Communication in Care Settings

Communication in Care Settings The Croft Nursery school is a chain of day-care centres throughout the Newcastle-under-Lyme area, it takes children from 0-4 years before preschool and has close links with the local hospital with kids need specialised attention for disabilities and medical conditions. Communication is very important in this care setting both between staff and children and there are different ways this communication takes place through oral, written, body language and special communication Oral communication is by far the most common between staff you can quickly and easily share information and build relationships easily with colleagues- it is also important to use oral communication with the service users as it builds a relationship with them and helps them learn and understand language. The use of oral communication and the language use differs for staff, parents and children-staff may use informal language the bond with each other and clear precise formal directions when exchange information. Calm and welcoming tones would be used to welcome parents and exchange information about their child, it is more informal as it is very stressful for parents to leave their children and they need to feel secure and relaxed. When using oral communication with children it is important to use clear and simple language, speaking slowly using other forms of communication such as body language and signs to help them understand. Listening is also very important as children are not al ways clear when they speak Body language and non-verbal communication links in with oral communication and helps connect with the service users when lack of language is barrier to effective communication- it is important to maintain eye contact, keep your body language open and relaxed and use non-verbal sins such as nodding and smiling to show you are listening-it is very important with children as they are very sensitive as their oral skills are less developed so they rely on facial expression and body language to communicate with you. I observed at the nursery with the younger toddlers they would teach the children certain signs such as patting their mouth to ask for food- so that they could communicate what they needed with the care workers before they learned the words to ask. It is important to watch a childs body language as they may not verbally express it if they are in pain or discomfort so a care worker needs to have effective communication and pick up on any non verbal signs that a child may be in distress. Written communication is often used in many care settings-it allows information to be recorded and therefore reviewed later and eliminates the possibility of human error-for example a human may not remember being told of a specific allergy or a medicine that a child needs- and the child cannot communicate it-but written notes support the care workers and allow them to keep a detailed account of the child needs. Written communication is used throughout the day-care- parents, children and staff have to sign in and out of the building to keep track of the children who are there in a emergency and protect the children-as the staff know who is in the building at all times. Written communication can make information readily available to service users through websites, leaflets and posters-they can see what services they are providing and their produces as well as seeing what their child does on a daily basis.As well as being aware of opening times and ways to contact the centre Computerise d communication also ties in as they can email or text to communicate with the daycare workers during the day and see how their child is doing. Sometimes special methods of communications are used especially with younger children who only have a simple grasp on language such as signs to direct them and give them instructions such as diagrams outside the toilet to tell them to wipe and wash their hands and directions on the coat hangers to direct them to how to easily put their coats on. Children can also communicate and express themselves through artistic activities and this allows them to grow and develop their communication skills and learn to express themselves. Children with special needs may need different forms of communication such as sign language or Braille and the centre has employees with skills the cater to their needs as they are learning to communicate. Makaton is also a useful for communication with children with learning difficulties as many of the children at the day care have learning difficulties or disability, Makaton uses signs and symbols, on picture cards and ties into to facial expressions to help the m understand. Communication between individuals does not always go smoothly, as there are often barriers to effective communication between people. If part of the communication cycle is unclear things can become confused for example if the person cannot correctly articulate or express what they are trying to say, they may not be listening attentively, they may use terms or colloquial language that the other person is unfamiliar with or try to communicate an idea with someone assuming they already have the relevant knowledge to understand it. There are many barriers’ that can affect communication such as sensory deprivation, foreign language jargon, slang, dialect or cultural differences. There are techniques to overcome barriers that occur in communication, oral communication is often used in care settings but there can be misunderstandings when people use slang, jargon or are simply not listening but you can overcome this using your verbal skills effectively, by paraphrasing to make sure you received the correct message, speaking clearly using simple English, and