Communication and Diversity

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1 Communication and Diversity If there were one aspect of healthcare delivery an organization could work on that would have the greatest impact on patient safety, it would be improving the effectiveness of communication on all levels written, oral and electronic. Communication Process Message Receiver Feedback 1

2 Communication Essentials Communication must: be patient-focused be accurate and timely be respectful acknowledge the presence of family/visitors be within your scope of practice Verbal Communication Verbal Spoken words Written words Voice intonation Slang and jargon Organization of sentences Humor Non-Verbal Paralanguage Body Language Touch Professional Appearance Physical Presence Visual Contact Points to Consider Average American reads at the 8 th to 9 th grade level 44% over age 65 read at the 5 th grade level or lower 48% to 80% of patients age 60 and older have inadequate functional health literacy 2

3 Common Patient Types Seriously Ill and Traumatized Patients Visually Impaired Patients Speech- and Hearing-Impaired Patients Non English-Speaking Patients Mentally Impaired Patients Substance Abusers Age as a Communication Factor Must be factored into communication techniques not a barrier to effective communication Consider techniques that should be used for effective communication with special populations Age Groups Infant Birth to 1 yo Toddlers 1-3 yo Preschoolers 3-5 yo School-aged children 5-10 yo Adolescents yo Young adults yo Middle-aged adults yo Mature adults >65 yo 3

4 Pediatric Patients Come down to their eye level Speak softly and less authoritatively Set up equipment away from child Soften room lighting Avoid loud and dramatic movements Use gentle touch Maintain eye contact Use age appropriate words Play and distraction Offer valid choices when appropriate Physical Changes of Functional Aging Slow/impaired psychomotor responses Slowing of information processing Decreased visual/hearing acuity Decrease in senses Dealing with Older Patients Maintain eye contact Speak clearly and slowly Face the patient Keep them warm Ask permission to touch Demonstrate compassion Address their physical/elimination needs Explain thoroughly/keep them informed Treat them with respect and patience 4

5 Terminal Patients Society s attitudes have changed more open with the patient s wishes and rights patients/families work through grieving process Five Stages of Grieving Process Denial and Anger Bargaining Depression Preparatory Depression Acceptance Communication First contact should begin with an introduction Always use their name Ask how they prefer to be addressed Good morning Mr. Smith Hiya sweetie The gall bladder in room 2 Confirm against ID band two identifiers (Name and DOB) 5

6 Communication When calling them in use first name or last name only HIPAA Give choices when able to restore autonomy and control Don t make assumptions Communication Non-English Speaking: language barriers are not handled very well in the US federal law states patients have the right to effective communication regardless of language barriers use the language line or approved translators especially for consents and instructions Stress Any situation that disturbs our activities imposes stress Hospitals/ED are full of stress Overly concerned inquisitive families increase stress Complex or crisis situations increase stress Disagreements about prognosis cause stress 6

7 Attitude Revealed by non-verbal behavior, tone, and choice of words Assertive calm but firm expression of feelings or opinion Aggressive involves anger or hostility Passive quiet, uncertain, don t make waves Passive Aggressive uses sarcasm or undermining Communicating with Coworkers Teamwork cooperative effort by a group to achieve a goal Busy department makes this difficult Goals are easier to accomplish when you work together Communicating with Coworkers Good interpersonal relationships are built on making others feel valued Non-verbal techniques used with patients are = important Praise and thank you Good listening skills Demonstrate respect Avoid cliques and gossip Be patient and considerate Never discuss patient s in a public place 7

8 Human Diversity Also known as cultural diversity Deals with the variety of human societies and cultures Examines similarities and differences Differences make each person unique and valuable Society is made up of many cultures Cultures establish behaviors of people Cultures do not always change with geographic location Provide comfort Human Diversity 100 years ago we had a very culturally homogenous society /8 Americans was non-white Culture of the majority prevailed Anyone who was different was expected to fit in Especially true in rural areas and small towns Immigrants moved to towns where their native culture/language prevailed Human Diversity Society today: much more diverse 1/4 are non-white growing daily Diversity: Can pose certain social problems Creates vast richness and creativity potential Not without disparities 8

9 Human Diversity Global health care issue Differences in outcomes related to race/ethnicity Racial/ethnic disparities have prompted reform and legislation Facilities have been forced to improve transcultural care Expect staff to have the knowledge and attitudes necessary Human Diversity Racial/ethnic characteristics used to be predictable not so any more Gender: male or female Racial: distinguishing skin color and other physical traits Generational: generation y s. gen x s, baby boomers, elderly Geographic: N-E-S-W, borders, especially Mexican Sexual: hetero, homo, bi-sexual, transgender Human Diversity Religious: numerous variations Disabled: Blind, deaf, obese, physically Socio-economic: low income, welfare, uninsured, middle income, affluent Family structure: married, single, unmarried, extended 9

10 Personal Biases Everyone has some degree of bias Human characteristic - needs to be addressed Play a major role in how we perceive others Dealing with bias requires education and knowledge There is no room for personal bias in healthcare!!! Professional Responsibility Cultural diversity had significant ethical dimensions ASRT Code of Ethics: Requires RTs to put aside all personal prejudices and emotional bias, rendering services to humanity with full respect for the dignity of the patient conduct themselves in a professional manner support colleagues and associates respond to patient s needs deliver care unrestricted by conscious of personal attributes or the nature of the illness without discrimination on the nature of sex, creed, race, religion, or socio-economic status Becoming Culturally Competent Gain knowledge of other cultures Be willing to engage other cultures Become an excellent multicultural communicator Recognize the value of empathy and practice it Help others understand the value of multiculturalism 10

11 Conclusion Always remember that you are unique, just like everybody else. Anonymous References Adler, A. & Carlton, R. (2012). Introduction to radiologic sciences and patient care (5 th Ed.). St. Louis: Mo.: Elsevier Saunders. 11

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