Professional Communication and Behaviour Lecture Notes PDF

PROFESSIONAL COMMUNICATION AND BEHAVIOUR Dr/ Sara Said Youssef Ali Assistant Professor at Faculty of Allied Medical Sciences Aqaba University of Technology Communication Skills In Rehabilitation PROFESSIONAL LECTURE (9) COMMUNICATION AND BEHAVIOUR...

PROFESSIONAL COMMUNICATION AND BEHAVIOUR Dr/ Sara Said Youssef Ali Assistant Professor at Faculty of Allied Medical Sciences Aqaba University of Technology Communication Skills In Rehabilitation PROFESSIONAL LECTURE (9) COMMUNICATION AND BEHAVIOUR Part (3)  Question ▶ What are the Roadblocks to Therapeutic Communication in The Patient’s Behavior? Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior Certain important behaviors can also impede, or serve as roadblocks to, the communication process. It is important for the HCP to be on the lookout for these behaviors. Often, as in the case of certain ineffective coping behaviors, The patient is probably not even aware that they are exhibiting these. In other instances, when the patient is angry or anxious, they may or may not understand what they are communicating. Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior 1- Ineffective coping behaviors Patients may sometimes behave in certain ways to protect themselves from feelings of anxiety, shame, or guilt. Compensation – When a patient does this, they compensate, or overemphasize, a certain trait or behavior in one area because they believe they must make up for what they perceive as a deficiency, or failure, in another. For example: The middle-aged obese patient who, despite the physician’s orders, does not exercise regularly or eat a healthy diet, nevertheless makes an elaborate show of telling the doctor and nurses that he has never missed a single dose of his cholesterol medicine. Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior Denial – This occurs when the patient attempts, generally unconsciously, to reject or deny the existence of feelings, needs, thoughts, desires, or even facts. The cancer patient whose diagnosis has been confirmed by blood tests, x-rays, computed tomography (CT) scans, and positron emission tomography (PET) scans still thinks the doctor might have gotten it wrong. Perhaps, this patient thinks, the medical staff has mistakenly confused their tests with those of another patient. Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior Displacement – This occurs when it is impossible for the patient to accept ownership of certain thoughts, feelings, needs, or desires, and attributes them unconsciously, to a more acceptable substitute - someone or something outside of the self. The father who is deep in grief after his child receives a cancer diagnosis would naturally feel anger as part of that grief; however, he does not understand what to do with this anger and so whenever he sees his child's doctor during an appointment, he is inexplicably hostile toward the doctor. Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior Dissociation – When this happens, the patient is attempting to disconnect the emotional significance of certain ideas or events from those ideas or events. The patient, for example, may relay an incident of childhood abuse that the HCP knows must have been painful, and yet, in the telling of the incident, the patient does not acknowledge the pain that must have been a part of the experience. Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior Identification – This occurs when the patient mimics the behavior of someone else in order to conceal their own natural behavior because they believe such behavior is inadequate. For example: A 16-year-old college tennis player has arrived at the clinic with his father, who sits impassively while the doctor explains to the young athlete that he has torn his rotator cuff, effectively ending the patient’s tennis career. The boy sits stoically and with a flat effect, or facial expression, while receiving this news from the doctor. The boy’s lack of an emotional reaction imitates what he believe is the correct response, taking his father’s behavior as an example. Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior Projection – This happens when the patient projects onto another person or object their own feelings, as if the feelings originated in the other person or object. For example, a patient who feels anger over some perceived adequacy in their care may not be able to own that anger but will instead accuse the HCP of being angry. Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior Rationalization – When a patient does this, they are using false reasoning to justify inappropriate or unacceptable behavior, hoping to make the behavior tolerable. For example, the patient who does not comply with the physician’s orders to show up for the Tuesday’s colonoscopy appointment may not admit that their failure to appear was because of fear but rather will change the subject and say that the HCP did not bother to ask whether the patient was free on that Tuesday. Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior Regression – A patient is regressing when they unconsciously return to immature, or even infantile, behaviors or thoughts. A patient may behave in this way when confronted with especially painful or difficult circumstances. Repression – This is when the patient simply puts out of their mind painful or difficult thoughts, feelings, ideas, or events. A patient who is confronted with a decision whether to undergo a difficult brain biopsy and then goes days without making a decision or even considering the options is repressing all thoughts of their condition. Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior Angry patients Patients can become angry for many reasons. They may believe that they have received inadequate care, been the subject of an unfair treatment, or been on the receiving end of some sort of personal slight or insult. They may be angry as a result of loss of control in the face of serious illness, or they may feel frustration over the illness itself. They may be angered by the behavior of another person. Or they may just feel that they have been the victim of ineffective therapeutic communication. As an HCP, you will need to be able to quickly identify anger in a patient. You will also need to be able to manage that anger in an appropriate manner. Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior Some steps that can help you in dealing with an angry patient include the following: Learn to recognize anger. Stay calm, stay respectful, stay genuine. Remember to stay focused on the patient’s physical and medical needs. Resist the urge to defend yourself in the face of the accusations from the patient. Encourage the patient to be specific when describing the reasons for their anger and what they think about those reasons. Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior Calmly and firmly present your point of view to the patient to help them understand what has happened. Be sure to follow through completely on any promises you make in addressing the problem, and do not make any promises you can not keep. Ask if the patient needs a few minutes alone to collect their thoughts and emotions. If you ever feel threatened by a patient’s anger or you fear that a patient may do you harm, leave the room immediately and seek the help of one of the physicians or other members of the healthcare team. Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior Anxious patients Patients can be anxious for just as many reasons as they can be angry. A patient may feel anxiety just because they are present in a medical practice, the so-called “white coat syndrome”. A patient may suspect they are ill but not be sure; a patient may know they are ill; a family member or loved one may be ill. In the same way an HCP needs to be able to recognize an angry patient, they need to be able to recognize the anxious patient. It is every bit as important to the care of the patient. Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior Following certain steps when managing anxious patients can help: Quickly identify the signs of anxiety in the patient. Acknowledge the patient’s anxiety to the patient. Use appropriate nonverbal communication. Maintain an appropriate distance and an open posture. Maintain appropriate eye contact. Listen attentively and empathetically, making sure to effectively paraphrase what the patient tells you. Identify possible sources of the patient’s anxiety: Perhaps a procedure they are about to undergo or test results they are about to receive. A patient who recognize that you understand the source of anxiety will more likely communicate with you. Roadblocks to Therapeutic Communication Part II – The Patient’s Behavior Make sure that the patient is as comfortable as possible physically. Determine what types of support the patient has, for example, family members or friends who are available and discuss those with the patient. Work to create a climate of warmth, acceptance, and trust. Control you own anxiety and remain genuine and truthful. Never minimize or make light of the patient’s anxiety, feelings, or thoughts. Try to help the patient cope with their anxiety by providing truthful information about the source of the anxiety. Notify the physician of the patient’s concerns. Communication with Other Members of the Healthcare Team – Your Colleagues The quality of your work experience will have a lot to do with how well you communicate with the other people at work. You and your colleagues are all members of the healthcare team whose shared purpose is to provide patients with the highest level of care possible. In fulfilling that purpose, you want to use the same good communication practices with your colleagues that you want to use with patients - tactfulness, courtesy, respect, empathy, genuineness, appropriate self disclosure, and assertiveness. Communication with Other Members of the Healthcare Team – Your Colleagues Always use an appropriate means of communication with co-workers There may come times when you need to resolve a dispute with a co-worker. The dispute may be work- related, or it may have a more personal aspect. If the matter is of such a serious nature (e.g., sexual harassment, quality of patient care concerns) that a supervisor should be immediately involved, do not hesitate to involve the supervisor. If the problem is less serious, you should generally first try to reach a solution with the other party rather than involving a supervisor. There is a good chance that you and the other party will be able to resolve your differences. For every matters in the medical practice, by far the most common means of communicating with others will be face-to-face. Some circumstances may call for email and others still for paper-based communication. Communication with Other Members of the Healthcare Team – Your Colleagues The appropriate attitude is assertive not aggressive Maintaining an assertive yet friendly manner of communication lets others in the workplace know that you are there to do your job as effectively as possible. Understanding what you believe is right and feeling comfortable and confident in asserting that will send a signal to your co-workers that you are someone who can be counted on to work hard in the service of patient care. Most conflicts in the workplace come about though misinformation or poor communication. Communication with Other Members of the Healthcare Team – Your Colleagues Always choose an appropriate time and place for important communication Remember to always be Considerate of your co-workers’ time. If you have an important matter to discuss with a co-worker and you believe it will take some time, show respect by asking if that co-worker has time available to make an appointment to talk. Communication with Other Members of the Healthcare Team – Your Supervisor In communication with other Members of the Healthcare Team – in this time your supervisor - How much you enjoy your job and how far your advance will have a lot to do with how effectively you communicate with your supervisor. As with patients and co-workers, you should use good communication practices. Communication with Other Members of the Healthcare Team – Your Supervisor Keep supervisors informed You must recognize early on that it is very important to keep your supervisor informed when anything goes wrong. Of greatest importance is the patient, and if you ever have a concern about the quality of patient care in your practice, you must let your supervisor know – immediately. If the concern is something less serious – such as disorderly conditions in some of the examination rooms’ cabinets; or even something purely office related, such as the breakdown of the copy or fax machine – you should let your supervisor know at an appropriate time. Informing your supervisor of these issues is important to the smooth running of the practice. In a larger, professional sense, though, informing your supervisor of these issues lets them know that you are someone who can be trusted to make sure that the practice is meeting patient care and work-place standards.  Communication with Other Members of the Healthcare Team – Your Supervisor Ask questions If you are ever unsure about the right thing to do, be sure to ask. It is always better to ask a question before acting than to act without asking and make a mistake. You might fear that by asking the question you will annoy your supervisor, and it is true that repeated questions about responsibilities and employee should already have mastered can be irritating. However, The risk of annoying a supervisor by asking a question is, in most cases, smaller than the risk of annoying a supervisor by making a mistake that could have been avoided by simply asking. Finally, where patient care is concerned, you should not take any risk: if you’re not sure, always ask. Communication with Other Members of the Healthcare Team – Your Supervisor Minimize interruptions of your supervisor's time You should show the same consideration to your supervisor that you show to your co-workers. If you have a matter you want to discuss with them, make the effort to make sure they have time. Ask them, “Do you have a couple of minutes to talk?” or “Is there a time I can talk to you?”. I have a couple of questions I want to ask. Finally, it is a good practice to save questions until you have a few you can ask at once, rather than repeatedly interrupting your supervisor during the course of a busy day. Behaving in this manner will indicate to your supervisor that you are thinking about effective professional communication practices. Communication with Other Members of the Healthcare Team – Your Supervisor Show initiative Keep your eyes and ears open at work. If you believe you have found a more effective or efficient way of completing some task, make it known to your supervisor in the appropriate manner. Your supervisor will appreciate your conscientiousness and will recognize in you someone who is working hard to provide the best patient care and for the good of the practice. ▶Thank You