using a range of open and closed questions to get the information you need for example using closed questions to get simple and quick answer and open questions for a more detailed and emotional response. Be-aware of cultural differences as certain words e.g. sick which means good to younger people but disgusting or unwell to older people and I gestures that are acceptable in one country can be extremely rude in others for example in Greece the okay hand sign is rude and is insinuating that you think they are a phallus. Sometimes communication is hindered because the service user may have issues hearing, see ing or simply understanding language therefore other forms of communication must be employed such as sign language, Braille or lip reading to allow the user to communicate. The most important things to assure effective communication is making sure that you are both comfortable and attentive taking into note environmental factors and making sure there are no physical barriers between people communicating and they are in a well lit comfortable area. You must be very aware of your body language, too close, eye contact and body language focused on the user can demonstrate interest and concern but can also be seen as aggressive especially in other cultures so be sure to keep a adequate distance but not too far to feel unapproachable or cold. Keep your body at a slight angle therefore leaving your body language open and keep frequent but not constant eye contact. Listening is always the most important aspect and is essential in care settings as you may miss a vital piece of information that could help you treat a patient or treat a service user in a critical situation. Research has been done into communication and several theories have arisen from this and can provide guidance for care workers. One of the most well knows is the SOLER theory- it follows five basic points S Sit attentively at an angle It is important to sit attentively at an angle to the person who uses the service. This means that you can look at the person directly and shows that you are listening to the person seated beside you and that you are conveying interest. O Open posture It is important for a practitioner to have an open posture. This means not sitting or standing with your arms folded across your chest as this can sometimes signal that you are defensive or that you are anxious. If a practitioner has an open posture the person may be more inclined to elaborate on their concerns. L Leaning forward It important that practitioners lean forward towards the person using the service, this shows that you are interested in what the person is talking about. It is also possible that the person may be talking about personal issues and so may speak in a lower or quieter tone of voice. In addition you may want to convey a message in a lower or quieter tone of voice if you are seated in a public environment. E Eye contact Eye contact is important as this demonstrates that practitioners are interested and focused on the message that the person using the service is conveying. You can also develop a sense of the person’s emotional state by making eye contact, therefore, enabling you to judge the extent to which the person may be experiencing difficulty. R Relaxed body language It is important to have a relaxed body language as this conveys to the person using the service that you are not in a rush. This will enable the person to develop their responses to questions in their own time Implementing this theory provide multiple benefits to a person using the service they will feel listened to, develop a close relationship with the practitioner and feel that they care, which will make him/her feel less vulnerable and will feel more positive about asking for help if they feel that they will receive it in a non-judgemental and productive manner. It also benefits the care practitioner as they will understand the needs of the person using the service and therefore effectively address the needs of the person using the service and review care plans more efficiently. Another theory of communication is Maslow’s hierarchy of needs, According to humanist psychologist Abraham Maslow, our actions are motivated in orderto achieve certain needs He presents this in a pyramid format as you need to fulfil the lower greater needs before you can fulfil higher lesser needs at the bottom of the pyramid is Physiological needs are the physical requirements for human survival, such as water, food, sleep, warmth etc If these requirements are not met, the human body cannot function properly and will ultimately fail. Physiological needs are the most important; they should be met first. With their physical needs satisfied, the individuals safety needs take precedence as in the absence of safety people feel stressed and can experience post traumatic stress disorder-people who are being threatened abused or live in a dangerous or war torn environment cannot concentrate on higher psychological needs and it is a basic animal instinct to need to feel safe and secure in their health and well-being. After physiological and safety needs are fulfilled, the third level of human needs is interpersonal and involves feelings of belonging such as love, family and friendship this need is especially strong in childhood and can override the need for safety as witnessed in children who cling to abusive parents. Lack of love and belonging– due to isolation, abuse, hospitalization or neglect. – can impact the individuals ability to form and maintain emotionally significant relationships in general, such as friendship, romantic relations or any intimacy with another person and Many people become susceptible to loneliness social anxiety and clinical depression n the absence of this love or