she should not be resuscitated. Mrs Smith is of sound mind and is perfectly capable of making her own decisions. She has documented in her care plan that she does not wish to be resuscitated in the event of a heart attack. Mrs Smith’s family are aware of her wishes and have reluctantly accepted them although they are not happy as they want her to be around for as long as possible, Mrs Smith does not want to be kept alive, she feels that she has “ had a good run and that her time is up when it is up”.
Health care workers have to respect client’s wishes at all times. It may not please staff that Mrs Smith does not wish to be resuscitated, but as health care practitioners, we have to respect our clients thoughts and feelings all times and we have to do as our client wishes, regardless of our own personal thoughts and feelings.
Values of care predicate any form of communication. Values must also be enforced at all times when caring for any service user, regardless of sex, age, gender or race.
Factors that can support or inhibit communication
There are lots of factors that can support and also inhibit communication. We use non-verbal signs subconsciously when we are communicating with a client. Non-verbal simply means not verbal, i.e. not spoken or using words. It is also called “body language”. ” It is a natural, unconscious language that broadcasts our true feelings and intentions in any given moment, and clues us in to the feelings and intentions of those around us”. (2012) Jeanne Segal, Ph.D., Melinda Smith, M.A., and Jaelline Jaffe, Ph.D. Helpguide.Org [Online] Available from: http://www.helpguide.org/mental/eq6_non-verbal_communication.htm (Accessed 26 October 2012).
We need to ensure that we use non-verbal signs such as smiling and touching to help “engage” a client, words would not be any use on their own, we need to keep a client interested in what we are saying, if we smile and use expressive hand gestures and maintain eye contact, a client would be more likely to give us their complete attention. We need to ensure that we gain a client’s trust. Trust is important as a client would be more inclined to confide in a health care worker if they trusted that person. If the client had a hearing, sensory or other health issue, we would try to use another form of communication. Non-verbal signs effectively “support” any other form of communication. We need to make sure that we use non-verbal signs as effectively as possible to ensure that all forms of communication are supported. The 7 main types of non-verbal communication are: * Touch - we need to touch a client appropriately, for example, shaking their hand when we first meet them, or even holding their hand when a client is upset, of course, we have to take our cue from the client, if a client wishes no touch at all, then we as carers, have to respect that. It is our job as a health care worker to get to know the client and find out what he or she likes. * Facial expression – we need to use the appropriate facial expression to communicate to our clients. A smile should be something that a carer does a lot of, nearly everyone responds to a nice happy face. Alternatively, if a client is sad or upset, we can read their body language and it can tell us if they are sad, even if the client cannot communicate this orally. A client would not be at ease with a health professional if he or she had an angry face. * Posture – how we hold ourselves says a lot, for example, if we are leaning towards a client, then this can tell the client that we are interested, if we were looking down at the floor, we may be bored or lack interest. This can be reversed, as can all types of non-verbal communication and the client can communicate boredom or interest back to us through their non-verbal communication. * Eye contact – the way we look at a client is important, eye contact is probably the most important of all non-verbal signs as it is difficult to hold a conversation with a person if you cannot see them. Our eyes portray our feelings, for example, anger, happiness, sadness. A client could be rolling their eyes with boredom or lack of interest; it is our job, as health care workers to notice these things. * Gestures – we wave, point, and beckon to people probably every day of our lives. We also gesticulate with our hands when we talk. This seems to be an unconscious movement as we do it without really thinking about it. We can use our hands to sign to people. Our hands are very important in communicating, whether it be by gesticulating, or using our hands in a conversation with a hard of hearing person. * Tone of voice – we need to be aware of “how” we speak to people. We cannot use strong tones when we are trying to convey kindness and compassion. We need to be aware of our voice tone at all times. We also need to use hushed tones when talking to someone who may be upset. A client can feel at ease when a health care professional uses the correct tone of voice. * Physical space – we all have our own defined “space” around ourselves when talking to a person. We are more comfortable with people we know well and therefore allow them to come closer to us whilst holding a conversation. We can all be a bit uncomfortable when a stranger comes to close to us, thus “invading” our personal space. We need to bear this in mind with clients, we cannot “invade” their personal space, indeed, we cannot be too far away from them either, especially if we need to try and communicate something to them. Positioning can also be a supportive or inhibitive factor in communication. We need to ensure that we are sitting close to our client but also ensure that we are facing them so we can see them. If we were too close, we could potentially be invading their personal space. If we are too far away from a client, we would have problems hearing them, and they would have problems hearing us. We need to ensure we are sitting at the correct comfortable distance from our client.
