Fourth step - Message received: The child has taken in the information and may react to the news in an upset, confused or angry way. The nurse must show empathy to the child so they can understand why the child is reacting the way they are. The child may have many questions and so the nurse must show through body language, such as sitting openly and leaving silences for the child to think about what they have just been told, that they are ready to answer any questions the child has.
Fifth step – Message decoded: The child understands what has been said to them. The nurse must ensure the child has the correct information about what has happened and what is going to happen in the future.
Sixth step – Message understood: The child understands what the nurse has told them, and has received and decoded the message. The nurse and the child can now move on to other things, such as how the child is going to be cared for and going to see the ill parent.
Tuckman looks at the way groups of people work together whilst communicating.
The first stage of Tuckman’s cycle is called forming. This is where the group is formed, and roles are allocated to people within the group. This stage is essentially used to get the members of the group to get to know each other and share information and knowledge, as at the moment they will still be acting independently as they are not quite yet comfortable with each other as a group. There will be a team leader who will have to play a big role in this stage of trying to get all the members to interact and get to know one another.
The second stage is known as storming. This is where the team is given a task and the members begin to understand the task given to them and begin to produce ideas that they believe will help the group succeed. If the ideas are successful, then bonds will be formed, people will begin to work more together and less independently, and the productivity of the group will increase. The team leader will have to interfere less in this stage.
The third stage is about beginning to form a ‘togetherness; within the group. This stage is known as norming. This is when the team members come together, get used to each other, and are all clear about who is doing what role in the group, and how they will do it.
The fourth stage is known as performing. The team are all confident now in what they are doing and fully understand the task they have been given. The group now has the ability to maintain relationships to a high standard, and any disagreements are solved in a calm manner, usually without the help of the team leader.
An example of Tuckman’s theory would be a new nursery starting up with all new members of staff, coming together under the leadership of the nursery manager.
In the first stage they would start to get to know each other and form relationships, and under the manager’s leadership, they would start to develop ideas of how the nursery will be run.
In the second stage they will begin to contribute ideas, and they will probably all have different ways of going about different things. The leader will have to make sure all the ideas are listened to and will guide the group into discussing which ideas would be the most effective and useful. There may be some disagreements in this stage in which the manager will have to intervene.
They can move onto the norming stage once they have identified how they want to run the nursery and what each team member will be doing. The team members should be working together and communicating with one another by this stage.
Finally, the group will be able to work together without the assistance of the manager, as they should all be confident in what they are doing and be able to solve any minor disagreements by themselves.
In my scenario, both Argyle’s and Egan’s would come in useful to use. Tuckman’s theory, however, would not be suitable, as it is not a group communication, it is one-to-one.
Argyle’s communication cycle will be useful as its very simple and general, meaning it can be applied to many scenarios easily.
Using the first step of Argyle’s communication cycle will allow me to plan the conversation beforehand, such as the environmental factors like the setting and time that I will talk to her (the activities room whilst the other children are upstairs getting ready for their evening activities, so that she is not distracted by other children in the room and she doesn’t feel intimidated by their presence.) Being on her own with me in an environment she is used to and comfortable with should also hopefully give her confidence to tell me how she really feels without the worry of being judged by other people around her listening in on our conversation. However as I am an authority figure she may be submissive and feel like she has to tell me only positive things, and may be apprehensive to tell me any bad things, so I will have to overcome this by being very friendly with her, and use both the communication cycle and the SOLER theory, so that she feels more relaxed and opens up.
I will be using Egan’s SOLER theory (whilst also using Argyle’s communication cycle step 1) to plan the way we will be sitting. This will be that we will be sitting squarely to each other at a 5 o’clock position, so that I don’t find myself staring at her as this could make her feel intimidated, but we will still be fairly close so that we can face each other and make appropriate eye contact when needed, so that she feels like I am attentively listening and I genuinely want to listen to what she has to say, and so that she feels like I am available to her. This is important because if I turn my body away from her it will lessen our amount of contact and make her feel uncomfortable, leading to her not wanting to open up and speak to me about how she feels, which will be the opposite of how I want to make her feel. If I make sure that I am acting relaxed and comfortable, this should, in turn, make her feel relaxed and at ease, so that she can talk to me confidently.
