Communicating in Health Care - Chapter 1

Communicating in Health Care - Chapter 1

• Learning Objectives:
  • Discuss the importance of rapport and confidentiality with patients.
  • Discuss the elements of communication.
  • Differentiate between verbal and nonverbal communication.
  • List the steps in effective communication.
  • Discuss the responsibilities of healthcare professionals and patients in the communication process.
  • Explain the purpose of maintaining a professional distance and using empathy in patient care.

Importance of Communication in Healthcare

• Communication is a vital and critical skill.
• It effectively transmits needs and wants.
• It forms important relationships, usually of mutual trust and regard.
• Communication transmits information to and from providers and patients.

Patient Confidentiality and HIPAA

• Patient-provider confidentiality is crucial and included in every specialty's code of ethics.
• HIPAA (Health Insurance Portability and Accountability Act of 1996) is a federal law that protects patient health information.
• Disclosure of patient information requires authorization.
• Protected Health Information (PHI) can be identified with an individual.
• It's the responsibility of healthcare professionals to protect PHI and not disclose to anyone without patient permission (including family).
• Professionals may only use the minimum necessary PHI to care for the patient.

Elements of Communication

• Message: The idea or information to be conveyed.
• Sender: The initiator of the message.
• Channel: The method of communication (verbal, nonverbal, or written).
• Receiver: The intended recipient of the message.
• Feedback: A response indicating whether the message was understood.
• Clarification: A request for more information.
• Verification: Confirmation of understanding by the receiver.

Verbal Communication

• Oral Communication: Spoken words, everyday speech, slang, idioms, colloquialisms, and jargon (unique to a profession).
• Written Communication: Medical notes, memos, letters, and faxes.

Nonverbal Communication

• Body Language: Exchanging messages without words (e.g., gestures, posture, facial expressions, eye contact).
• Paralanguage: Sighing, humming, laughing, volume, pitch, and tone. Nonverbal cues can be more important than verbal exchange and can indicate if a patient is not telling the truth. Inconsistencies in nonverbal cues can lead to communication breakdowns.
• Kinesics: Body movements, gestures, posture, and facial expressions. Eye contact can have different meanings in different cultures.
• Proxemics: Physical closeness and spatial awareness. Personal space can vary by culture and may be affected by smells or presence of infection control measures. Touch can show concern or compassion but could also be considered assault in certain situations.

Communicating with Patients

• Therapeutic Relationships: These benefit patient health (physical and mental) and are built on respectful interaction. They aim to fully understand the patient's needs, and communication is key for patient compliance.
• Dynamics: The psychological background and inner workings of interpersonal relationships are important considerations in communication.

Steps in Communication Process

• Preparatory: Introduces participants, forms mutual agreement to exchange information.
• Maintenance: Focuses on the task at hand, keeps the exchange on track.
• Termination/Conclusion: Achieves successful exchange, both parties are satisfied. Goals of the patient are achieved.

Your Responsibility to the Patient

• Self-understanding is crucial before communicating with a patient. Assess your readiness for the healthcare demands.
• You are responsible for maintaining the conversation.
• Communication should be honest, ethical, legal, and within your scope of practice. You must honor the provider's instructions.
• Never share patient information without consent (HIPAA), even for family members.

Patient's Responsibility to You

• Active patients are more likely to follow instructions and communicate effectively.
• Be truthful and open about concerns.
• Provide a full medical history.
• Participate in self-care to the best of their ability.
• Comply with health care directions.

Addressing Your Patient

• Approach demonstrates professionalism (poise, appearance, actions).
• Respectfully address patients (use surnames with adults).
• Avoid pet names and refer to patients as individuals, not medical conditions.
• Balance friendly demeanor with professional distance.

Maintaining a Professional Distance

• Focus on the patient, not personal lives; patients have their own burdens.
• Steer communication back to health care if appropriate.
• Step back if tending towards friendships with patients.

Sympathy, Empathy, and Compassion

• Sympathy: Feeling sorry for another.
• Empathy: Experiencing the same feelings as another; drives compassion, taking action to alleviate patient distress.
• Compassion Fatigue: Exhaustion from caring for others; can impact physical and mental health.

Learning from Communication Failures

• Avoid establishing dependent relationships with patients, aiming for independence in self-care.
• Discourage dependence.
• Use successful therapeutic communication strategies in the future.
• Avoid clichés and idioms.
• Avoid imposing personal moral values.
• Be aware of kinetics and facial expressions.
• Be honest when unable to answer a question.