The environment can also be a barrier to effective communication. According to the National Centre of Audiology, “some of the factors that affect communication are as follows: * Poor lighting * Noise * Distance”
(2012) Wikianswers.com. [Online] Available from: http://wiki.answers.com/Q/Environmental_factors_that_affect_communication (Accessed 21 November 2012).
We would not be able to hear our client or concentrate fully on them if we had background noise happening, for example, a building site outside and sawing or hammering happening. Noise can be very off-putting and affects our ability to concentrate. If we were in a room that was too dark, we would not be able to read any notes, now would we be able to see our client. Good lighting is required at all times.
We need to ensure that at all times; we are using the most appropriate form of communication for our client. The client’s needs must be met at all times. We must also ensure that we can understand the client at all times. The content of the communication should always be tailored towards the client. We need to use all our skills as a health care worker to provide the best possible care that we can for our client at all times.
A01
Oral Communication
Oral can be defined as “spoken rather than written” (2012) Oxford Dictionaries.com Oxford University Press [Online] Available from: http://oxforddictionaries.com/definition/english/oral?q=oral (Accessed 25 October 2012). Communication can be defined as “the imparting or exchanging of information by speaking, writing, or using some other medium” (2012) Oxford Dictionaries.com Oxford University Press [Online] Available from: http://oxforddictionaries.com/definition/english/communication?q=communication (Accessed 25 October 2012).
Therefore, oral communication is the conveyance or swapping of information using spoken language. Communication is fundamentally important in all settings …show more content…
but especially in care settings. Talking doesn’t cost anything; it is the easiest and the quickest way for health care professionals to exchange vital information with other health care professionals.
As health care professionals, we need to always be aware of client’s needs, both medical and personal. Our job as a practitioner is to make sure that our clients can understand what we are saying to them and that we can understand exactly what they are saying to us. Communication of any kind is a two way street. Barker (2000, p.2) states “Until you have shared information with another person, you haven’t communicated it. And until they have understood it, the way you understand it, you haven’t shared it with them”.
Information needs to be passed to clients using any method that they can understand. Health care professionals need to make sure that they can interact with their client in the best possible professional manner.
Some practitioners offer “talking therapy”. This involves listening to a client’s innermost thoughts and feelings and talking about problems. A client has to be able to share their thoughts and by talking to a practitioner, can offload any problems or worries they may have. A practitioner has to listen very carefully and has to be able to understand what is being said to them. The practitioner can then potentially offer practical, helpful solutions to the client’s problems. The client has to feel comfortable with the practitioner before they can start talking about personal issues, the practitioner’s job is to make the client feel warm and welcome and he does this by talking to the client and making them feel relaxed and totally at ease. A client would be more likely to talk about their most private worries if they felt comfortable and relaxed with the practitioner. Listening is also imperative in the whole communication process; we need to listen to information first to understand it.
Oral communication is usually the first form of contact that can be made; we usually start conversations by saying “hello”. Talking is second nature to the majority of people. We do it automatically. We do not have to even think about it, we just open our mouths, and out the information flows, for some, though, it is not so easy. This is why we have lots of other forms of communication.
When a surgeon is operating in theatre, he has a mask on and so he communicates by talking to other health professionals.
Without oral communication, he would not be able to convey important information to others. It is vital that his staff listen carefully to his words whilst he is operating on a patient, any misunderstanding could potentially result in the patient being harmed accidentally or even death. The Anaesthetist also has a vital role during an operation. They have to continually monitor their patient and relay the patient’s vital signs to the surgeon at all times. This is done by talking. It is also imperative that the rest of the theatre staff can hear properly so usually there is no background noise to allow the staff to hear the surgeon’s instructions clearly. Any misunderstanding in the operating theatre could literally be a case of life or …show more content…
death.