The lighting of the room will be natural light, as it will still be light outside at the time of our conversation (about 6 O’clock), and artificial inside light will not be needed. This means that the child won’t be startled by any very bright lights in the room, but the room won’t be too dimly lit that we cannot see each other’s facial expressions, lip movements and body language. Lighting is also an important factor to take into account with this particular child as she has a noticeable stutter and because of this she sometimes experiences fear and/or embarrassment. As a result of this, she sometimes tries to hide her stuttering by avoiding saying certain words or avoiding speaking at all, meaning the conversation won’t be successful as she won't be able to tell me her true feelings. If the lighting is too dim, I will have trouble lip reading as she speaks, and may not be able to understand her properly, meaning I will have to ask her to repeat herself which draws attention to her stutter making her even more embarrassed and apprehensive to talk, so the lighting needs to be bright enough to see her properly but not too bright that she is startled and intimidated.
The language I will be using will be English, as this is both mine and the child’s first language, meaning there shouldn’t be any communication barriers caused by language.
Using the second step of Argyle’s communication cycle will allow me to think about what I want to say before I speak, and how I am going to say it. For example what kind of language I will use (slang, jargon, informal, formal), because of the child’s age, as using jargon may confuse them and they may not understand what I’m trying to say. Using slang also may confuse her, as she is fairly young and as she has lived in care homes for the majority of her life, with children with learning disabilities, she may have not been exposed to many people using slang, and will therefore not understand it either. So I will have to plan out my speech using simple words that she will understand, but not too simple that they don’t prompt her to give a detailed answer. I will also be using more informal language, as if i use formal language she will associate this with me being an authority figure and may change her behaviour and what she says, whereas if I use more informal language then she will see me as more of a friend and hopefully tell me how she truly feels. I will use open questions to prompt her to give me more detailed answers and then further encourage her to elaborate on what she says if I feel that it is necessary. Using closed questions will often lead her to just answer simply ‘yes’ or ‘no’ and I will not get enough information out of her to know if there are any things about living in the care home that needs to be further assessed, and I won’t know how she is feeling, for example if she is happy whilst in the care home or not.
A strength of using Argyle’s communication cycle theory for this conversation is that it allows me to think before I speak, plan out beforehand what I am going to say, where I am going to say it, and what kind of language I will use. This should make the conversation more effective, and have the effect that I intend it to (to make sure the child is happy in the care home and find out about and assess any problems she may be experiencing). However, a weakness is that no matter how much planning and thought I put into this conversation beforehand, it does not completely guarantee that the child will fully understand me, or interpret what I am saying exactly how I intend it to be interpreted.
In the conversation I will ask the child some questions, but not too many that she gets bored or feels uncomfortable. At first I will start off lightly, like ‘how was your day today’ to ease her into the conversation, and then I will explain why I’ve asked her to come and talk to me, to put her at ease almost straight away and remove any worries that she is in trouble or something bad has happened, before moving onto the real questions I want to ask. I will ensure I talk to the child clearly and use the types of language that I planned to in step two. I will make sure that I am always sitting in a relaxed manner and have an open posture at all times, so that I am always coming across as approachable and as if I genuinely want to listen to the child. This should make the child also feel relaxed and she will answer my questions openly. Once I have asked the questions I will give the child time to think about what she wants to say before she answers, and whilst waiting I will avoid making direct eye contact as this could make her feel pressured into answering me straight away and then not saying what she truly feels. I will be prepared throughout the conversation to comfort the child if she gets upset over anything that she is talking to me about, such as something during the time she has been living in the care home that has upset her.
After the main part of the conversation has ended I will ensure that the child has told me everything she wants to and reassure her one more time that she is able to tell me anything without getting herself in trouble or making me angry by telling her in a friendly way “ (name) is there anything else you would like to tell me today before you go back and join in with the other’s and their evening activities?”. I will ask this with a smile and friendly body language, and I will leave a slightly longer silence after asking, to let the child have her final thoughts about what she wants to tell me, if anything.
When having my conversation, I may encounter some communication barriers. These are factors which may affect an individual’s ability to communicate effectively by preventing or interfering with the person's ability to send, receive, and/or understand a message. Some examples are:
Visual and/or hearing impairments can act as barriers to effective communication. These barriers mean that the person has difficulty is seeing written communication, such as a letter or email, and/or hearing spoken word conversations.
These needs can be seen to by speaking clearly and slowly, and/or repeating, rephrasing what has been said, to help people understand what is being said to them. Time should be given to the message receiver; so that they can digest the information they have received and think about how they want to respond. Electronic devices can also be used, such as text phones, telephone amplifiers and hearing loops, and it is important to give the individuals using the devices enough time to use it whilst communicating. An induction loop system helps deaf people hear sounds more clearly by reducing or cutting out background noise.
