This essay analyses the importance of communication and inter personal skills. E. C. Eyre states the definition of communication as ‘transferring of a thought or a message to another party so that it can be understood and acted upon’(Eyre and Eyre, 1987). Communication is an integral part of healthcare. It is utilised in many ways, even if we don’t realise it. Examples of this include the intentional, verbal ways, like talking, patients notes and emailing, but also the un-intentional and non-verbal ways, like posture and dress. The importance of this is to make a good first impression to the patient at a time when they can feel vulnerable, due to the stressful time they are no doubt in. Interpersonal skills is defined as “the skills used by a person to interact with other people”.(Skillsyouneed.com, 2016). The use of interpersonal skills are important between the various healthcare professionals in a multidisciplinary team. They are also necessary when dealing with the patients as the quality of care of a patient can ultimately be decided by the healthcare providers communication with the patient, and also with the other members of the inter-professional group treating them. From a podiatrists point of view, there is a need for communication and interpersonal skills as podiatrists are often referred to by other members of the healthcare service, like doctors, physiotherapists and paramedics.This means they will often have to refer to patient notes to give the podiatrist a more thorough background and understanding of the position the patient is in, and the problems that will no doubt have to be dealt with which, assuming the communication between the different professions is as efficient as can be, there will be more information to work with and so the highest possible quality of service can be provided.
From a podiatrists point of view, many different parts of their job will often be unknown to the general public, and therefore the patients they treat. This means time will have to be spent informing them of the processes and theory behind the practices they are performing on them, so they can “support them so service users can make informed decisions”(Standards of conduct, performance and ethics, 2012). By communicating effectively and ensuring they understand what they could be consenting to, they are more likely to be confident in what is happening. Active listening is also useful in confirming the full understanding of both parties. By explaining and potentially asking them to relay the information they just have received in their own words, it can be reassuring to the practitioner in knowing they are going forward with full cooperation and they have successfully made an informed decision. This can be further seen in the idea that a person has the right to their treatment, and the lack of information can be distressing to them, as they are “unclear about the management plan”(L Fallowfield, V Jenkins, 2016). In many cases, people will feel they have little control about their decisions and whats happening, causing them to potentially ask questions about the treatment constantly, or alternatively, appear ‘closed’, depending on the person, which from an outside perspective could be portrayed as the person being difficult, or ‘a nuisance’. As a healthcare professional, communicating with them clearly and allowing the patient to provide their opinions and contribute towards their overall management plan can help in making them feel more comfortable with the plan of action.
Another major part of communication is patient notes. In the case of referrals, it can often be the only source of information on a patient. This means that all patient notes should be clear and concise, with all necessary information documented as if it were to be admitted as evidence in court. This is to provide a safety net to the health practitioner if the need should arise that they have clear evidence that their care was of high quality, and they made the correct decision in terms of treatment. The data protection act (Legislation.gov.uk, 2016) states patient notes should have accurate, complete and up to date information that should be easily accessible to the necessary people. This is often performed via computers, and electronic records that allow anyone with access to the NHS database to easily retrieve them, though are often still done via multidisciplinary care notes, which though could be conceived as less convenient, is still accessible to each member of the inter-professional care team.
When communicating with patients, though it is important to personalise the way you communicate to the patient depending on various styles, such as race, age, language barrier or any disabilities, there are certain rules that should be followed. this is done by changing your tone of voice, and possibly changing the way you interact with the patient. Such examples include muslims, that refrain from the opposite genders touching them. Though this will cause slight difficulties in the examinations and diagnosis, by successfully performing said examination while respecting the patients cultural or religious preferences, this will increase the rapport between the two, and so make it more likely the patient will disclose certain information that can be helpful, that they may have felt embarrassed or unsure about telling. Examples of this is maintaining eye contact with the person when they are talking. This is important to show that you are listening, and encourages the person to elaborate on the subject they’re talking. Another important rule when communicating with patients is being at eye level. There are certain people that may be less likely to give useful information if they are intimidated by the person they are talking to. This could be due to them being in a hospital bed, a plinth or a wheelchair. This means that standing over the patient will be intimidating. This can be resolved by pulling up a chair, which will cause the healthcare professional to be at a similar level, and so be less intimidating. Overall, all these rules and techniques produce a conversation that is best put by Merrimann; ‘It is essential that the practitioner provides ample opportunity to convey his/her concerns and worries. In other words the interview should be patient-centred.’(Yates and Merriman, 2009)