belonging element. T The fourth tier is esteem-All humans have a need to feel respected; this includes the need to have self esteem and self-respect. People often engage in a profession or hobby to gain recognition. These activities give the person a sense of contribution or value. People with low self-esteem often need respect from others, and seek to please others or achieve fame or glory but self esteem needs acceptance from within and is not found in others Psychological imbalances such as depression can hinder the person from obtaining a higher level of self-esteem or self-respect. People need self esteem and it makes them aim to better themselves and achieve things. Without these things low self esteem may lead to an inferiority complex, weakness, and helplessness. At the top of the pyramid is self actualization this level of need refers to what a persons full potential is and the realization of that potential.individuals may perceive or focus on this need very specifically. For example, one person may have the strong desire to become an ideal parent, another to build their own business and simply gain great athleticism; it may even be expressed in paintings, pictures, or inventions.As previously mentioned, Maslow believed that to understand this level of need, the person must not only achieve the previous needs, but master them. Using this theory in care settings help us understand what the patient needs by looking at what they have fulfilled in their life and what they still need-for example a depressed patient cannot be treated for hormonal imbalances or issues with intimacy etc. If they are in an unsafe environment or have no shelter or lack of food-those needs must first be addressed before you can address issues further up Maslow’s hierarchy of needs. It helps us better structure our care and help patients more efficiently. I experience all these forms of communication and issues when I did experience at The Croft nursery. During my time their I circulated between the different ages of children and learned about the communication between the staff with children of different ages and also how they communicate with each other, which helped me better explore communication and understand it rather than simply reading about it. At the nursery, I participated in games with the children, sat them down for dinner, took them for walks and laid them down for naps. I found it very easy to engage with the children and feel this was a strong point of mine I kept my body language open and very positive and was good at getting the children to open up. Sometimes I struggled with the language barriers with younger children as it is hard to understand what they want and can be confusing but I got used to looking for other signs and body language to understand what they wanted from me. I took direction well from the staff and enjoyed working with them-they were very clear and had good communication all over the building, there was no confusion where I was going and what I was doing and the use of telephones connected in each room made it easy for them to ask for help or anything else they needed from other rooms. The only complaint I would have is some of the staff could be a bit more rude and less welcoming and would discuss topics around the young children that wasn’t appropriate especially as the children were just starting the learn language. I would say that my weak point would have been communicating with the children to make them understand what they couldn’t do- I found it very easy to get them to do things and play with them but when it comes to the negative side such as telling them off I found it difficult as I felt uncomfortable being so negative to other people’s children and would need to work on and research it for next time. I a lso feel that I could benefit of more extensive training and explanations of techniques to use with the children. Communication in Care Settings Communication in Care Settings Introduction This unit investigates the different types of communication skills used in care settings and their purpose. I will give an in-depth description of the different types of communication used in care settings and their purposes. The description will clearly show how people are valued and supported by the different types of communication. These include; written, oral, computerised and special methods. Also, I will show my understanding of how the application of the values of care by practitioners when communicating with people who use services can be supportive. These values of care include; promoting equality and diversity, maintaining confidentiality and promoting individual rights and beliefs. For example, confidentiality is a key value in health and social care and that may be faced by confidentiality dilemmas and in such cases what to do if information is given and is felt this should be shared. I will show a high level of understanding of how communication can be supported and inhi bited by factors, which can influence communication which includes the use of the values of care. The factors include; positioning (for example, space, height), emotional (for example, fear happiness, self-esteem, trust, empathy, responsiveness, attentiveness, respect) environmental conditions (for example, space, noise, lighting, ventilation) and special needs (for example, using appropriate vocabulary, sign language). A wide-range of examples will be given. Furthermore, I will also show my understanding of the importance of the content that is being communicated. Within health and social care settings communication is key to communicate with other practitioners, people who use these services and relatives. I will consider the different types of interaction, their purposes, the people involved