Conditions such as Cerebral Palsy, Down's syndrome, and Autism tend to limit a person's ability to interpret other people's non-verbal communication, such as body language, and their ability to communicate verbally. In a care setting these needs should be attended to, so that effective communication can be achieved.
A big issue in Britain, being a very culturally diverse country is the foreign language barriers between people. Even though in Britain, the official language is English, to many residents of Britain, English is only a second or third language to them, or possibly not spoken/understood at all. This can be overcome in health and social care settings in many ways, depending on the situation. For example in a doctors surgery the information leaflets given to patients could be in more than one language, or in care homes translators could be employed so that the care workers can communicate effectively with the patients easily, through the patients preferred language and know that both parties are being understood by one another.
Different people from different cultural backgrounds also interpret non-verbal communication differently (see cultural differences in communication) so care workers who work with people of these different background should be trained and have basic knowledge of the cultures they work with, so as not to offend patients, or give off the wrong impressions, as one thing that may be seen in British culture as friendly, may be seen as extremely rude and offensive in another.
A dialect is the language used in a specific area or culture. This can create communication barriers if someone not originally from a certain area is trying to communicate with someone in that area, or vice versa. For example people from Thanet may use certain words that are local and specific to Thanet. An elderly person who is not from Thanet, but just recently moved into a care home in Thanet may encounter communication barriers if the staff members in the care home try to speak to them using 'Thanet-specific' words, as they will not understand the local dialect.
Jargon is technical language that is understood by people in a specific area of work or industry. Health and social care workers often use jargon to quickly communicate with each other, for example a doctor communicating with a chemist about what drugs and dosage to prescribe an individual. These jargon terms used will only make sense to those with the knowledge of how to use and understand them. So if the drugs and dosage are not explained to the patient in a more general way that they will understand, not using slang or jargon that is industry-specific, then the patient may be very confused and end up taking the wrong dosage or taking the drugs at the wrong time of day.
Environmental problems can be large communication barriers. For example an environment that is noisy will reduce an individual's ability to listen and communicate. An environment that is poorly lit can affect someone's ability to read non-verbal communication signs, like body language, or can reduce a hearing-impaired person's ability to lip-read. Such environmental problems can be overcome by making changes to the physical environment. For example moving into a room with brighter lighting so that someone with hearing impairments can lip read more easily (this is improved even more if the care worker is facing the light so that their face and mouth is more clear and visible, or moving into a quieter room, so that the background noise is reduced.
In my scenario I may encounter some of these communication barriers, such as speech (the fact that the child has a stutter), the dialect that is used, jargon, and environmental problems.
Speech: I will overcome the communication barriers caused by the stutter by not drawing attention to it, as this will make the child become more self-aware of it and might discourage her from talking. Environmental factors will also contribute to this, as the room will have to be well-lit so that I can see the child’s lip movements as she speaks which will enable me to understand her speech more and not have to ask the child to repeat herself, causing further embarrassment to her.
Jargon: When planning my conversation I discussed how using jargon may confuse the child, and therefore I will overcome that issue by not using it unless necessary.
Dialect: The dialect used must be fairly simple so as to not come across communication barriers linked to this. Dialect is the language used in a specific area or culture. The child has lived in this area for her whole life, but for the majority of it she has been in care homes, and so she has not been exposed as much as other children to the local dialect. This means that using the local dialect to communicate with her may confuse her and make her feel uncomfortable and/or embarrassed that she doesn’t understand what I am saying to her.
Environmental: The activities room at this time of day will not be in use, so it will be quiet meaning we will both be able to hear one another clearly, reducing any noise-linked communication barriers. The room will be lit with natural light and because it will only be about six o’clock, the sun will still be up and the room won’t be dim. If the room was dimly lit then we would not be able to see each other’s lip movements, facial expressions, and body language, meaning that some messages may be wrongly interpreted.
Muslim women have very different cultural beliefs and rules compared to British women. The child I am speaking to is still a child, however she is 14 years old and is seen as a young woman in the Muslim culture, therefore follows many of the Muslim traditions and regulations. This means that I have to take into account these cultural differences whilst planning my conversation with her.
