Communication Principles, Techniques and Strategies used in Health and Social Care Settings - Term Paper Example

Communication Principles, Techniques and Strategies used in Health and Social Care Settings In all health care settings, the use of good communication skills is what ensures that patients are able to receive the care that they require. In healthcare settings, communication is used to increase the medical practitioner or patient’s awareness of a health related problem and define its solution. Communication can also impact the attitudes of patients while also demonstrating the abilities of medical practitioners. People can communicate verbally by use of words, or non-verbally by means of gestures or facial expressions. Communication breakdown is something that can result in dire consequences such as misdiagnoses, increased pain for the patient, extended stays in hospital, and errors in drug treatment (Shannon, Long-Sutehall, and Coombs 2011). In the worst case scenario, miscommunication could result in the death of the patient. In the case of Anne, who suffered from a stroke, delayed communication in the period between the moment when she first felt unusual symptoms and when she reached the hospital caused her to suffer a stroke. If her husband Paul had been successful in reaching an ambulance or other medical firm and enabled her to reach the hospital in time, this could have been averted. However, Paul, Anne’s husband, was unsuccessful in reaching the ambulance. In addition, when she finally reached a hospital, Anne was left unattended for approximately four hours. During this interlude, her face sagged on one side and she lost control of her bodily functions. It does seem that the attitude of the medical professionals concerned was shockingly callous. However, it is more likely that they simply were unequipped with the right coping skills for dealing with the extreme stress that is often encountered in the medical field. The medical emergency number dialled by Paul may have been disconnected. However, it is more likely that the line was busy and there were many people trying to use it at the same time. On his arrival at the first hospital, Paul and Anne may have walked in at a time when all medical professionals were busy attending to serious cases; thus the lack of attention for the first four hours. In addition, the doctors were probably strained after a hard day’s work. This is not a suggestion that their attitude was excusable; however, it is important to point out that medical practitioners deal with extreme stress on a regular basis. When they are not equipped with coping skills that allow them to be able to find expression for negative feelings, the way in which they make decisions or even attend to and communicate with potential patients could be severely affected (Dysart-Gale 2005). The miscommunication, in this case, resulted in Anne needlessly suffering from a stroke even as she sat in a hospital. In the case of Elaine Bromiley, from http://www.youtube.com/watch?v=JzlvgtPIof4, a routine sinus surgery resulted in the death of the patient. Essentially, her anaesthetist effectively caused her death when he neglected to place a laryngeal mask over the patient and instead chose to use ventilation by means of bag and mask which was quite inadequate. There were further efforts to effect intubation even while the patient’s pO2 remained at less than 40% throughout this period. The attending doctors, all of whom were considered as professionals, then chose to opt for their patient being given the opportunity to wake up by herself. Ms. Bromiley remained lifeless and was finally removed from life support. In this case, there were different issues that resulted in Elaine Bromiley’s demise in the hands of qualified surgeons; one of whom, as an ENT surgeon, had more than 30 years of experience. In the first place, there was the lack of situational awareness. The consultants were concentrating so much on ensuring that the patient was successfully incubated that they momentarily forgot about keeping track of the rest of the patient’s body functions. In addition, Mrs. Bromiley may have survived if there was a leader of the group who oversaw all procedures and facilitated communication between the different specialists in the room. A leader, for example, would have pointed out the importance of following the clinical guidelines before the consideration of the process of endo-tracheal intubation. However, from the video, the most obvious sign of the failure of communication concerned the nurses and their seniors who were the consultants. A factor that affects how different levels of professionals relate with each other in workplace settings is the absence of inter-professional understanding. Sometimes, medical professionals do not appreciate the roles of other medical professionals- particularly if these other professionals happen to hold junior positions (Varprio, Hall, Lingard, and Schryer 2008). For example, the different educational experiences of nurses and doctors can contribute towards each of these parties having a lack of insight into each others responsibilities (Leonard, Graham, and Bonacum 2004). From the video, it is evident from the shocked faces of the nurses who entered the room some time after the first efforts of intubation were underway that they considered this process to be wrong. They even quickly brought surgical equipment for clearing the airway into the room. What is most startling, though, is that they appeared unable to correct the consultants. It is an established fact that most hospitals have their own hierarchies (Heaven, Clegg, and Maguire 2006). Consultants are considered to be more knowledgeable than nurses; and thus had the right of way. Even though the nurses knew that what was happening was the wrong way to correct the situation, they were unable to express their feelings freely to their seniors. Miscommunication does not just occur between junior and senior level medical officials (Street, Slee, Kalauokalani, Dean, Tancredi, and Kravitz 2010). It can also take place in the course of physician-physician exchanges. In Mrs. Bromiley’s case, there were several experts overseeing the process of intubation. Naturally each of these individuals may have felt strange about what was taking place. Each of them had the opportunity to question each others’ actions but chose not to. However, the most common cause of miscommunication in hospitals can be attributed to hierarchies. Hospital hierarchies can actually increase the chances of poor communication taking place in some level of the vertical structure (Priest, Sawyer, Roberts, and Rhodes 2005). For example, it is not uncommon for residences to avoid occasionally asking for assistance from attending doctors even though they would be well within their right to do so. Nurses also follow the same routine and tend to