AO1 - Communication in Care Settings
by beccabradford2googlemailcom (student)
Communication in Care Settings
There are many different types of communication that can be used in care settings. The first that I will be looking at is Oral Communication.
When talking about Oral Communication, many people look into the communication cycle. This diagram below shows how effective communication can be achieved.
When two people are communicating with each other, the first person has an idea, they then code their message, this message is sent on to someone else through talking, the second person receives the message and has to decode it so that finally, the message is understood and they can think of an appropriate response.
Oral Communication can be defined as the process of expressing or sharing ideas and information by word of mouth.
Informal communication can be defined as a type of verbal communication
Some examples of Informal Oral Communication can include: Spoken word, telephone conversations, face to face conversations and business meeting discussions.
These examples of Oral Communication are used in most people's daily lives and are more known to occur everyday.
Formal communication can be defined as a type of verbal communication where the changing of information has already been defined, for example; requests, reports and commands.
A few examples of more formal types of Oral Communication include: Classroom lectures, graduation speeches and presentations.
These examples of Oral Communication are used less often in everyday life and are for more special occasions.
As with everything, there are pros and cons to using Oral Communication. I am going to talk through the advantages and disadvantages that can be found when using Oral Communication.
The advantages of Oral Communication are as follows; it is more personal because it is a conversation between two people that are expressing themselves face to face.
An example of this is between a GP and a patient.
The GP faces the patient and listens in order to show complete understanding and make the patient feel more comfortable in the environment. It is also a lot less formal to talk face to face and it is much quicker than most types of communication such as writing.
Talking face to face can help resolve conflict between people as if a text is sent, it can be taken the wrong way and cause bigger arguments.
When talking, the responses are quicker which helps people with decision making which is also another advantage.
Giving verbal encouragement is a great way to maintain energy in a team of people.
There are also disadvantages to talking face to face. A few of these disadvantages include; written communication can be more effective when giving confidential information, an example of this is receiving a letter from your hospital containing information about an appointment you may have scheduled. This is to ensure that you have all the information necessary for that day as it will usually contain a date, a time, which doctor/nurse you will be meeting with and which building you should be in for the appointment.
Another disadvantage is that important information usually needs to be documented in writing than speech. An example of this is care documents for the elderly that may be in residential homes. All of their dietary needs, allergies, next of kin information, any medical needs/history and other information. This is so that it can be easily accessed and is already documented so there is no need to phone family or hospital to find out medical records. It makes things a lot easier and helps run a lot smoother too.
Having a conversation face to face can often lead to missing things out or forgetting what you wanted to say. This is why a written letter is a better way of communicating in this case because you can plan what you want to say before you write it down, lowering the possibility of forgetting certain things.
Oral Communication is often seen to be used in various settings associated with Health and Social Care and Early Years, such as a hospitals, residential homes or nurseries.
In a hospital, Oral Communication can be witnessed through conversations between a Doctor and a Nurse, Doctor and Patient, Patient and Family Member. More of a connection can be made through Oral Communication as those that are engaging in conversation can view facial expressions and body language. Interest can be shown through maintaining eye contact, and use of tone and pace enables people to pick up on how a person is feeling. Being able to pick up on a person's tone is an essential skill needed in order to recognise exactly what is wrong with a person, for example, when they are examined by a doctor, the doctor must be able to pick up on the situation if the patient does not talk very much.
When a Patient is discussing their symptoms with a Doctor, this will be done through the use of Oral Communication. They will explain everything that is wrong with them, and the Doctor will diagnose appropriately, explaining the diagnosis fully to the Patient and talking through any medication they will need, how often to take it and what dosage to take. However, if the Patient lacks the mental capacity to understand, the Patient will have a named person (advocate) to assist them with any decision making and the Doctor will explain everything to this named person, who will then ensure the Patient's needs are met. This will lead to the patient feeling positive about their care and they will feel very supported throughout this.
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In a residential home, Oral Communication can be seen through the conversations between Management and Care Assistants, Care Assistants and Residents and Residents and Family Members. As with the above examples, a Care Assistant must be able to pick up on changes in the behavior and speech of the Residents, in order to recognise if the Resident is unwell. I work in a Residential Home for Dementia and I know that usually if the Resident is acting more out of the ordinary than usual in the way that they talk or the way they behave, they may be displaying signs of an oncoming water infection, as this can affect the person. If a person working in a Care Home cannot pick up on slight changes in a Resident's behavior, they could neglect to recognize other important factors.
Care Assistants offer the Residents a choice of clothing every morning to give them freedom to choose whatever they wish, this is through Oral Communication and asking them specifically, 'What would you like to wear today?'. By doing this, they will feel as at home as they can whilst still being in a care setting.
