Passive listening is the opposite of actively listening. Passive is defined as “not involving visible reaction or active participation” (Dictionary.com, 2009) Passive listening is one way communication in which the recipient does not give feedback or ask questions. When someone is passive listening although they are present their mind is elsewhere. For example when someone is talking about their day or a holiday that doesn’t appeal to the other they may just let them talk rather than being verbally rude, however they are probably doing their shopping list in their mind at the time of conversation or thinking about problems at work and so on. The receiver’s attention can sometimes wander back to the conversation but they miss crucial points of the story. If asked to recap the conversation they wouldn’t be able to do so for it to make sense or if at all.
(Business balls.com, 2001-12)
However sometimes passive listening can have its benefits. As a human being fully concentrating all the time to every single bit of information through the day would be draining. It is up to the individual to use intelligence to sift through this information for crucial time to listen to be fully assertive. For example a nurse should be fully on form when listening to patients symptoms and relaying medical information back to the client.
(Business balls.com, 2001-12)
4.1 Due to the complexity of communication in the health profession miscommunication often occurs. There are many possible barriers preventing either a patient or healthcare provider such as a nurse or Doctor from listening effectively which then has a knock on effect in other areas.
Some possible barriers for miscommunication are:
Language interpretation – This could be down to the wait for interpreters/advocates for the translation of a different language or even the wrong interpretation of the message. Strong accents could also be a factor.
Personal problems – Not being able to leave problems outside of work can be a major distraction affecting the ability to listen and relay the correct message.
Tiredness – Working in the health profession can be very demanding and stressful leading to tiredness which then affects concentration
Concentration span – Health Care staff often work gruelling 12 hour shifts or even more if they are on call. Concentration span for each individual is different however you can imagine that towards the later part of the shift concentration could be a problem.
Staffing situation due to government cuts and workload – These problems have had much publicity lately in many areas
Pressures/targets – Along with the cut backs there is also added pressure from the government to meet specific targets in a certain amount of time. This can cause staff to rush and stress.
Judgements – A judgement on either the situation or of the person they are in communication with can cloud the mind and ability to listen and understand.
Butting in – Not allowing someone to finish what they are talking can be frustrating for the sender making them annoyed and possibly lose interest in the conversation and withholding valuable information.
Pre- thought responses before people have finished talking – Forming a response before someone has finished talking takes away the concentration of listening to a message.
(Royal college of nursing, confidentiality, 2012)
Task 2
3.1 In the first few seconds of people meeting one another it is decided whether or not they
like each another. It is based mainly on how tone of voice, facial expressions and choice of words
appear to the other. For communication to be successful between a nurse and their patient they
have to have a good relationship. To enable this there are five components to the nurse-client
relationship. They are trust, respect, professional intimacy, empathy and power.
(Nursing together, 2009)
Trust - In the nurse-client relationship trust is vital as the client is in a vulnerable position. Broken trust is hard to regain it.
Respect is the recognition of essential worthiness, dignity, and each individual’s uniqueness no
Matter what their socio-economic status, characteristics or the nature of the health problem.
Professional intimacy is vital in the health care provider’s duties such as bathing the patient
Access to the client’s personal information also further adds to professional intimacy.
Empathy is the expression of genuine understanding. In nursing, empathy includes appropriate
Emotional
Distance from the client to guarentee detachment and a fitting professional response.
Power should be correctly used in the way of authority and influence but in a caring manner.
A misuse of power is deemed abuse. (Nurse- Client relationships, 2006)
These need to be established at the very beginning as first impressions account for a lot. In doing
so positive outcomes are that the patient is at ease and confident enough to make the right choices
and the health care provider is seen as authorative but approachable, leading to good
communication and assurance. (The complete networker, 2012)
If a good initial meeting is not established it can cause mistrust and fear in the patient, making the
whole experience a daunting one which could lead to many issues such as the patient withholding
important information as they don’t feel confident or they could even try to discharge themselves
which depending on the individual and situation could be disastrous or life threatening.
Continuous good impressions are important when working on wards such as dementia and
Alzheimer’s due to the nature of the illness, patients are continually forgetting things in many
areas including ever meeting people so for them every time could be a first time.
(The complete networker, 2012)
5.1 & 5.2 Please refer to the 3 debate sheets regarding the main part of this question.
Methods of initiating conversation
Open questions such as “how are you today?” initiate conversation to the patient. It not only
gives them a chance to get any worries off their chest but it opens the lines of communication to
allow to get the intended information in.
Methods of maintaining conversation
The Communication cycle is a great way to be assertive in listening to the patient and also maintaining conversation as the system clearly shows them they are being listened to.
Communication cycle broke down
- A sends a message to B reading their body language to see how it is received
- B tells A his clarification of the message (reflection)
- A judges that clarification is precise. If not they send the message in a different way which is again translated by B
- When A judges that B has the correct message he repeats stage B with the new information the cycle is repeated
- Lastly B paraphrases the whole message to show interpretation
(Communication, 2012)
6 steps of communication
-
Aiming – The sender formulates an idea of what message they want to send
-
Encoding – The sender uses words, expressions, body language and gestures to encode the message
-
Transmitting - The sender reads the recipient for signs in body language and so on to show that they are ready for transition which is then vocally submitted
-
Receiving – The recipient then absorbs the message
-
Decoding – After absorbing the receiver then decodes their understanding of the message
-
Responding - Showing a person that they have been heard, including the use of non-verbal techniques that show interest, such as nodding of the head.
(Communication, 2012)
2.1 Non-verbal communication
Non- verbal communication is said to account for around 80% of all communication.