and how to build a professional partnership with people who use services. There are a variety of skills used within care settings when communicating with others and these influence the effectiveness of the communication. I will give a detailed and comprehensive explanation of four communication skills used by practitioners in one care setting and how skills may affect interaction, how they can minimise communication barriers and help value individuals. Examples of skills include; tone of voice, pace of voice, eye contact, facial expression, clarifying, posture, paraphrasing and empathising. Detailed reasons for using each skill will be given. Also, I will show a high level of understanding of how people who use the service are valued and supported by the application of values of care and appropriate use of communication skills. A wide range of appropriate examples will be included. I will demonstrate the ability to select and use appropriate information from a wide range of sources, for example, books and the internet, for at least two theories of communication. I will give an in depth explanation, showing a high level of understanding of how these theories can be used as a strategy to enhance and prevent barriers to communication and to provide guidance about how to effectively communicate with people who use the service/practitioners. I will include theories relating to; group structures, the communication cycle, the structure of interactions, SOLER and theories of formation. I will provide comprehensive records of one interaction with a person who uses services/practitioners or a small group of people who use services/practitioners. These will be supported by records that show how the interaction was planned and conducted, the aims and objectives and the skills used for the interaction. The information considers, at a comprehensive level, the skills used the factors that supported and/or inhibited the interaction and information which shows a high level of understanding of how the values of care were applied. I will produce a comprehensive evaluation of the interaction which shows evidence of reflection, analysis and conclusions; I will consider the interaction from their own and the person/people who use services/practitioner(s) perspective. I will include a witness statement. Lastly, I will describe in detail realistic improvements that could be made. Different Types of Commutation used in Care Settings There are many circumstances in a care setting, where is it vital to exchange information. Communication enables the building of appropriate relationships and meeting the physical, intellectual, emotional and social needs of service users. The quality of communication will form the value of relationships and the ability of carers to meet service user’s needs. Types of communication include; oral, written, computerised and special methods. Oral Communication http://ec.l.thumbs.canstockphoto.com/canstock6638212.jpg Having a conversation with someone consists of the development of skills and social coordination. This means; showing an interest, being interesting and having the ability to start conversations and end them. When communicating orally with others within a care setting may have different intentions. These may include; giving information (for example, service providers within a GP may state what and where services are available), obtaining information (for example, when a child begins nursery contact information will be given to early years staff and is used if contact with any child’s parents is necessary) or even to exchange ideas (for example, within a care home elderly individuals may share present or past experiences with others) Giving and obtaining information is essential because the content must be accurate. If incorrect ‘facts’ are given, the individual who needs the information will be misled and this may result in serious consequences. An effective approach of ‘making a connection’ is by putting people at their ease by taking an honest interest in them. This should apply whether you are giving the information to an individual or even if you are receiving the information. In addition, if an individual is from a different culture, it is vital as this shows the value of diversity. Also, being open about what individuals are aiming to accomplish and inspiring the others to do the same is also needed when giving, obtaining information or exchanging ideas. When talking to people, non-verbal signals, such as gestures or smiles are regularly used. This is reffered to as ‘body language’ and is also a method of giving messages to individuals with whom we are talking to: for example, smiling will express friendliness. When individuals communicate with each other they send messages and unveiling information. When communicating verbally, messages are encoded by a sender and decoded by a receiver. http://www.mindtools.com/pages/article/newCS_99.htm Communication in different settings is likely to be of a complex nature; therefore this means it may have a number of intensions. For example, care workers will need to be conscious that each individual will have their personal way of understanding messages. Effective communication refers to more than just passing on information and consists of involving or engaging with another person. Tearesa Thompson (1986) argues that communication is significant for two main explanations. Primarily, communication allows individuals to share information. Also communication allows relationships between people. Thompson states ‘communication is the relationship’. Therefore, speaking or signing is essential to creating relationships between people, and care workers must have highly developed social skills, to ensure their ability to work with the variety