Chapter 11 Patient Interactions (8ed) PDF

Chapter 11 Patient Interactions 1 Objectives (1 of 2) ˜ ˜ ˜ ˜ Identify qualities needed to be a caring radiologic and imaging sciences professional. Specify needs that cause people to enter radiologic and imaging sciences as a profession. Discuss the general needs that patients may have according to...

Chapter 11 Patient Interactions 1 Objectives (1 of 2) ˜ ˜ ˜ ˜ Identify qualities needed to be a caring radiologic and imaging sciences professional. Specify needs that cause people to enter radiologic and imaging sciences as a profession. Discuss the general needs that patients may have according to Maslow’s Hierarchy of Needs. Relate differences between the needs of inpatients and those of outpatients. 2 Objectives (2 of 2) ˜ ˜ ˜ ˜ ˜ Explain why patient interaction is important to patients, as well as their family and friends. Analyze effective methods of communicating with patients of various ages. Explain appropriate interaction techniques for various types of patients. Discuss considerations of the physical changes of aging with regard to radiologic and imaging science procedures. Discuss appropriate methods of responding to terminally ill patients. 3 Patients’ Needs ˜ ˜ ˜ ˜ ˜ ˜ ˜ Understand that if patients had a choice between visiting a nice restaurant and visiting the medical imaging department, they would naturally choose …! They are in an altered state of awareness. Fear of the unknown is profound. They fear loss of control. Emotions may be unnatural. Fearful of possible pain and discomfort. Apprehensive about exam results. 4 Emotional Intelligence Self-awareness ˜ Self -regulation ˜ Motivation ˜ Empathy ˜ Social Skills ˜ Securing a patient’s cooperation is one of the most important and challenging parts of your role as a radiologic and imaging sciences professional. 5 Your Personal Needs as a Technologist ˜ ˜ ˜ ˜ ˜ ˜ ˜ Helping others Working with people Making a difference Thinking critically Demonstrating creativity Achieving results Working with patients requires an understanding of one’s emotional intelligence. When personal needs are met, experiencing increased confidence in technical abilities as well, is not unusual. The patient often perceives this confidence as competence.… 6 Communications Skills Are Critical ˜ ˜ ˜ ˜ Understand what you’re walking into when greeting a patient. Understand and “have in check” your current emotions when working with patients. Your emotions should demonstrate caring and empathy for patients. Individuals with high Emotional Intelligence are said to be more successful on and off the job. 7 Maslow’s Hierarchy of Human Needs ˜ ˜ ˜ People strive from a basic level of physiologic needs toward a level of selfactualization. Each level of needs must be satisfied before an individual proceeds to the next level. Patients are often at the lower levels of Maslow’s hierarchy. See Figure 11.1 in the textbook for more information Fig. 11.1 Maslow’s hierarchy of needs. 8 Patient Dignity ˜ ˜ ˜ ˜ ˜ ˜ Deals with a patient’s self-esteem. Patients feel a strong loss of power over their fate. Embarrassing situation that they feel isolates them from others. Loss of privacy and access to loved ones. Feelings of guilt on several fronts. Referencing them in an impersonal, “slang” fashion: Ø BE patient, mammo patient, stomach patient, etc. 9 Initial Patient Interaction ˜ ˜ ˜ ˜ ˜ ˜ ˜ Patient Assessment. Use their name and ask preference for name. Confirm identity. Introduce yourself. Explain procedure in terms they can understand. Obtain a brief and relevant history. Obtain Informed. Consent, if required. See Figure 11.3 in the textbook for more information A patient’s family/friends should be viewed as an “extension” of the patient in terms of communication methods 10 Patient Classifications Inpatient Ø Ø Ø Ø Someone who has been admitted to the hospital for diagnostic studies or treatment. Generally occupy a hospital bed for 24 hours or longer. Move up and own Maslow’s hierarchy during stay. Previous hospital stay experiences often shape their attitude coming into medical imaging. Outpatient Ø Ø Ø Ø Someone who has come to the hospital or outpatient center for diagnostic testing or treatment but does not usually occupy a bed overnight. Often arrive to radiology with pre-conceived expectations. Usually have outside schedules or commitments to keep. Expect to be cared for on time, according to a scheduled appointment time. 11 Communication Is Critical to the Likelihood of Exam Success ˜ ˜ Communication and patient safety go “handin-hand. Effective communication is ESSENTIAL at all levels of the healthcare delivery system: Ø Ø Ø Written Oral Electronic 12 Communication Essentials ˜ ˜ ˜ ˜ Patient care communication must be patient focused. Communication needs to be accurate and timely. Always remember to consider communication and relating with patient’s family and visitors. As a technologist, communicate within your Scope of Practice. Ø Practice Standards of the Profession 13 Verbal Communication ˜ ˜ ˜ ˜ ˜ ˜ Spoken words Written words Voice intonation Slang and jargon Organization of sentences Humor 14 Nonverbal Communication ˜ ˜ ˜ ˜ ˜ ˜ ˜ ˜ Paralanguage Body language Touch Professional appearance Physical presence Visual contact Personal hygiene Body art See Figure 11.4 in the textbook for more information 15 Touch Three common forms of touch are used by the radiologic technologist See Figure 11.6 A in the textbook for more information See Figure 11.6 B in the textbook for more information See Figure 11.6 C in the textbook for more information 1. 