Residents are also told the menu choice each day by the Care Assistants during lunchtime, which is again to enable them to have a choice in the meal they eat. They are provided with a variety of meals to choose from which helps cater to each Resident's needs. By giving individual's the choice to pick what they would like to eat, they will feel empowered about their care because they will feel in control.
In a Nursery, Oral Communication is noticeable in conversations and discussions between Children and Parents, Parents and Nursery Nurses and Nursery Nurses and Children. When working with young children, a Nursery Nurse must be able to pick up on whether a young child is feeling unwell, unsettled or unhappy. If a child is left unsupported for too long, they can become distressed and this could lead to problems with development and attachment further on in life. A child needs to be supported from a young age in order to reach their full potential.
When a young child is showing signs of being unwell (irritability, drowsiness, bad behaviour), the Nursery Nurse on duty will phone the Parent of the child to come and pick the child up from the setting. Once the Parent has arrived on site, the Nursery Nurse that phoned them, will explain to them exactly why they phoned them, through the use of Oral Communication to make sure that the Parent listens to the concerns of the Nursery Nurse about their child. They may suggest appropriate suggestions for the benefit of the child's health and well being. This will make the parents feel supported when dealing with their child's illness.
Oral Communication is vital in Care Settings, otherwise good relationships between everybody would be non existent, and there would be a bad or tense atmosphere within the settings which will not benefit anybody. It is the easiest way to build relationships between a care worker and a service user.
There are many more examples of Oral Communication that can be used throughout many different care settings. The next type of communication that I will be looking at are Special Methods.
Special Methods can be defined as the use of all available receptive and expressive modes to enable communication with visually impaired, hearing impaired and disabled people. Some examples of Special Methods can include:
Sign Language – a way of communicating using visual gestures and signs to communicate with deaf people.
Braille – a form of written language for blind people, in which they use their fingertips to feel for characters made up of raised dots
Makaton - is a language program made by using signs and symbols to help communication
Translators – a person helps communication by translating one language into another
Advocates – a person that speaks for someone who is unable on their behalf
Again as before there are advantages and disadvantages to using Special Methods of communication. Some advantages include; being easy to learn from a young age since if a child is taught early, they will remember more than being taught at an older age.
Special Methods can be very clear and quick, meaning it is more convenient for people to use them rather than speech if they cannot do so, or have difficulty with their speech.
One huge advantage to Special Methods, particularly Sign, is that the different signs remain the same throughout, no matter what language.
They are also very useful for immediate translation (translators).
There are still some disadvantages to using Special Methods of Communication. One main disadvantage is that there are issues with privacy and accuracy when using Sign Language.
There is also another major disadvantage, and that is that Special Methods are also quite time consuming.
A barrier of Special Methods is that both partners must be able to understand, which can become a problem if one person is an avid user of Special Methods and the other person is used to communicating through speech.
Special Methods can be seen in Early Years settings such as nurseries. If a young child enrolls at nursery and they are deaf, there should be at least one adult that can use sign language to communicate with the child in order for them to feel included in every group activity, rather than isolated for being different.
Special Methods are also used in many Health and Social Care settings such as hospitals. If you walk into a hospital, most signs and medications have Braille labels, in order for people with sight difficulties to still be able to know where they are and what medication they could potentially be taking.
Many documents now can be sent in the mail to people with sight problems, with the option to send them back and have the letter re-sent in the format of Braille to cater to their needs.
A Patient that may be from another country, may attend a hospital in England and a Doctor may be struggling to understand their speech. This is where a translator comes in, they translate from one language to another to help reduce the barrier between Patients and Doctors.
There may also be a time where a person does not have the mental capacity to make choices for themselves when it comes to their health. People with this problem usually have a named Advocate to make these decisions for them based on their best interests and their health. By still allowing this person to have a say in their health plan, they will feel empowered and feel their views are being valued.
Special Methods are very important in both Health and Social Care settings and Early Years settings because they enable every person to keep involved and informed about events going on in the settings, no matter whether they are deaf, blind, or have no impairment.
A third type of communication that can be used in care settings is Computerised Communication.
Computerised Communication is any communication that occurs through the use of two or more electronic devices.
Some examples of Computerised Communication are: writing Emails, using mobile phones, internet web pages holding information, and the use of social networking.
To show how web pages are adapted to fit the needs of those with impairments, I am using the Norfolk and Norwich University Hospital web page as an example.
As you can see above, when first loading up the Norfolk and Norwich University Hospital page, there is a drop down menu which can enable those going into hospital to find out more about what will be going on, where they will be staying and they can even look up leaflets about any operations they could be having. This is to help anyone feel calmer and supported about the experience that they could be facing as it is a nerve-wracking experience for anyone who has not been before, or who has no knowledge of what a hospital is like.