Oral communication is used everywhere in the health care environment, Doctors speak to other Doctors, nurses speak to other nurses, everyone involved in a multi-disciplinary team meeting has to talk at some point, information is relayed to other members of the health care team by talking. A cleaner in a ward may ask a client if they can have access to their room to clean it. A catering assistant may ask a client if they would like a cup of tea. Oral communication is absolutely everywhere. It is great for welcoming people into new environments; it can be used alongside other forms of communication to make the client feel totally at ease in their new environment. There is nothing like a friendly smile and a hello to make us feel welcome. A new client should be able to sit down with a health care worker over a cup of tea and discuss openly any concerns that they may have. It is the practitioner’s job to make the client feel important and that they are being listened to.
Another example of oral communication; a member of staff finds Mrs Smith lying on the floor unconscious, the staff member immediately shouts for help, thus communicating the urgency of the situation. Of course, there are times when people cannot talk and it is up to us, as health care workers to find other alternative forms to enable us to communicate as effectively as is possible. Oral communication is the absolute heart and soul of any communication. Barker (2000, p.6) concludes that “conversation is the stock exchange where we trade ideas. It’s the most important means of communication you possess. It is flexible and dynamic. Your organisation – any organisation – is, in essence, a network of conversations. In fact, that’s all it is. Without effective conversations, it cannot operate”.
Written Communication Written communication is the writing down of information, whether it is by the listener, or the person trying to convey the information. “Written communication in care settings has many purposes, it ensures the client’s medical information is clear and available to everyone in the health care profession. It is the means of “giving and obtaining information and the exchanging of ideas”. (Fisher et al 2012).
Everyone should have a personal record or paperwork of some kind, this starts when we are born, we receive a birth certificate, a legal piece of paper that states our name and when and where we were born. We then have a personal medical file that all health care professionals use to record any illness or medication that we may receive at any time. This file accompanies us throughout our life and any practitioner can read our file when they need to know anything about our past illnesses, care etc. This file is usually kept in a health care environment and can be easily transferred to another health care environment, i.e. Hospital, when required. As well as having past health information on it, a client’s personal file also should include current care or health needs, as prescribed by the relevant practitioner. We need to make sure that we document a client’s personal information. “There are lots of advantages to written communication: * It serves as evidence of events and proceedings. * It provides a permanency of record for future references. * It reduces the possibility of misunderstanding and misinterpretation. * It can save time when many persons must be contacted. * It is reliable for transmitting lengthy statistical data. * It appears formal and authoritative for action”.
(2012) Preservearticles.com. [Online] Available from: http://www.preservearticles.com/2012051932619/6-important-advantages-of-written-communication.html. (Accessed 20 November 2012).
There can be no confusion if a practitioner reads important information about a client, whereas verbal information could be misheard or misunderstood. Of course, practitioners need to make sure that their writing is clear and legible and can be understood by others in the health care profession. The content of the communication should be easily understood.
In a health care setting, all types of communication are imperative, health care workers need to interact, listen and read information as effectively as they can, a client’s life may depend on this, if health care workers misinterpret a number for example, and give 100 mgs of a medicine and the correct dosage was 10mgs, the client’s life may be in danger, therefore it is critically vital that health care workers are one hundred per cent positive that they have the correct information. Medication and care requirements need by law, to be written down. There should be absolutely and categorically no margin of error for staff to give the wrong medicine or even dosage if it is written down and they can see it in black and white. Health care professionals spend a large amount of time writing about their clients. They must document everything, even if there is no change. For example, “Mrs Smith sat and dozed in her room all morning after being assisted with washing and dressing”. Of course, this is just one example; health care workers need to liaise at all times with other health care workers and professionals to ensure that the correct medical and nursing care is always given to their clients. This is also done in a handover at the end and start of every shift. Key health care workers and professional staff will have a meeting in private to discuss if there has been any changes at all with their clients, it is imperative that all changes, no matter how small, are divulged.
“Shift handover should be: * Conducted face-to-face; * Two-way, with both participants taking joint responsibility; * Done using both verbal and written communication;
Based on an analysis of the information needs of incoming staff; given as much time and resource as necessary.”
(2012) Safe Communication at Shift Handover-setting and implementing standards - Health and Safety Executive. Contains public sector information published by the Health and Safety Executive and licensed under the Open Government Licence v1.0’. Available from: http://www.hse.gov.uk/humanfactors/topics/shift-handover.htm (Accessed 25 October 2012).
When a shift handover occurs, oral and written communication both play a pivotal role; the on duty shift talks and the new shift writes down the information, it is vital that they do this as they need to make ensure that the clients get the correct care, as prescribed by senior health care professionals.