In the 1960-70’s Albert H Mehrabian did various experiments and his statistics are still widely used today. He suggests communication is broke down into:
- 7% Verbal (word count)
- 38% Vocal (tone of voice)
- 55% Body language/facial expressions
As suggested in the name body language the body speaks a language of its own which might not match up to words that are being spoken orally. For example when people are telling lies there are often tell- tale signs such as looking shifty or having bad eye contact. Regarding the nurse-client relationship it is important to consider all of the above when communicating. Mehrabian’s study suggests if a nurse were to say something nice to the patient but in a nasty sharp tone the patient would be a little confused of the mixed signals which then cause mistrust. The patient would then read body language for more clues to the true message. A look of genuineness, a warm smile in the right places, hang gestures and a nod of the head are non-verbal signs that help gain trust and show they are listening. This then encourages people to continue speaking.
(The complete networker, 2012)
(See Annex 1 for Body language facts & stats)
Verbal communication
As mentioned above the words a person speaks only account for 7% of whole communication. However the right use of language along with the right tone can go a long way. A health care provider can encourage the continuation of talking with adequate use of open and closed questions at the right time. They can also use yes and no in the right places, all of which show assertiveness and interest.
(Verbal and non-verbal communication, 2012)
(See Annex 2 for more information on verbal and non-verbal communication)
Task 3
1.1 Confidentiality
“Confidentiality means keeping information given by or about an individual in the course of a professional relationship secure and secret from others. This confidentiality is seen as central to the maintenance of trust between professional and service-user. The obligation to maintain confidentiality does not normally end with the individual's death. Confidentiality is owed equally to mature and immature minors, and adults who lack the capacity to make decisions for themselves. It also applies to fellow professionals and students studying to enter one's profession. It applies to all forms of transmission; verbal, written, digital, or hardcopy records, videos and illustrations etc. -wherever they can be identified with a specific individual.” (The Higher Education Academy, 2007)
NHS & the need for confidentiality
There are strict laws and regulations to ensure that health records are kept confidential for ethical (right & wrong) and contractual reasons. They can only be accessed by health professionals directly involved in the care of that person. NHS Staff and even volunteers for the Health Board are bound by the code of confidentiality. They are bound by a contract they have to sign agreeing to a number of different laws that relate to health records. The two most important laws are:
- Data Protection Act (1998)
- Human Rights Act (1998).
Under the terms of the Data Protection Act (1998), organisations such as the NHS must ensure that any personal information it gathers in the course of its work is:
-
Only used for the stated purpose of the information (In the case of the NHS it provides a good standard of healthcare)
- Kept secure
- (Department of health, 2012)
(Please see Annex 3 for more information confidentiality regarding volunteering for the Health Board)
1.2 Breach of confidentiality
To breach the Data Protection Act (1998) would be breaking the law which can result in incarceration. The Human Rights Act (1998) also states that everyone has the right to have their private life respected. This includes the right to keep health records confidential. To release any information whatsoever staff must have written consent from the patient.
(NHS choices, health records, 2012)
Examples of a health care provider breaching confidentiality are if they were to speaking with friends or family about a patient so that they could be identified. Or using social networking sites such as Facebook or twitter to post pictures or reveal information about a patient. There was a case at the Nottingham University Hospital NHS Trust. A member of medical staff was dismissed for taking a photograph of a patient in bed and then uploading the picture for friends to see on Facebook. (Rainey, Sarah, 2011)
An article in the daily telegraph printed figures released by Freedom Information Act shows that:
- In the last 5 years Private records belonging to vulnerable and ill patients were breached more than 800 times by nurses, doctors and administrative staff at 152 NHS trusts and hospitals. Figures also
- 806 incidents in which NHS employees breached data protection policies between July 2008 and July 2011
- There were 23 cases where medical staff posted confidential medical information on Facebook, sharing details about a patient's name, medical condition or discussing their treatment.
- There were more than 90 incidents where employees admitted to inappropriately accessing the medical files of colleagues, and more than 30 incidents where they looked up family members, the figures showed.
- Their actions resulted in 102 doctors, nurses and hospital staff being sacked.
- The figures also showed unsecured confidential medical information was lost on 57 occasions across 24 NHS trusts. (Rainey, Sarah, 2011)
When it has to be breached
However there are times when this is breached whether it is illegally because of ethical reasons thing to do. For example a Doctor may see fit that his H.I.V patients children and partner should be informed of her condition for the safeguarding of them all as they are unaware and could be at risk. It can only be breached legally when for example when someone has obtained a court order to retrieve information. For instance if the partner off the above example had heard rumours that his partner and mother of his children had H.I.V and after being challenged she was reluctant to tell him, he could then apply for a court order ordering the Doctor to release the information.
It can be breached in cases where the Doctor believes it is in the patient’s best interest to disclose information. A good example of this would be if the lady with H.I.V was refusing to accept treatment and her condition was deteriorating he could go to his management to discuss possible interventions. (Royal college of nursing, confidentiality, 2012)
Confidentiality can be breached in the following ways:
1 With consent of the client
2 If disclosure is clearly in the patient’s interest but it is not possible or is undesirable to seek consent
3 If it is required by law
4 If it is unequivocally in the public interest
5 If it is necessary to safeguard national security or to prevent a serious crime
6 If it will prevent a serious risk to public health
7 In certain circumstances for the purposes of medical research.
(Royal college of nursing, 2012)
If confidentiality is broken an individual can sue through a civil court. That person can also complain to the Information Commissioner if there is a breach of the 1998 Data Protection Act. (See Annex 4 for further information on breach of confidentiality)
Word Count
2650 excluding referencing
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