Another feature that can be seen on the home page, if you scroll down to the end of the page, are translations. This is to enable people, who may not speak English as their first language, access to the same information that others have because they too have a right to know what will or will not be going on during any procedures. The hospital homepage looks much more professional and people friendly, as it shows that they cater for the needs of people from other countries too.
Not only is information gathered from web pages on the internet, information can be gathered and communication can also happen through social media such as Facebook, Email and other applications. Email is not often used nowadays because people find it much easier to text or call because it is much more instant when a response is needed, such as when a GP Surgery needs to confirm an appointment, they would phone the person up to confirm this and have an instant answer, instead of having to send out an email and wait for a reply which may not come because the person might not have checked their emails recently. This is why instant messaging is much simpler for finding out information when it is needed. I myself am a daily user of social media and texting, and only check my emails once a day so I find it more convenient to text and call.
If something had happened to a resident in a care home, such as they had a fall, a phone call to the family members of this resident would be in order straight away rather than sending out an email because it enables a quick response that is personal to the recipient.
Computerised communication does also have its drawbacks such as the internet and emails can sometimes crash and important information could be lost and not be able to be recovered. This is an inconvenience to everybody involved as it means a lot of time is being wasted. This is when some would suggest that oral communication would be better. However, many care settings use computers to keep records or files about the children in their nursery, the residents in their care home and the patients in their hospital. These files are supposed to be strictly confidential as part of the care value of maintaining confidentiality. This is why many computers are password protected in order to keep whoever the file is about, safe and secure. This is to help them feel valued and supported. It will also help them feel confident and trusting in their carer's because they know their personal information is being kept private, only being released to the appropriate people when necessary.
The final type of communication, is Written Communication. Written communication can be defined as any correspondence between people through the use of writing. For example, writing a letter to a person talking about symptoms they may be having. Although written communication is very similar to oral communication, the rules are quite different.
If someone writes something down incorrectly, in a hospital or doctors setting, a person may be given the wrong medication or the wrong treatment. Those that use written communication to talk to others must ensure that they have their facts correct as giving out false information could cause people to feel less trusting towards them and could have serious consequences. In a Residential Home, there may be computers that are password protected in order to keep Resident's private files confidential and kept away from others. Whereas most people can ensure that documents on a computer are not going to be released into the world, it is a lot easier through written communication because a person may drop the paper and it would get into the wrong hands causing chaos and plunging fear into the hearts of whoever the letter was about. Again this links to the maintaining confidentiality care value, however sometimes, it is unavoidable as written communication is not as secure as computerised, yet is more secure than oral communication as anybody could be eavesdropping when important information is exchanged by word of mouth.
Other examples of written communication can include the use of signs, which can give either instructions, advice, or directions in order to help those that may have a hearing impairment. Signs are there to enable those that need to see things for themselves visually to understand what is required of them. Another type of written communication are letters. These can come from hospitals, GP's, Blood Donation or opticians etc. These are used to inform people of any appointments they may need to attend, any information they have requested from these services, or just leaflets being sent through their door. One final example of written communication are care plans. These can be found in any care setting such as a care home. These show all the different requirements of certain individuals like their allergies, height and weight, and any health concerns. Care plans are also found in early years settings such as nurseries and primary schools, however these are slightly different in comparison to care plans. They are called learning journeys. A person called a key worker fills these in. They talk about how a child develops all throughout their nursery and primary school life such as their literacy, numeracy and reading skills. They inform parents on how their child is doing. This will help the parents to feel more involved in their children's learning.
Presently, not many people still communicate using letters or other means of writing to communicate because it is very time consuming to hand write anything that needs to be said.
Many find it is easier to use one of the other communication methods in order to exchange information, they may find this because they feel more secure with emails rather than letters because absolutely anyone can open a letter that isn't addressed to them, however with an email, they must have the correct log in and password. Password protected computers enable the Data Protection Act to be put in place. The Data Protection Act enables confidentiality to be in place between two people, to stop private files getting seen by people that are not supposed to see them.
If the different types of communication are used correctly, and in the way that they are supposed to be used, it will leave service users feeling extremely valued, supported and will leave them feeling empowered, due to having people care for them and being listened to whilst in the different care settings. I know that after a visit to the GP, I feel much better because I feel I have been listened to and had each and every one of my worries taken care of.
Some factors that can inhibit or enhance communication are positioning, environment, emotions, special needs and pace/tone.