Non-verbal communication can be used to show that you’ve been listening. If you don’t do so, it’ll look as if you haven’t been paying attention; ‘that you’re not in the least interested in what the other person has been saying; that you are, in fact, a rather rude person.’ (Barker, 2010) Other non-verbal techniques include nodding to the person, and saying small filler words, such as “alright”, “ok”, and “go on”. These, like the nodding, allow the patient to continue talking, but can also be used in a situation when they are not making eye contact, such as if they feel uncomfortable due to them feeling shy, or if they are focusing on documents or their phone. Non verbal communication techniques such as these help convey professionalism and increase confidence in the patients that the healthcare professional is well suited to helping the difficulties that the person has. Bernard moss stated on the physical body; “What we communicate to that person is more than the actual words we use: it is the whole bundle of messages, signals and symbols that our physical presence conveys.” (Moss and Moss, 2012) It is seen in various practices where inappropriate dress can misrepresent the practitioner and cause their words and advice to have less weight. Examples of this could be in court hearings where a healthcare professional is presenting evidence, if they turn up in inappropriate dress, for example tracksuit or jeans, they may be looked upon unfavourably, or even be turned away. It can also be seen at the other end of the spectrum, where dressing in extremely expensive clothes could make people feel intimidated and provide little information, giving off a cold air. Also, wearing smart clothes that restrict movement or cause you to focus on the clothes not getting dirty will cause you to be less focused on the patient, and may cause unnecessary mistakes. This means that a compromise should be met, that shows off a professional exterior, while allowing the necessary task to be fulfilled.
When communicating with people, there are techniques that will cause the patients to disclose more information, thus increasing the accuracy of a diagnosis as it allows for more subjective information. One such example is open questions. By asking this category of questions, the patient has an opportunity to elaborate on the question that is asked, and give more detail to the person asking the question. One such example is “Do you have any complaints?”. This allows the person to talk about all complaints that they have, therefore releasing more. This is significantly better than closed questions, which allow only one word yes or no replies, such as “Do you smoke?”. This means there is little to work with, and so a higher chance of making mistakes.
A podiatrist will be working with many vulnerable patients due to not just the physical condition they are in, but also potential mental health issues, or even just the stress the constant visits and referrals may put them in. This means podiatrists must show complete empathy to all patients, regardless of the decisions and actions they have taken, that you in your opinion would not have done. This is known as empathy. By showing empathy, it allows a better insight from their point of view; why they made those decisions and the reasons they didn’t explore other options. This will make your client feel accepted, which allows them the ability to open up further to them, and so build a stronger relationship between the patient and the healthcare professional. There are many ways to show empathy. One such way is picking up on various cues they give off, be it verbal or non-verbal. If they are positioned in a defensive manner, ask them about it, which will allow you to potentially put some of their discomforts at ease. If they mention they feel apprehensive about a given form of treatment, ask them why that is the case, if they want to explore other options, and overall make the process easier for them. Another way to do this is to change your manner slightly to make them feel more comfortable in the clinical environment. By making subtle changes to the way you speak, via volume or tone, or the way you are postured, you can make them feel less cautious over what is happening. It is important to note, however, that this can be seen as derogatory towards the patient if over done. This means that the podiatrist should be careful not to overstep their boundaries when performing this, so as not to offend them. A third alternative technique that shows empathy is to ask specially designed questions that causes them to talk about a specific topic, or lead onto a useful line of questioning. Empathy can also be shown in touch. A slight touch of a persons hand can go a long way in showing empathy towards the patient, but should be done in the correct environment and context. If done incorrectly, what was intended to be a kind gesture could be portrayed as inappropriate. There are many examples of hearings on the HCPC website that show inappropriate behaviour (Hcpc-uk.org, 2016), and various cases involve touching, so if there is doubt over whether it would be inappropriate, it would be best to avoid contact.
In conclusion, communication has a significant role to play in healthcare. Regardless of whether we want to or not, we are always communicating something, we are always expressing something, be it the way we dress, how we sit or stand, how we talk, or even how punctual we are. We can get this wrong, and in a healthcare background, it is vital that we do not get it wrong, as it can lead to serious implications in the treatment and diagnosis of patients, which is what caused such problems as the ones highlighted in the francis report (Culture change in the NHS, n.d.), which believes that healthcare professionals must improve “communication with patients and colleagues, shared decision making with patients and families, teamwork and inter-professional learning.” This means that widespread healthcare must focus on the quality of patient care, and one way this can be done is by improving their communication skills, which explains the importance of achieving the 1000 clinical hours before graduating- all podiatrists must be able to show sufficient communication skills such as empathy and patient note taking to ensure they will be a competent podiatrist in a clinical environment. I hope to use the findings of my research to apply into my clinical hours, making me a more competent podiatrist.