Even in a health and social care setting, many Muslim women will react strongly against any physical contact with men (for example a medical examination by a male nurse or doctor), as in their culture it is seen as dirty and humiliating, leaving the woman feeling sinful and spiritually unclean. Females should not greet or shake hands with males unless they are family, for example a husband, brother, or father. Females are also not allowed to sit with males in privacy, like the setting in which I am planning to have my conversation. If I was male these factors could be very big barriers, however, as I am a female, this should not be an issue with the child I am talking to. However unless she gets distressed and upset, and needs physical comforting, like a hug, I will refrain from making physical contact.
Traditional Muslim women are usually clothed from head to foot, sometimes covering their face if there are males present, as this is seen as sinful to show other males who are not family their faces. The child I will be speaking to only wears a hijab (a Muslim covering that covers the hair, neck and shoulders, leaving the face exposed) This is good because if the child wore a niqab (a veil that covers the whole face, showing only the eyes) as some Muslim women are expected to do, then it would create a huge communication barrier in non-verbal communication. I would not be able to see her facial expressions and/or read her body language properly, leading to misinterpretations and both myself and her not getting the best possible outcome of having the conversation. However as she only wears a hijab, this is not a large problem as I can still see her face clearly.
Muslim adults are expected to say certain prayers at set times every day. Although the girl I am speaking to is only 15, at that age both genders are considered adults and expected to behave like adults. I will ensure that my conversation does not take place during a time where the girl is supposed to be praying so that I don’t disrupt her daily schedule or offend her by scheduling a meeting when she is supposed to be praying.
M1 A case study is included which includes a group of service users with at least one from a specific culture
M1 The theories of communication are applied to the case study in research and planning throughout with comments as to their usefulness.
(Welcome part introduction of the conversation.)
First I will approach the girl and say “hello, would you like to come for a chat with me for a little bit?” so that I sound friendly and she knows from the start she is not in trouble or going to be told off. I will start with open questions to begin the conversation and make her feel relaxed. As she has a minor speech disorder I will give her time to answer and not pressure her into talking straight away so that she can think and plan what she wants to say.
“Are you feeling good today?”
“The weather is nice isn’t it?”
These questions are simple and can either be answered with a yes/no answer or they can be elaborated on. This will help me and will give me an insight into how talkative she is feeling today, for example if she just answers yes/no answers, then I will use more open questions and prompt her to give more detailed answers later on in the conversation. However, if she is talkative from the start I will not need to do this as I can be confident that she will tell me how she is feeling confidently, and not be apprehensive to talk.
This part of the conversation would take around 1- 2 minutes.
(Main part of the conversation: finding out how she feels about having lived in the children’s home for 2 months)
I will start off by asking her some easy to answer questions about how she is feeling living in the home, that will begin the conversation and lead from the opening questions that aren’t related to the care home, into what the topic of the conversation is really about. If she answers anything negatively then I will ask her to elaborate and try and find out why she has answered negatively, and then try to work out a solution with her how to solve her problem. As she is sometimes apprehensive to talk, I will prompt her after asking a question with suggestions to how she may be feeling to help her decide what she wants to say.
“How do you feel you have settled into the children’s home? Do you feel like you’re in a homely place or is it still a bit hard?”
“Are the other children being nice to you and do you feel like you are getting on well with them?”
After asking these questions and having them answered I will take notes on what she says so that I can make any changes that need to be made, or talk to any other children about anything she has told me, for example if she says that a certain child has been picking on her for her speech disorder, I will have a word with that child and find out if they have been picking on her and if so, why have they.
This section should take around 5 minutes.
(Middle to end part of the conversation. Starting to wrap it up.)
After she has told me about how she feels she is doing in the children’s home, I will begin to end the conversation by asking them some final questions and explaining how I will try to help her if she has told me about any problems, and make sure that she is happy with how I will do this. I will also ask her a final question to give her a last chance to tell me anything she may have been holding in, and then tell her it’s been nice to speak to her and that she can return to her friends, so that she knows again she is not in trouble and I just wanted to help her.
“Is there any last things that you would like to tell me that I might be able to help you with?”
“Okay, so the way I will try and help you out is I will speak to *name* and ask him why he hasn’t been very nice to you about your speaking, because that’s not very nice of him and he might want to apologise to you so you can be friends again. Is that okay with you for me to speak to him?”
“Okay I’ll see you later, Thankyou for talking to me this afternoon it’s been very helpful, you can go back to the others now if you like.”
This section should only take a couple of minutes.