Health And Social Care Coursework

Desi Gillespie

One To One Interaction – 29/09/2007

For the one to one interaction we were set in the scene of a post operation clinic and I was a student shadowing a member of senior staff. With this position I was able to ask questions to the client. For this situation I was dealing with a client in the category of sick adult. This is due to her needing to go into hospital for surgery to improve her well being.

Planning

For this interaction I will be interviewing a client that had recently had a hospital experience. I will ask questions using open and closed questions to gain information hopefully this will enable me to extend my knowledge.

I will set up the room appropriately to create an environment that suits the type of interaction I will be undertaking. I would like the room to be set up in a way that will make the client feel relaxed due to the fact I would like them to feel comfortable and to have the ability to open up and speak without hesitation. I have chosen a small room to undertake my interaction because a smaller space will not be as daunting as a large space. An empty room would be most appropriate because it can lower the chance of distraction in the interaction. In the room I will make sure that there are no tables to create a barrier between us and hopefully create a connection. Another barrier that I will try avoid is the disturbance of other people entering the room. Barriers can block understanding and can change the meaning of a message that is being put across. I will insure the chairs in the room are at the same height so the client does not feel empowered if the student’s chair is at a higher level. Empowerment enables the client to make choices and take control of their own situation. I would like to have comfortable chairs, this should make the client to concentrate on the interaction then get distracted by the chairs they are sitting on by moving around or moving around in the chair. These can all be signs of agitation or a nervous reaction.

Diagram represents the room set-up

To present myself I will use certain body language to create a message to the Panel and to my client to show that they are supported and that what they are saying is being heard and acknowledged. Also the listening skill will insure that I know what is being heard by the other members of the Panel, so I can analyse and use what they are saying in a way that can win our case. The skill I will use is active listening which involves more than hearing, it also involves using the communication cycle and being able to demonstrate what I have understood when I am listening to the client and other members of the Panel. The communication cycle will have to be used multiple times to each member of the Panel, to show I am listening to all the members. This will be more challenging especially when more than one person tries to talk at the same time. I will have to try and undergo the communication cycle multiple times at once.

The Communication Cycle

Due to this particular client being older to myself I will modify my language to have respect that they deserve. It is possible that this client has hearing problems due to age but I will insure that I will modify my language that will suit the client. I will have to make sure that I will not be discriminating them because of their age and modify my language in a non-obvious way. I will have to make the modification as discreet as possible. This is vital when maintaining the client’s dignity and to show that I am respecting them.

In the interaction I will hope to have an open stance to look confident but lean forward to indicate that I am interested and being supportive. Throughout the interaction I will insure that I am making eye contact the whole time even if the client is not. This will make sure that they know I am concentrating on them the whole time and not getting distracted. This can be another sign of respecting a client because it shows that I have full focus on them and not thinking about anything else. If a situation comes I might use touch ...

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For verbal communication I will use open and closed questions throughout, I will start with closed questions to make the client comfortable then use open questions to get more information out of the client. If the client is reluctant to speak I will use the aid of prompts, which are different approaches to getting the answer I would like from the client. I will keep an encouraging and supportive tone throughout so the client can tell through voice that I am supporting them. Another skill I will try to use are understanding checks, this could either be by repeating something and evaluating or by nodding and saying check words like ‘yes’ or ‘I understand’.

Effective communication depends on identifying barriers that may block understanding. Barriers can exist at a physical and sensory level, at the level of making sense of a message and at a cultural and social context level, whereby the meaning of a message may be misunderstood. Before the interaction I will try and eliminate as many barriers that could occur, and try to prevent any others occurring. This can be by making sure the room where the interaction will take place is quiet and there are as little distractions as possible. To prevent emotional barriers I will insure that I will not impose my own agenda and make sure that I think about the client’s feelings all the time. I will also need to insure that I do not give any inappropriate advice or to be patronising. These emotional barriers can all be avoided by preparing beforehand. To prevent social barriers I need to avoid stereotyping, labeling the client, having no respect towards the client or having a defensive or a distant attitude. Throughout the interaction there can be no inappropriate language, aggressiveness, interrogating or repeating words without thinking.

What I will make vital is the confidentiality between the client and myself. I will not mention the clients name or gender, this will insure that they cannot be recognised to any extent. Confidentiality will include keeping the information discussed safe and only passing it on where there is a clear right or need to do so, it is also important moral and legal right, promoting safety and security of the client. This maintenance of confidentiality is vital in order to maintain a sense of trust between the clients and the worker. To transmit confidentiality I am not able to transmit by non-verbal skills such as body posture. I will need to physically close doors or tell the client about it. Whereas I can respect the client by using my body language, by having a lower seat or by having a respectable tone of voice.

For the interaction I have some questions that I plan to ask to gain as much information as I can to help extend my knowledge or interacting with hospitalised clients.

Questions to Be Asked

What did you have operated? (closed question)
When did you have your operation? (closed question)
Where did you have your operation? (closed question)
How was the ward that you were on? Did you feel you got the support and attention you needed or wanted? (open question)
Did you feel you got the support you wanted or needed once you returned home? (open/closed question)
Was physiotherapy required after your operation, if it was did you get the amount you wanted? (closed question)
(Depends if she had Physiotherapy) Were you able to carry out these exercises once you returned home? (closed question)
Did you feel the operation went well and as you hoped? (open question)
If there were to be any improvements in your stay or operation what would they be? (open question)
Were the staff helpful throughout the process of having the operation? (closed question)
Do you feel better for having the operation? (open/closed question)

Interaction

In the interaction the client started answering with direct answer but as the interaction progressed they gave more detailed and longer answers. My partner saw that throughout they were fiddling with their hands and used hand gestures when talking or explaining. They had a confident tone and the posture was mainly open throughout the interaction but at points they closed their positions. When I asked them about their operation they were confident enough to show the scar on their knee.