2. 3. Emotional support Emphasis Palpation Before touching a patient, permission to do so should be obtained. Touching without consent can have legal ramifications. Fig. 11.6 Proper palpation is accomplished by using fingertips to provide precise and gentle localization information. (A) Proper use of a single fingertip. (B) Proper use of several fingers. (C) Improper use of the palm. 16 Common Patient Types ˜ Seriously ill and traumatized patients. Ø Cancer patients Ø COVID patients ˜ ˜ ˜ ˜ ˜ Visually impaired patients. Speech- and hearing-impaired patients. Non–English-speaking patients. Mentally impaired patients. Substance abusers. 17 Mobile and Surgical Patient Communication ˜ ˜ ˜ These unique patient care environments require special patient communication considerations. Begin by calling the patient’s name, identifying yourself and your qualifications to the patient, and explaining the procedure. Consider the patient’s visiting family and friends. 18 Communication with Patient Family and Friends ˜ ˜ ˜ Professionally introduce yourself. Briefly explain the procedure. Explain why they must leave the immediate area during exposure. Showing empathy is a very powerful tool when dealing with a patient’s families and friends. 19 Age as a Communication Factor ˜ ˜ ˜ Patient age must be factored into communication techniques. Age is not a barrier to effective communication. Effective communication strategies can be used to accommodate age-related challenges. 20 Age Groups ˜ Infant ˜ Adolescents ˜ Toddlers ˜ Young adults ˜ Preschoolers ˜ School-aged children ˜ ˜ Middle-aged adults Mature adults 21 Pediatric Patients (1 of 2) ˜ ˜ ˜ Come down to their eye level to speak. Talk softly and less authoritatively. Set up equipment before the child enters the exam room. See Figure 11.7 in the textbook for more information Fig. 11.7 “To stand tall in pediatrics, you have to get down on your knees.” Entering the child’s environment by squatting to the child’s eye level can begin a rewarding relationship. 22 Pediatric Patients (2 of 2) ˜ ˜ ˜ ˜ ˜ Soften room lighting. Avoid loud and dramatic equipment movements. Use gentle touch. Maintain eye contact. Use radiation protection methods and show them being used to family members, if present. Remember to Image Gently 23 Gerontology ˜ ˜ ˜ ˜ This age group is expected to rise in numbers for years to come. Referring to older patients as geriatrics is viewed as being inappropriate. Terms such as senior citizens and “Golden Agers” are also considered unprofessional. Treat these patients just like any other patient, regardless of age, with patience and respect. Ø ˜ Avoid using “childish language” The aging process itself is now divided into primary aging and secondary aging. 24 Physical Changes of Functional Aging ˜ ˜ ˜ ˜ Slowing psychomotor responses. Slowing of information processing. Decreased visual acuity. Decrease in senses. Ø These changes are most often seen in patients in their 80s and 90s. 25 25 25 Respiratory System ˜ ˜ ˜ ˜ Decreased cough reflex Shallow breathing Decreased pulmonary capacity Kyphosis 26 26 26 Musculoskeletal System ˜ ˜ ˜ ˜ ˜ Osteoporosis Arthritis Decreased muscle strength Atrophied muscle mass Fear of fractures 27 27 27 Cardiovascular System ˜ ˜ ˜ ˜ ˜ Decreased cardiac efficiency Orthostatic hypotension Arteriosclerosis DVT General feeling of tiredness 28 28 28 Integumentary System ˜ ˜ ˜ ˜ ˜ Loss of skin elasticity Change of skin texture Loss of touch sensation Diminished sensation of heat or cold Loss of subcutaneous fatty layer 29 29 29 Gastrointestinal System ˜ ˜ ˜ ˜ Loss of appetite Decreased secretions Decreased GI motility Decreased sphincter muscle control 30 30 30 Dealing with Older Patients ˜ ˜ ˜ ˜ ˜ ˜ ˜ ˜ ˜ Maintain eye contact. Speak clearly and more slowly. Speak to them, not away from them. Keep them warm if needed. Ask permission to touch. Demonstrate compassion. Ask them what makes them more comfortable. Explain thoroughly and keep them informed. Treat them with respect and patience. See Figure 11.4 in the textbook for more information 31 Terminal Patients (1 of 2) ˜ ˜ ˜ Understand that death is part of the cycle of life. Radiologic and imaging sciences professionals often deal with the dying process as part of acute death events. Radiation oncology staff deal with terminal patients often. 32 Terminal Patients (2 of 2) ˜ ˜ ˜ ˜ Society’s attitudes toward death and dying have changed to become more open and respectful of the terminal patient’s wishes and rights. Dying patients and their families and loved ones need to work through the grieving process in a natural and individualized timeframe. Advanced directives. Patient autonomy. 33 Five Stages of Grieving Process Denial and isolation ˜ Anger ˜ Bargaining ˜ Depression ˜ Ø Preparatory ˜ depression Acceptance 34 Conclusion (1 of 2) ˜ ˜ ˜ ˜ Communication skills are essential to good medical imaging. Increases likelihood of exam success. A good communication process is a closed loop. Communication strategies need to accommodate the uniqueness of each patient. 35 Conclusion (2 of 2) ˜ ˜ ˜ ˜ Patients enter the health care setting feeling vulnerable and outside their comfort zone. Medical professionals recognize these feelings and act with compassion and empathy for the patient’s welfare. Aging and terminal patients present their own set of patient care challenges. Caring and empathy are critically important to effective and compassionate patient care. 36