avoid ‘bothering’ physicians with seemingly ‘easy’ questions. As all these medical practitioners have to cooperate when attending to patients, it is inevitable that it is the patients who will suffer from miscommunication (Hall 2005). The existence of poor communication can also hold back the advancement of potential collaborative efforts in terms of medical discoveries and technologies. Delayed communication between medical practitioners is also considered to be as hazardous as the complete lack of communication because it brings about similarly disturbing results (Puntillo and McAdam 2006). The proper orchestration of various events by numerous nurses and doctors is primarily dependent on the timely sharing of information between different types of medical practitioners. In incidences where this function is hampered, there will likely be serious consequences; as happened in the case of Elaine Bromiley. Understanding how values and cultural factors influence the communication process in health & social care How a person reacts to others as well as to situations in different settings is something that is dictated by his or her cultural background (Reader, Flin, and Cuthbertson 2007). In a healthcare sector, when the patient and the medical practitioner both come from different cultural backgrounds, the nurse-patient connection could be adversely affected unless definite steps are taken to address the different perceptions that each of the parties have. A person’s expression of his or her inner feelings or even the consideration of the appropriateness of his or her non-verbal or verbal expressions in a medical setting will also be determined by his or her culture. It is very important for medical practitioners to be aware of how their individual belief systems affect their reactions to patients. This is particularly important when the nurse is from a different cultural background from his or her patient. In most cases, it is a fact that nurses and doctors have to set aside their inbred ideas and attitudes aside so as to ensure that their dispensation of healthcare is not negatively affected. This, however, takes place over a long period of time. In the case of the young English student nurse who was being mentored during her initial exposure to a practical medical setting, her culture affected her reactions to the less touted functions of nursing. It would be easy to decide that her seemingly inexcusable conduct towards the Arab patient who was recovering from a hysterectomy was as a result of personal indiscipline. However, the reality is that, being from the English society, she is more likely to have been encouraged to openly express any feelings, good or bad, that she had when she was growing up. Even if the British believe that they are more reserved than other Westerners like Americans, they still have a fairly open and communicative society than most of the world’s cultures. The mentee was first accused by colleagues of being belligerent and not keeping time. She then openly expressed her disgust the thought of having to clean up her patient’s bodily discharges in front of her patient. She literarily refused to touch the patient’s soiled clothes and went to ask another medical assistant to help the patient. When her mentor pointed out the errors she was making, she in turn accused him of bullying her. It would seem that the young English nurse was brought up in a culture that encouraged people to openly express their feelings; even at the expense of hurting or upsetting others. In addition, it is evident from the reactions of the young English nurse that in her culture, bodily functions are not discussed in public or even thought about a lot of the time. They are considered to be a taboo subject that should remain a personal matter. Also, it does not seem that the new nurse was properly schooled by her mentor on what to expect as a nurse, or how to deal with her feelings of disgust when she was faced with having to deal with the more unsavoury realities of nursing. It actually seems that the young nursing student suffered from some form of ‘culture shock’ when she first entered the hospital. Cultural shock is descriptive of the process of experiencing mental as well as emotional characteristics such as uncertainty, fear, and confusion when first exposed to a new culture or work culture (Liu, Mok, Wong, Xue, and Xu 2007). There are different factors that can affect the level at which a person experiences culture shock in a work setting. Some of these factors include demographic characteristics, the lack of proper training, the extent of organisational support, and the new medical worker’s level of technical competence. In the first stage of shock, the worker has a feeling of euphoria at the idea of being immersed in a new culture (Suter, Arndt, Arthur, Parboosingh, Taylor, and Deutschlander 2009). In the subsequent stage, the worker rejects new operations in the new settings as he or she is not accustomed to them and they do not make sense. In the next stage, known as the adjustment phase the worker will begin to miss the familiarity and simpler practices of his or her former environment. In the last stage of culture shock, which is identified as the recovery stage, the worker comes up with personal strategies on how to best deal with the challenges of his or her new environment. He or she also accepts the new environment and makes the decision to stop isolating him or herself from the new colleagues. Cultural shock, even though bewildering to an individual, should not always be considered to be a bad or negative thing. According to Kissane, Bylund, Banerjee, Bialer, Levin, and Maloney (2012) it can actually improve a person’s learning experience and increase his or her self-efficacy. For the young English student to be able to provide quality care, her colleagues as well as mentor has to allow her to go through the different stages of acculturation while also providing her with constant training on her to deal with challenges in her new work setting. It would be something to cause concern if, as any normal human being, the new nurse did not have normal reactions to the bodily discharges of other grown human beings. However, the key to becoming a good and efficient nurse is to learn how to conquer her fear and disgust of these functions in a timely manner and learn how to communicate with her patients in a way that does not leave them feeling disempowered. There is a great need for her mentor to give proper informal training on a daily basis so as to help her with this process. Nurses, by reason of their profession, are forced to deal with many stomach churning incidences on a daily basis (Levinson, Lesser, and Epstein 2010). These incidences may include having to clean or wipe blood, pus, spit, urine, phlegm, saliva, vomit, faecal matter, or even spilled medicine from their patients’ bodies or