In the interaction I tried to use all the skills that I mentioned in my planning. My partner judged me and highlighted what I did throughout the interaction and what the client did during the interaction. For non-verbal communication I tried to use as much eye contact as possible even if the client wasn’t trying to make eye contact. My partner, who judged me also noticed this, they saw that I was attempting to keep the contact to show that I was listening to the client and focusing on them. For my posture I had an open stance but leaned forward slightly to show that I was listening. My partner noticed that I used hand gestures, these can be used to emphasise something with the assistance of gestures. The main problem during the interaction was that my knee started to shake, my partner noticed this, whereas I did not realise. This happens when I get agitated therefore I will need to improve on this to insure I do not give off gestures that could make me appear rude.

To show that I undertook active listening I tried to make a signal to show that I was understanding what was being said. My partner noticed that I was saying ‘yes’ while nodding and occasionally summing up what was said after a few questions had been asked, to evaluate and insure that the correct information was taken in. This was also shown as a reassurance gesture for the client as it shows that what they are saying is being understood.

To show that my verbal communication skills were active I used a tone that was reassuring and supportive. I was trying to insure that my tone was modified to be respectable for the client. I tried to use prompts to seek more information or to get more detail this was noticed by my partner as they noted and said it was an understanding act. They also noted that the questions asked were respectable and respected the client’s dignity. I wanted to make sure that the questions asked did not throw the clients nerves. At one point with one question the client closed their posture which indicated that it was an uneasy topic to discuss. In the interaction I started off with closed questions to put the client at ease then I moved onto more open questions so I could get more information out of them.

In the interaction there were a few physical barriers such as noise outside due to the window being open and beside a busy road. This could have been a distraction to the client, another noise barrier was a washing machine. It was going beside us. During the interaction a person walked into the room and started to observe the interaction even though I said beforehand that I would like to keep the room to ourselves. This could have been intimidating for the client due to another person listening to personal details.

To highlight care value base I insured that my language and tone of voice was modified to have a respectable tone. I also talked to the client about confidentiality of the interaction. My partner stated that they noticed this in the interaction and how I respected the client’s dignity throughout.

Conclusion and Evaluation

To improve the non-verbal section for the interaction I need to insure that my knee does not shake during a conversation. This can be put off as rude or a sign of agitation. I believe that I had the correct amount of eye contact throughout to maintain a constant focus. I was pleased with the verbal communication because I was able to create the right tone of voice and used the understanding checks at reasonable points. The interaction was meant to be between 2-5 minutes but my interaction lasted 7 minutes 20 seconds therefore I need to improve my time management and be able to finish a conversation in a respectable way.

I could improve the barriers by undergoing the interaction in a different environment. The best place would be in an empty room with little distractions. For the next interaction I need to make sure that no other people enter the room because that was a very disrupting barrier.

To show I was transmitting care value bases such as confidentiality, I told the client that the information discussed would be confidential. I stated it in the consent form, I kept the door closed whilst undergoing the interaction and throughout this write-up I do not mention the clients name or any information discussed in the interaction. To respect the client’s dignity I asked the client if I could call them by their first name, if I called them ‘darling’ or a pet name or their first name without their permission, this would have been very unrespectable. Another form of respect for the client was giving them choices, asking if it is alright o discuss certain matters and also giving them the option to not discuss a situation.

Another factor that I wanted to maintain in the interaction was to make the client feel that they have empowerment. This enables the service user to make choices and take control of their own life and decisions. To make them feel empowered I tried to get a slightly higher chair. By asking the client questions it can make them feel more important as the student wants to gain information and they can only gain that from the cooperation of the client.

I thought the interaction went reasonable well but there were still things that I needed to improve for another interaction. In this interaction I was able to gain the information that I wanted and I feel it was in a respectable way and I was able to use all my skills that I have gained by studying effective communication.

If I were to interact with a child in a play school, if there was a sick child or if I was shadowing a social worker to find out what the children thought of the environment of the play group. I would modify my language by using shorter, simpler sentences. I would also need to insure that I make the interview short because young children normally have short attention spans. For my tone of voice I would need to make it a happy yet comforting tone this is so the child would feel comfortable talking. When asking questions there should not be too many open questions but some questions that could be interpreted as open or closed questions should be asked. This is so the child can open up if they feel confident. When in the interaction I would have to make sure that I am at a lower level to the child because if I were to be higher this can be very daunting on a child.

Another situation would be in a residential home where there can be clients that are blind or deaf. If there was a blind client that was being interacted with, I would need to make sure that my tone of voice is supportive and reassuring, also I must not raise the volume in my voice because this can be discriminating. For this case I would need to improve my verbal skills in a tactical way. If I wanted to show them an article or a consent form I would use Braille to communicate with them. Another case in a residential home is a deaf client. I would need to use my non-verbal skills more this is because the client would be able to analyse myself by my posture and presentation. To communicate effectively I would use sign language. In both of these cases I will keep confidentiality and care value bases the same.

For another interaction I could also change the environment by making more barriers purposefully such as having a table in-between the client and myself. This could create empowerment for myself in an obvious way to the client. Different environments can change the feel of the situation. To improve confidentiality I could interact with the client in his or her own home, this can relax them more as it is their space. Similarly if I were in a hospital I would not be able to make sure that no one else hears the interaction yet I can still close the curtain to show a physical barrier to the client.