When clients are brought into a new health care setting, their previous medical and care prescription needs to be divulged to the new staff. Usually, a new client is designated a named nurse. “A nurse designated as being responsible for a patient's nursing care during a hospital stay and who is identified by name as such to the patient. The concept of the named nurse stresses the importance of continuity of care”. (2008) A Dictionary of Nursing. [Online] Encyclopedia.com. Available from: http://www.encyclopedia.com/doc/1O62-namednurse.html (Accessed 25 October 2012).
The named nurse will introduce herself to the client and answer any questions that the client may have, the named nurse will go through the clients care plan with the client. “A care plan is an agreement between you and your health professional (and/or social services) to help you manage your health day-to-day. It can be a written document or something recorded in your patient notes”. (2011) NHS Choices. [Online] NHS Choices UK. Available from: http://www.nhs.uk/Planners/Yourhealth/Pages/Careplan.aspx (Accessed 25 October 2012).
The named nurse needs to communicate to the client and she does this in a way that the client can understand.
On the opposite side of the spectrum, if health care workers did not communicate with one another, there would be potentially life threatening predicaments, care staff have a legal and moral obligation to alert other carers and health professionals to any problems, for example, if a client was allergic to something, this very important information has to be passed on to all members of the care team, the allergen must not be given to the client at all costs. This information would be written down and highlighted. Health professionals need to know about past medical histories, they need this information to be able to treat a client as effectively as possible. Clients have to sign consent forms to allow treatment. Clients have to read written menus to decide what they would like to eat. For example, Mrs Smith may be given a menu on a Monday and she has to tick the boxes to pick what she would like to eat on Tuesday.
Written communication is everywhere in the health care setting, clients may receive information from other health care environments, i.e. meeting times, appointments and test results. Health care staff would not be able to do their job at all without information. Communication, in any way, shape or form, is absolutely vital to a health care setting, the implications for not communicating to others is literally life threatening.
Computerised communication
“Computerised communication is when communication takes place electronically. It is also a very quick form of interacting with people”. (2012) Wiki.answers.com. [Online] Available from: http://wiki.answers.com/Q/What_is_the_importance_of_computerised_communication_in_health_care_settings (Accessed 27 October 2012).
Since the invention of email, messages can be passed on in an instant; we no longer have to rely on “snail mail”. We now have the capability of speaking to someone online instantly, be it they are in the same health care facility, or even in a different country. Health care professionals can email other colleagues and receive an instant response to their query; they can have an online multi-disciplinary team meeting when all the team members are in different places. Staff rotas can be emailed, we can use the Internet for research, and we can find the answer to our question in a heartbeat. A client’s information would be kept on an electronic file, therefore every health care professional involved in that client’s care would have easy access to the information, this could be a G.P, Pharmacist, Physiotherapist, Occupational Therapist or staff nurse. We have a duty to protect this very private, personal information about a client; therefore we have a law in place known as “The Data Protection Act.
The Act: * Creates new obligations for those keeping personal information. * Requires that any individual using services can be given a copy of any information that is kept about them. This is known as your “right of access”. * Requires that any inaccurate information about a person is corrected or deleted. * Gives a person the right to complain to the Data Protection Commissioner if they think someone is keeping data and is not complying with the act.
* Allows individuals to claim compensation through the Courts if they suffer damage through mishandling of information about themselves. * Permits an individual who uses services to find out from any person or organisation whether information is being kept about them, and if they do, to be told the type of information kept and the purposes for which it is kept”.
(Fisher et al 2012)
A client is allowed access to their personal records, should they wish to see them. They have a legal and moral right to see what has been written about them.
Most prescriptions are now printed electronically by the prescribing practitioner; this ensures that the Pharmacist can read it and also the prescription is impossible to alter.
Sign language
Sign Language is a visual means of communicating using gestures, facial expression, and body language. Sign Language is used mainly by people who are deaf or have hearing impairments”. (2012) British-sign.co.uk. [Online] Available from: http://www.british-sign.co.uk/british-sign-language-bsl/what-is-british-sign-language-bsl/ (Accessed 29 October
2012).