Firstly, when looking at positioning, you must take into account the height of the person you are engaging in conversation with. If you are looking over the person, they may feel intimidated and uncomfortable and as a result of this, the conversation will not be very long lasting. However, if positioning is used correctly and the people are sitting near each other and facing each other, the conversation will be more comfortable as the people will believe that they are being listened to. An example of this is in a doctor's appointment, where the doctor faces the patient so that they feel comfortable enough to discuss their issues. If a person feels as though they have no personal space, they are less likely to open up and be comfortable discussing their health.
When looking at how the environment inhibits communication, there are many different subtopics that are involved. The subtopics are space, lighting, ventilation and noise.
Spacing must be thought out so that sufficient eye contact can be made between the recipients so that they can give the impression that they are listening. Also, people should be positioned so that everyone involved can hear and see each other. People should not be too close as they may feel very awkward and not want to engage in conversation, but likewise, they should not be positioned too far away because if they feel as though they are shouting to each other just to be heard, they may find it embarrassing and pointless.
In some situations, when appropriate, background music is used to give a comfortable environment for the people involved. We use this in my care home, where we have quiet and appropriate music on so that the silence is always filled, however if it is too loud, they may feel overpowered and unable to talk. When an environment is too quiet, the situation may not feel like it is a conductive environment to talk in. I have found that some hospitals also use the technique of background music when it is appropriate to break the silence that is usually noticeable.
If a room is not well ventilated, the environment can become uncomfortably stuffy and warm, which will inhibit the conversation because the people in the room may feel sleepy and not want to talk, whereas if the room is too cold, the people are unable to concentrate as they will be focused on their body temperature. This is why in a doctors surgery, they may have heaters in winter and air conditioning in summer to make sure that the conversation can take place and make the patient feel a little more comfortable.
Lighting can also affect how well or not well a conversation flows. If a person needs to take notes, the lighting is more effective when it is on full, however if the atmosphere needs to be more relaxed, dimmed lighting works better. People that have certain disabilities, require different types of lighting, such as those with epilepsy, they cannot look at flashing lights or they could have a fit. In a hospital, it is more often found to have full lighting because they have notes to take and records to fill in about certain patients, whereas in a place of childcare, they often use the sunlight through the windows because they only have to complete the learning story of each child which they can complete at home.
Emotions tend to have an effect on communication too. This can be either positively or negatively. If a person is in a happy and comfortable mood, they will be more likely to engage in a long conversation and discuss their needs. However, in comparison with a person that is very emotional and could be crying, they are less likely to open up and discuss their health. An over-emotional person may not feel as though they can talk about their health, which could be mental health, and due to this, they can end up not getting the support and help they require.
A person that has special needs may find it hard to get the help they need to, whether they have a speech impediment, hearing impediment, or learning difficulties. It could just be down to not being able to communicate appropriately such as not having an advocate to help get your views across, or get the help they need. This can cause problems with communication for these reasons. People tend to avoid situations where they have to ask for help, if they struggle with talking incase they end up embarrassed or mess their words up because of a speech impediment. This is a barrier if a person does not have the necessary help they need to talk or communicate with people.
Pace and tone can also affect communication both positively and negatively. If a person speaks in a too stern tone, they may come across as a nasty person or a person to avoid. But just as a person can talk in a too stern voice, they may also speak in a way that comes across as patronizing and offensive to others. People interpret tone in different ways to each other. One person may find it nice and comforting, whilst others might feel they are being rude. It all depends on how a person thinks. Using tone appropriately can enhance the conversation because people will feel comfortable talking to each other if a person is being kind and comforting with their voice.
Pace of voice can also affect communication in a positive and a negative way due to different things. Negatively, would be when a person talks to quickly or slowly for a conversation. If a person is talking too slowly, the other person in the conversation is likely to get bored and become uninterested in the conversation. Similarly, if a person talks to quick, the other person will be unable to keep up with the conversation and will again, become uninterested. The person using inappropriate pace may not even realise that they are doing it. However, if a person speaks in the appropriate pace, communication is enhanced and the conversation will flow well.
Finally, language can perform as a barrier to communication. If a person headed to their appointment and found that the GP they were seeing speaks in a different language, it would be very hard for the communication to flow properly for this reason. They both would be unable to understand each other. This is also the same when a person falls ill or has an accident whilst they are abroad on holiday. When they get to the hospital, they may not have a doctor that speaks their language available. This could mean they consent to things without fully understanding the procedure, meaning the person with ill health or an injury, could feel unsafe and unsure about their care. This is an example of bad communication. However, still using this example, if the hospital had a translator available to use, the communication would be much better because this translator works both ways. He or she would tell the patient what the doctor had said and vice-versa. This helps keep patients calm and feeling at ease about what goes on at the hospital.
There are many different inhibitors and enhancers of communication as seen above. If they are dealt with in the correct way, communication should not be affected and it should be very effective.