of emotional needs that service users will have. Examples of tasks, where verbal/oral communication is vital; Asking for information Explaining issues, policies and procedures Building an understanding of another person’s life Clarifying issues Problem solving Exchanging ideas/learning new ideas Carrying out interviews and assessments Building a sense of trust Establishing professional relationships Providing emotional support Calming people who are experiencing strong emotions Welcoming people Written Communication http://files.www.lawyersmutualnc.com/Newsletter_Clipart.gif http://comps.fotosearch.com/comp/IMZ/IMZ199/writing-letter_~szo0432.jpg The written word is used extensively and is the most frequently recognised method of communication. The rules that administer writing are different from those that are accompanied for spoken language. Within many settings accuracy of the written word is particularly essential. For example, if inaccuracies take place with keeping of formal records within a GP; an individual might have the incorrect treatment or be given improper information with possible severe consequences. Essentially this could result to a complaint being put forward or even court proceedings being taken against the organisation. When writing information down it must be; clear, accurate and legible. Inaccurate, written records could result in; inappropriate actions, failure to act or complaints and litigation (legal action). In many settings, written information is used to record personal history. For example in early years settings communicating in writing helps care workers to keep in contact with parents, friends of the organisation and other professionals. The intentions may be on giving or obtaining information or exchanging ideas. In many settings the communication policy will lay down that all written communication needs be shown to the manager before it is passed on. It recommended that copies of written communication should be kept in case they are essential for future reference. Types of written communication may include; Letters Appointments, information about meeting, visits, tests results Accident slips To inform of minor injury to children Care plans A plan of the care an individual is to receive Menus The choices available at meal times Monitoring medical records Temperature, pulse or, in early years, the progress that is being made Newsletters Giving information about events Notice boards These can be reminders or information about group meetings Personal history Individuals details about past and current experience Computerised Communication http://www.fcps.edu/LibertyMS/images_top/News/email%20clipart.png In recent years the development of email has grown to be a frequently used method of communication. Emails can be both formal and informal depending on their intension. An advantage of emails is that it is a fast technique of communicating with another individual or organisation as answers can be received in a matter of minutes, rather than having to wait for a number of days. Care must be taken to make sure that confidentiality is maintained and only shared on a ‘need to know basis’ only. In addition, the internet is too increasingly being used as a source of information for various types of purposes. Computers use the written word, as their main function, but they are also used to show information in graphics and sounds. Electronic forms of communication such as mobile devises are currently the most used technology in the many individuals everyday life. In many settings computers may be used for interacting between one organisation and another. For example, a GP surgery could use the computer to send information about a patient to a consultant at a hospital, to send a prescription to a pharmacy or even to send essential information to an individual’s home address. Moreover, this is similar as an internal network system can also be in place to ensure that employees within one setting can be linked with others to share information. For example, within school organisations, teachers can be sent key information via email. With electronic records it is important to; Keep a ‘back up cop’ increase the system crashes Use a password security check to make sure that only certain staff have access Find out about the policy on the printing of details so that hard copies do not get lost, or even seen by others Know the policy on who is authorised to update or change records. The recording system must prevent information being altered or lost by accident Print out fixed documents in an appropriate confidential area and keep the documents in a safe system to prevent unauthorised people having access to confidential material In all situations care needs to be taken to guarantee that the requirements of the data protection act are followed when using the computer. The act: generated new obligations for those keeping personal information, entails that a service user can be given a copy of any information that is kept about them (this is known as your ‘right of access’), requires that any incorrect information about a person is modified or deleted, gives an individual the right to complain to the data protection commissioner if they think someone is keeping data and is not conforming with the act, permits individuals to declare compensation through the courts if they suffer damage through mishandling information about themselves, enable an individual who uses services to find out from any person or organisation whether information is being kept about them and if they do to be told the type of information kept and the purposes for which it is kept. People keeping personal information should give individuals access to their personal information and can correct or delete any