Children are taught Sign Language using their hands to communicate; they form pre-determined words and letters with their fingers, almost like spelling out. They take to it almost instantly as it is great fun and easy to learn. Sign Language is commonly learned by health care workers, for some it is the only way of communicating with deaf or hard of hearing clients. Hearing loss can be caused by age, it is one of the processes associated with getting older, and therefore it stands to reason that the majority of older persons will have hearing difficulties. Some manage perfectly well with a hearing aid, others may lip read and some may hear by the carer speaking louder, but clearly. Others, perhaps, born deaf or becoming deaf at an early age, may use Sign Language, they may have their “own version”, just as we have local dialects in different parts of the UK, deaf or hard of hearing have different versions of sign language, British Sign Language, however, is a universally recognised language in its own rights in the UK, it has been officially recognised by the British Government as a minority language. Some hard of hearing persons communicate through written information, a health care professional may write down important information for them. Many people who have Deaf relatives also use Sign Language to communicate with their Deaf relative, when they may not have any hearing issues themselves. We could say that Sign Language is a visual way of communicating. Fire-fighters who learn Sign Language can actually communicate with their colleagues in a room full of smoke, as can Scuba divers underwater. Sign Language is hugely beneficial not only to the Deaf or hard of hearing community, it also has other uses. “Many Deaf children nowadays, got to main-stream schools, there is no need for them to go to a Special school, and many schools have persons who can sign and therefore interpret things to and for the children.” (2012) Squidoo. Using Sign Language to Communicate. [Online] Available from: http://www.squidoo.com/using-sign-language (Accessed 31 October 2012)
An example of health care workers using Sign Language; Mrs Smith comes into Hospital after falling and breaking her hip. She is very upset. Staff are immediately suspicious that Mrs Smith may have a potential broken hip. Mrs Smith cannot speak but can convey immediately to staff that she is in a lot of pain. The Doctor overseeing Mrs Smith in the Accident and Emergency department of the Hospital sees that Mrs Smith’s daughter has accompanied her in the ambulance and speaks to her; Mrs Smith’s daughter knows Sign Language and can translate and interpret for the Doctor and relay this information back to Mrs Smith. Mrs Smith is therefore informed at all times as to what is happening. Sign Language is undoubtedly an extremely useful tool, both for Deaf and hard of hearing but also for others who may not be able to communicate either orally or indeed any other way due to their environment.
Makaton
Makaton is “a language programme using signs and symbols to help people to communicate. It is designed to support spoken language and the signs and symbols are used with speech, in spoken word order”. (2012) The Makaton Charity. [Online] Available from: http://www.makaton.org/aboutMakaton/default. (Accessed 01 November 2012)
Signs, speech and symbols can all used in Makaton to help communicate.
“Makaton was developed in the early 1970s in the UK for communication with residents of a large hospital who were both deaf and intellectually disabled. The name is a blend of the names of the three people who devised it: Margaret Walker, Kathy Johnston and Tony Cornforth”. (2012) Wikianswers.com. [Online] Available from: http://wiki.answers.com/Q/Who_invented_makaton. (Accessed 2nd November 2012).
Makaton is used primarily by persons with learning and communication difficulties as their main form of communication. Relatives and carers of persons with learning and communication difficulties also use Makaton. Makaton is an internationally recognised language in its own right. “Makaton was first developed by identifying the words that are used most frequently in everyday conversation. After this, signs from British Sign Language ("BSL") were matched to these words, so that a person is able to speak and sign at the same time. Makaton users are first encouraged to communicate using signs, but then as a link is made between the word and the sign, the signs can be dropped and the speech is allowed to take over. (2005-2010) Douglas Silas Solicitors. [Online] Available from: http://www.specialeducationalneeds.co.uk/UsefulInformation/SEN-EducationInfo/Makaton.html (Accessed 2nd November 2012).
If you had a child with a learning or communication difficulty and therefore couldn’t tell you what he or she wanted, they could point to a symbol, i.e. food or drink of water. These same symbols could be pinned up around the child’s environment to allow the child to point at and therefore communicate their needs or wants. Of course, the child needs to have a basic understanding of what they are pointing at, this could be taught with the aid of pictures and signing Makaton. Some people may use Makaton for a short period of time until they grasp how to speak but others may have to use Makaton for the rest of their lives.
Braille
“Braille is a series of raised dots that the blind or partially sighted feel with their fingers, Braille consists of patterns of raised dots arranged in cells of up to six dots in a 3 x 2 configuration. Each cell represents a letter, numeral or punctuation mark. Some frequently used words and letter combinations also have their own single cell patterns”. (1998-2012) Omniglot.com. [Online] Available from: http://www.omniglot.com/writing/braille.htm (Accessed 05 November 2012).