from surfaces. Normal people do not have to deal with the stress of handling such things daily. To stop themselves from feeling overwhelmed, it is therefore important for nurses to learn ways of keeping what is important in focus while learning practical steps on how to stop themselves from vomiting or passing out when they encounter things that they may feel disgusted at (Williams, Silverman, and Schwind 2007). The benefits of IT to the health and social care worker In the health sector, information technology is often used to create ways of ensuring patient safety while also enhancing nursing efficiency. Patients tend to favor health care institutions that emphasise on ensuring efficiency, safety, and user satisfaction (Greenberg, Regenbogen, and Studdert 2007). The use of information technology methods can also result in lesser numbers of errors in terms of prescriptions as well as treatment suggestions, while improving decision-making among medical practitioners. Information technology is also important because it ensures that there is better communication as well as improved documentation. There is a great need for IT techniques that can be used to affect healthcare operations in ordinary ways. The use of IT would also successfully eliminate the delays in the delivery of healthcare that are often caused by interruptions and disruptions (Gutheil and Heyman 2005). It would also greatly reduce the amount of time that nurses tend to spend in indirect patient functions which remove focus from time spent in genuine patient care. Examples of duties that keep nurses from patient care operations include the confirmation of medication orders, patient-admission duties, the preparation of prescriptions, incident reports, charting, telephone follow-up to relay the results of tests, work requests, dietary ordering, patient transportation, procedure scheduling, the restocking of supplies, housekeeping, competency training, and holding discussions about the progress of patients with visitors and other family members (Bylund, Brown, Gueguen, Diamond, Bianculli, and Kissane 2010). In the healthcare sector, IT constitutes of a variety of new technologies that are created to manage and dispense health-related information to various healthcare stakeholders. The simplest available kind of health IT arrangement is one that electronically gathers, stores, and manages all aspects of health information regarding patients (McCabe and Timmins 2006). When correctly utilized, this system is able to reduce the incidence of errors, successfully organise patient care, and enhance administrative competence. The electronic health record IT structure is able to share patient information among different institutions in large information networks. This allows EHR systems to be able to accumulate patient information, while allowing doctors to be able to record patient care orders. Another healthcare based system of IT is known as the CPOE (Computerised Physician Order Entry). It is a significant part of the EHR system (Stewart, Brown, Hammerton, Donner, Gavin, and Holliday 2007). The CPOE allows doctors to be able to digitally order for tests as well as medications, thereby increasing the potential errors that may result from manual ordering. The CPOE network can easily assess prescription orders for accuracy and prevent suspicious order from being supplied. According to a research study documented by Back, Arnold, Baile, Fryer-Edwards, Alexander, and Barley 2007, in matters concerning prescription accuracy, CPOE systems can effectively prevent errors by approximately 55%. In recent times, there has been increased focus, within the healthcare sector, on initiatives created to ensure that there is improved patient care. This has resulted in the discovery of advanced new technologies in different medically related disciplines. Some of the more common types of medical technologies include: The Clinical Decision System (CDSS): This is a computer system that is often used by medical practitioners in determining issues concerning patient diagnoses, or the evaluation of patient data. The CDSS also improve efficiency by connecting doctor’s observations with the available information about patient symptoms. In healthcare, the CDSS system is tasked with the deliverance of significant quality medical evidence that is focused on disease management as well as the regulation of that data. This ability then improves the process of delivering treatment as well as operating margins. The Picture Archiving and Communication System (PACS) Radiology is an essential healthcare-related procedure which assists medical personnel to be able to determine the correct treatment for their patients. The Picture Archiving and Communication System makes it possible for technologists and radiologists to be able to control images so that they can correctly visualize the patient’s anatomy when trying to determine the presence or absence of any pathology. The PACS system also allows for numerous images to be taken. It is also able to establish links with other diagnostic centers situated in different geographical locations around the world; and thus make it possible for the transfer or sharing of patient information. PACS systems have the necessary software that permits radiologists to be able to observe numerous same plane images concurrently. For radiologists, this is extremely useful because they are able to view the patient’s anatomy alongside the suspected pathologies. The Frequency Identification (RFID) Frequency identification technology in the medical sector is important because it allows patients to have chips which hold their medical information on their own bodies. This makes it relatively easy for doctors to be able to access it. In addition, radio frequency identification implements such as chips also have the patient in question’s patient ID number, demographic information, hospital code, and ward number. The Automated Dispensing Machine The Automated Dispensing Machine is an appliance which medical personnel can use to retrieve prescriptions for their patients once they have been approved by pharmacists. With the fast-paced advance of technology in the medical sector, there is a bigger push for pharmacy operations and functions to be automated. Automatic dispensing systems are able to adequately perform dispensing tasks. The Electronics Materials Management The system of electronic materials management enables medical practitioners to be able to efficiently perform duties concerning the procurement and management of different health care resources. In addition, it is mainly through the electronics materials management systems that managers in the healthcare sector are able to learn about acquiring cost-effective purchases, as well as how to sparingly use the existing medical equipment and supplies. 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