information found to be inaccurate. Settings must: get personal information fairly and openly, use it only in ways compatible with the intension for which it was given in the first place, secure it against unauthorised access or loss and make sure that it is accurate and kept up to date. Special Methods All health, social care and early years’ settings must be ready to offer individuals with special needs where communication is concerned. Special needs may include the following: hearing impairment or deafness, poor eyesight or blindness, language difficulty (including English not being first/preferred language). Therefore, there are a number of organisations that can provide support with such needs for example, Makaton, Braille, Sign Language and Interpreters. Makaton http://www.jacobbailey.com/wp-content/uploads/2010/03/MAKATON_SIGNS.png Makaton is a language programme using signs, speech and symbols to help people to communicate. Makaton aids individuals who have a hearing impairment or who may have a learning difficulty to communicate with others. It is designed to support spoken language and the signs and symbols are used with speech, in spoken word order. Makaton uses an established set of hand movements to convey meaning. Today over 100,000 children and adults, use Makaton symbols and signs. With Makaton, children and adults can communicate straight away using this language programme. With young children it is usually as soon as it is recognised that they have a need. Some individuals then naturally stop using the signs or symbols at their own pace, as they develop speech. However for others this system is required throughout their lifetime. For those who have experienced the frustration of being unable to communicate meaningfully or effectively, Makaton really can help. Makaton takes away that frustration and enables individuals to connect with other people and the world around them. This opens up all kinds of possibilities. Makaton helps deliver extra clues about what someone is saying. Using signs can help people who have no speech or whose speech is unclear. Using symbols can help people who have limited speech and those who cannot, or prefer not to sign. Makaton is extremely flexible as it can be adapted to meet an individuals needs and used at a level appropriate for them. It can be used to: Share thoughts, choices and emotions Label real objects, pictures, photos and places Take part in games and songs Listen to, read and tell stories Create recipes, menus and shopping lists Write letters and messages Help people find their way around public buildings Braille http://thumbs.dreamstime.com/x/braille-reading-1484302.jpg Braille is a system of raised dots that can be felt with fingers, for people who have limited vision or are blind, this system provides the opportunity for independent reading and writing as it is based on ‘touch’. Braille was introduced by a Frenchman blind person named Louis Braille in 1829. Using the correct computer software, individuals can translate written material into Braille and print out using special printers. Braille can be very useful to individuals who use services who have poor eye sight as they are able to read leaflets and hand-outs that provide information regarding their treatment, as well as being able to read books and magazines and satisfy their personal intellectual needs. Sign Language http://www2.le.ac.uk/departments/modern-languages/lal/NEW%20COURSES_FROM_JANUARY_2014/images%20NEW2014/BSL.jpg Sign Language is a visual means of communicating using signals, facial expression, and body language. Sign Language is largely used by people who are deaf or have hearing impairments. Within Britain the most common form of Sign Language is known as British Sign Language (BSL). British Sign Language has its individual grammatical structure and syntax, as a language it is not dependant nor is it associated to spoken English. British Sign Language is used amongst 50,000 – 70,000 people within the UK. The government officially recognised British sign language, in March 2003 as an official minority language, this lead to an increase in raising awareness of the BSL campaign. British sign language has a phrase ‘make your fingers counts’ which appeals to children. British sign language can be taught at any age, for example even children are intrigued about BSL. It is a language that has developed over hundreds of years and enables interaction between people who otherwise might experience difficulty. Interpreters http://www.lexlogos.com/images/blog/Lexlogos-LLC-Happy-International-Translation-Day.jpg Interpreters can be used to support communication with service users for whom English is not their ideal or first language. In the past usually service users have brought along translators which have been people who are members of their own family. However this has currently been decreasing as it was considered by many individuals that using family members was not beneficial, as service users became aware that the information may not necessarily be kept confidential even by using family members. For example, a daughter (family member) who is translating for her mother (service user) can discover that her mother has a terminal illness, in this case a mother would rather have someone who is not a member of the family to ensure nay health problems are kept confidential and shared only on a ‘need to know basis’. Within a lot of health, social care and early years’ services, there are leaflets available which cover a variety of health topics or health facilities and are produced in a number of other languages (including English). Therefore many service users within our multi-cultural society have full access to the information needed, rather than having to use a translator.