Braille gives the blind and partially sighted persons the ability to communicate with others, they can “read” Braille and in fact they can “write” in Braille. There are mechanical machines out there that blind or partially sighted persons can use. They operate in much the same way as a typewriter, i.e. there are buttons to press but they are in fact producing raised dots on paper. There are computer keyboards as well that can allow a person to type in Braille. Braille is used in everyday situations; it is used on lift buttons, medicine labels, toxic chemicals and household cleaners. There are raised dots on potentially dangerous products that partially sighted or blind people can feel and know exactly what they are touching. This promotes empowerment for the blind and partially sighted, they no longer have to rely on someone else to read out aloud to them, they can in fact, communicate for themselves.
Interpreter
“An interpreter is a person who provides an oral translation between speakers who speak different languages”. (2012) Dictionary.com. [Online] Available from: http://dictionary.reference.com/browse/interpreter?s=t (Accessed 05 November 2012).
An interpreter can act as a go-between between a client and a practitioner; they can translate the language the client is speaking and relay it back to the practitioner. The interpreter can then listen to the practitioner and relay their words back to the client. The interpreter is usually fluent in his or her chosen language. An interpreter may also converse in Sign Language and therefore can communicate to persons with hearing difficulties; they can then translate Sign Language back into verbal words for the practitioner. Interpreters are indeed fluent in multiple communication tasks and may work in all kinds of care settings as there is a platitude of multi-cultural clients in every care setting.
All the above are tools that allow communication to take place, whether it is visual, tactile, written, oral, or aural.
Values of care
A care value is an “ethical code which governs how caregivers ought to act in certain situations within a health or social care setting, to be certain that they are not discriminating, violating people's rights, or providing poor care for their clients”. (2005. pp. 42-60) Moonie, Neil; Windsor, Gwyneth.
When practitioners are communicating with clients, who use services, they have a duty to ensure that communication is made as clear as possible, i.e. that clients understand what is being communicated to them, whether it be through written or verbal, or in fact any other kind of special communication mode. Practitioners need to also make sure that they themselves understand what the client is trying to say to them. Practitioners need to read verbal and non-verbal signs from the client. They need to make sure that they know how to comfort a client who may be upset, sad or angry. They need to be supportive, reassuring and sensitive to their client’s needs at all times. All this is done by using the relevant communication skills. We need to remember that everyone is different and that we all do things in different ways, this is the same with clients, we may be able to do one thing with one client who is sad but we may find that we cannot use the same technique with another client, we need to understand that clients are all individuals. Service users may have personality traits or characteristics that may make them difficult to deal with or indeed very easy to deal with, we may indeed have our own characteristics, as health care professionals, we need to make sure that we do not allow our own personal values, beliefs or opinions to interfere with the care we give to a client. Every client deserves the right to be treated with dignity and respect. They also have the right to access services that are correct for them. A client has the right to their own beliefs, i.e. they have the right to attend their own place of worship, and they have the right to eat the food that they wish to eat. They also have the right to live at home and live an independent a life as possible, with the support of the most appropriate care package that has been tailored to their individual needs. Values of care are borrowed from Human Rights.” Values are beliefs that people hold that allow persons who use services to be in control of their own lives”. ( Fisher et al 2012).
Care settings have anti-discrimination policies in place to ensure that staff is knowledgeable in ways to communicate with service users that do not discriminate against them. There are eight individual guidelines. Support staff needs to ensure that when interacting with clients they: * Give individual help and assistance * Accept dialects or variations in language * Are aware of any religious views or spirituality * Celebrate diversity * Use a multi-cultural approach * Do not stereotype * Challenge discriminatory behaviour * Make sure there is full inclusion for all
Practitioners are bound to treat clients as above. There may be a great mixture of diversity in care settings, everyone is different and also clients come from many different cultures. We need to be aware of this when treating clients. We cannot treat everyone the same, as client’s needs are all different, but we must ensure that we apply all the above principles at all times to our interactions.
When a client is being treated, he or she has the right to say “no”. They do not have to accept any treatment or care planned for them. They can say no to any food that is offered, they can also complain if they feel like they are not being treated as they should be. We absolutely cannot enforce our own views or opinions on clients, a client has the right to be listened to, we must as health care professionals “respect” our clients as individuals, as stated in our basic Human Rights.
