Chapter 6: Communications & Critical Thinking Skills Flashcards
Abraham Maslow
The pyschologist who created the basic needs pyramid concept from the lowest (base) needs to the highest (apex) needs.
Maslow’s basic needs for human survival and functioning are…
physiologic safety and security love and belonging self-esteem self-actualization
What are the physiologic needs?
oxygen water food elimination rest shelter
How does a SG tend to the pt’s physiologic needs?
Be aware of the patient’s need to pee during your exams, particularly ones that require a full bladder.
What are the safety and security needs?
to be protected from fear, danger, and harm
How does a SG tend to the pt’s safety and security needs?
Patients are often afraid of procedures and for their health. Alleviate stress by explaining the reason for a procedure, who will be doing it, how it will be performed, and what sensations or feelings to expect.
What are the love and belonging needs?
closeness
affection
meaningful relationships
How does a SG tend to love & belonging needs?
If you encounter a patient who is clearly in need of support, contact the hospital pysch person or their doctor’s office with your concerns.
What are the self-esteem needs?
believing in yourself
believing that other people value you
How does a SG tend to self-esteem needs?
Don’t put a patient down directly or indirectly. Value their modesty as much as possible. Find a way to compliment them and thank them for their cooperation.
What are the self-actualization needs?
the ability to meet your full potential
learning, understanding, setting & reaching goals
What is the highest level of need?
self-actualization. As such it is rarely, if ever, met.
Communication is the exchange of information that includes…
receiving info
interpreting info
responding to that info
For good patient communication…
ORGANIZE your thoughts.
USE COMMON WORDS so you’re not unclear.
BE CONCISE and avoid unrelated info.
Effective communicators use both…
verbal and non-verbal communication.
Verbal communication includes
the transmission of words in either verbal or written form.
Nonverbal communication consists of
eye contact, facial expressions, body movements and posture, tone of voice and touch.
Social conversation is
the type of communication people use out of habit; superficial chitchat/small talk
Social conversation is important because
it helps establish a relationship with the patient and creates a climate of supportive communication.
Supportive communication is
goal oriented and information bearing. Helps relieve anxiety, anger, and frustration.
Supportive communication is possible only if the SG has the following skills:
LISTENING to the words the pt is saying
OBSERVING the pt’s nonverbal cues
RESPONDING to the message
MAINTAINING SILENCE if it seems prudent
CLARIFYING to make sure they were heard correctly by
REPEATING and
GATHERING INFORMATION with open-ended questions
SUMMARIZING the pt’s viewpoint
ACCEPTING the pt’s feelings even if they’re negative
TOUCHING if the pt seems accepting
Communication barriers are…
anything that interferes with the communication process like talking too fast, using slang, broad generalizations, hostile or insulting tones, different languages, etc
Communication cutoffs: judgemental responses
telling people they should not feel angry or afraid leaves them feeling guilty or ashamed for complaining
Communication cutoffs: arguing
debating with pts instead of learning what they are thinking
Communication cutoffs: solving
Don’t offer advice. It’s not your job to solve their problems.
Communication cutoffs: interrupting
You’ll receive only part of the message and risk giving an inappropriate response.
Communication cutoffs: changing the subject
Pts will feel that you don’t want to hear what they have to say.
Communication cutoffs: distractions
Shows disinterest through body language or behavior
Communication cutoffs: false assurances
kidding and being overly-cheery may make you feel better, but not the pt
Communication cutoffs: untruthfulness
Don’t fabricate or construct excuses to avoid confronting unpleasant news.
Communication cutoffs: evasion
focusing on signs & symptoms only avoids the bigger questions
Communication cutoffs: avoidance
redirecting to someone else just reveals that you don’t want to answer
Communication cutoffs: false reassurances
Don’t say everything will be fine - it might not be! Listen non judgementally, correct any misinformation you may hear, direct them to someone with better info if you need to.
If your patient is deaf…
get an interpreter if at all possible
write back and forth
If your patient has a hearing aid…
get their attention face them speak normal - don't shout! no bright lights behind your head reduce background noise don't eat or chew gum while talking use paper and pen
If your patient is visually impaired…
treat their glasses respectfully
offer an arm to help guide them
warn them of ramps and steps
follow their lead on how they do things
If your patient is speech impaired…
talk with them during the exam like equals
speak slowly and clearly
keep directions simple; rephrase if necessary
be patient; don’t hurry them
assist them but don’t speak for them
respect them as adults
If your patient is confused or disoriented…
try to understand their message use reality orientation (who they are, what day it is) talk face to face with simple sentences appreciate their attempts to cooperate be caring and gentle don't support confused beliefs or argue
A communication triad is…
a coalition formed by three people in a social situation, for exchanging information
Use a communication triad with coworkers to…
review information, assure understanding, explain a decision, and block manipulation.
Use a communication triad with patients to…
support anxious pts and resolve language barriers.
Don’t use a communication triad with coworkers when…
someone’s anxiety level is very high or confidentiality may be breeched.
Don’t use a communication triad with patients when…
confidentiality would be breeched or it puts family members in an untenable position.
Profession communication opportunities are…
departmental meetings, pt instructions, reported u/s findings, recordings in the pt’s chart
Remember your telephone manners:
give name and dept ask for the receiver's name answer calls promptly deliver messages promptly be courteous to pts and their families
SGs provide written and verbal reports because…
they are trained observers of the interactions of u/s transmission and reflection in the human body.
SG’s reports serve as aids to diagnosis by…
documenting normal measurements and
drawing attention to unusual findings that might indicate disease or need additional exams.
The SG’s report/impression should be limited to:
providing measurements comments on echogenicity comments on location of normal/abnormal structures ususual pt positions scanning planes changes in instrumentation any technical difficulties
Negative aspects of SG reports include:
- ordering MDs using it as a diagnosis instead of waiting for the interpreting MD’s report
- inexperienced MDs using it verbatim
Recording obstetric exam pros:
fetal bonding
education
increased acceptance of sonography
Recording obstetric exam cons:
extends scanning time
increases pt exposure
distracting for the SG
The nondiagnostic use of fetal u/s (aka “keepsake u/s”)
is inappropriate and contrary to responsible medical practice; opposed by the SDMS and the FDA.
Elizabeth Kubler-Ross
a Swedish physician who described the five stages of grief
The five stages of grief are..
- denial & isolation
- anger
- bargaining
- depression
- acceptance
The grieving process…
takes time and is unpredictable. People may skip stages, do them out of order, or do them more than once.
Stages of Grief: Denial & isolation
“No, not me - it must be a mistake.”; a defense mechanism
Stages of Grief: Anger
“Why me?”; pt makes unreasonable demands and unfair criticisms. May act paranoid.
Stages of Grief: Bargaining
Pts may try to bargain with God, delay the inevitable, or try alternative treatments
Stages of Grief: Depression
Overwhelming sadness and sorrow; loss of interest in their surroundings. Be willing to let them express their feelings or not, as they wish.
Stages of Grief: Acceptance
Lack of intense feelings, may ask questions about death and dying. Be present for them.