We also need to maintain confidentiality at all times.
“Client confidentiality is the principle that an institution or individual should not reveal information about their clients to a third party without the consent of the client or a clear legal reason. This concept is commonly provided for in law in most countries”.
(2012) Wikipedia.org [Online] Available from: http://en.wikipedia.org/wiki/Client_confidentiality. (Accessed 05 November 2012).
When a client enters a care setting, their most private and personal information is written down for health care professionals to see, it is imperative that nobody else sees this most personal record. As stated before, “The Data Protection Act” allows for complete confidentiality. Practitioners must also ensure that they do not discuss this private information with anybody, i.e. a relative of friend of the practitioner. A health care professional has a “duty of care” and this duty of care ensures that a client’s record and personal information is kept as confidential as possible. Most professional bodies have their own confidentiality policy in place. For example; if a client had a meeting with a health care professional and it was discovered that the client was suffering from a communicable disease, the health care professional would have a duty of care to report this.
“There is a clear public good in having a confidential medical service. The fact that people are encouraged to seek advice and treatment, including for communicable diseases, benefits society as a whole as well as the individual. Confidential medical care is recognised in law as being in the public interest. However, there can also be a public interest in disclosing information: to protect individuals or society from risks of serious harm, such as, serious communicable diseases or serious crime; or to enable medical research, education or other secondary uses of information that will benefit society over time”. (2009) http://www.gmc-uk.org [Online] Available from: http://www.gmc-uk.org/static/documents/content/Confidentiality_0910.pdf. (Accessed 05 November 20212).
I have used the General Medical Council confidentiality policy as an example. This is the regulatory body for General Practitioners. Doctors have a right to protect a client’s confidentiality as much as is possible, unless there are circumstances, such as above, that may require the practitioner to disclose that confidential information.
“Action must be taken quickly, for example, in the detection or control of outbreaks of some communicable diseases, and there is insufficient time to contact the patient”.
(2009) http://www.gmc-uk.org [Online] Available from: http://www.gmc-uk.org/static/documents/content/Confidentiality_0910.pdf. (Accessed 05 November 2012).
The Doctor in the example above is required “in the public’s best interest” to disclose that his patient has a communicable disease, this is to make sure that the disease is not spread to anyone else. This is a good example of a health care professional disclosing something that is told in confidence. Of course, there must be an extremely good reason for the health care professional to do so. They will be guided by their regulatory body policy and indeed their care setting may have its own confidentiality policy in situ as well.
Many practitioners in their professional lives will come across many moral dilemmas, for example, Mrs Smith aged 83 has a serious heart condition and wishes for no medical intervention, should she suffer another heart attack. Mrs Smith has had several heart attacks and every time she has been treated successfully and in time. Mrs Smith now wishes to be left to die, should she have another heart attack. This in itself provides a moral dilemma for practitioners, to leave a client to die goes against everything that they have been taught. Of course, clients must not suffer, so Mrs Smith should be given painkillers to alleviate pain and any other drug that may help settle her, but no drug should be given to promote or prolong her life. Mrs Smith should be made comfortable and kept as pain free as possible. Practitioners have to accept Mrs Smith’s opinion; it is the client’s wish that she should not be resuscitated. Mrs Smith is of sound mind and is perfectly capable of making her own decisions. She has documented in her care plan that she does not wish to be resuscitated in the event of a heart attack. Mrs Smith’s family are aware of her wishes and have reluctantly accepted them although they are not happy as they want her to be around for as long as possible, Mrs Smith does not want to be kept alive, she feels that she has “ had a good run and that her time is up when it is up”.
Health care workers have to respect client’s wishes at all times. It may not please staff that Mrs Smith does not wish to be resuscitated, but as health care practitioners, we have to respect our clients thoughts and feelings all times and we have to do as our client wishes, regardless of our own personal thoughts and feelings.
Values of care predicate any form of communication. Values must also be enforced at all times when caring for any service user, regardless of sex, age, gender or race.
Factors that can support or inhibit communication
There are lots of factors that can support and also inhibit communication. We use non-verbal signs subconsciously when we are communicating with a client. Non-verbal simply means not verbal, i.e. not spoken or using words. It is also called “body language”. ” It is a natural, unconscious language that broadcasts our true feelings and intentions in any given moment, and clues us in to the feelings and intentions of those around us”. (2012) Jeanne Segal, Ph.D., Melinda Smith, M.A., and Jaelline Jaffe, Ph.D. Helpguide.Org [Online] Available from: http://www.helpguide.org/mental/eq6_non-verbal_communication.htm (Accessed 26 October 2012).
We need to ensure that we use non-verbal signs such as smiling and touching to help “engage” a client, words would not be any use on their own, we need to keep a client interested in what we are saying, if we smile and use expressive hand gestures and maintain eye contact, a client would be more likely to give us their complete attention. We need to ensure that we gain a client’s trust. Trust is important as a client would be more inclined to confide in a health care worker if they trusted that person. If the client had a hearing, sensory or other health issue, we would try to use another form of communication. Non-verbal signs effectively “support” any other form of communication. We need to make sure that we use non-verbal signs as effectively as possible to ensure that all forms of communication are supported. The 7 main types of non-verbal communication are: * Touch - we need to touch a client appropriately, for example, shaking their hand when we first meet them, or even holding their hand when a client is upset, of course, we have to take our cue from the client, if a client wishes no touch at all, then we as carers, have to respect that. It is our job as a health care worker to get to know the client and find out what he or she likes. * Facial expression – we need to use the appropriate facial expression to communicate to our clients. A smile should be something that a carer does a lot of, nearly everyone responds to a nice happy face. Alternatively, if a client is sad or upset, we can read their body language and it can tell us if they are sad, even if the client cannot communicate this orally. A client would not be at ease with a health professional if he or she had an angry face. * Posture – how we hold ourselves says a lot, for example, if we are leaning towards a client, then this can tell the client that we are interested, if we were looking down at the floor, we may be bored or lack interest. This can be reversed, as can all types of non-verbal communication and the client can communicate boredom or interest back to us through their non-verbal communication. * Eye contact – the way we look at a client is important, eye contact is probably the most important of all non-verbal signs as it is difficult to hold a conversation with a person if you cannot see them. Our eyes portray our feelings, for example, anger, happiness, sadness. A client could be rolling their eyes with boredom or lack of interest; it is our job, as health care workers to notice these things. * Gestures – we wave, point, and beckon to people probably every day of our lives. We also gesticulate with our hands when we talk. This seems to be an unconscious movement as we do it without really thinking about it. We can use our hands to sign to people. Our hands are very important in communicating, whether it be by gesticulating, or using our hands in a conversation with a hard of hearing person. * Tone of voice – we need to be aware of “how” we speak to people. We cannot use strong tones when we are trying to convey kindness and compassion. We need to be aware of our voice tone at all times. We also need to use hushed tones when talking to someone who may be upset. A client can feel at ease when a health care professional uses the correct tone of voice. * Physical space – we all have our own defined “space” around ourselves when talking to a person. We are more comfortable with people we know well and therefore allow them to come closer to us whilst holding a conversation. We can all be a bit uncomfortable when a stranger comes to close to us, thus “invading” our personal space. We need to bear this in mind with clients, we cannot “invade” their personal space, indeed, we cannot be too far away from them either, especially if we need to try and communicate something to them. Positioning can also be a supportive or inhibitive factor in communication. We need to ensure that we are sitting close to our client but also ensure that we are facing them so we can see them. If we were too close, we could potentially be invading their personal space. If we are too far away from a client, we would have problems hearing them, and they would have problems hearing us. We need to ensure we are sitting at the correct comfortable distance from our client.
The environment can also be a barrier to effective communication. According to the National Centre of Audiology, “some of the factors that affect communication are as follows: * Poor lighting * Noise * Distance”
(2012) Wikianswers.com. [Online] Available from: http://wiki.answers.com/Q/Environmental_factors_that_affect_communication (Accessed 21 November 2012).
We would not be able to hear our client or concentrate fully on them if we had background noise happening, for example, a building site outside and sawing or hammering happening. Noise can be very off-putting and affects our ability to concentrate. If we were in a room that was too dark, we would not be able to read any notes, now would we be able to see our client. Good lighting is required at all times.
We need to ensure that at all times; we are using the most appropriate form of communication for our client. The client’s needs must be met at all times. We must also ensure that we can understand the client at all times. The content of the communication should always be tailored towards the client. We need to use all our skills as a health care worker to provide the best possible care that we can for our client at all times.