“Communication is essential to the role of the healthcare professional”
Introduction
Communication is vital to the role of healthcare professional. Ramlaul & Vosper (2013:1) defines communication as a complex, dynamic process that involves creating, exchanging and sharing thoughts, ideas, emotions and information. Communication in healthcare takes different forms to include verbal, non-verbal and visual (Ramlaul & Vosper, 2013:1; O'Toole, 2008:4). In health care setting, Professionals use these communication channels to communicate with patients, carers, amongst professionals and in professional teams. In doing so, healthcare professionals are guided by different NHS specific six core values which should always be taken into consideration when working with patients. These values consist of respect and dignity; working together for patients; commitment to quality of care; everyone counts; compassion and improving lives.
Therefore, this essay will explore the importance of communication to the role of the healthcare professional specifically in the radiography sector. In doing so, successful communication strategies and barriers to communication and how they can be addressed will be discussed. The discussion will be done in the context of the chosen three core values of respect and dignity; working together for patients and commitment to quality of care. Recommendations pertinent to the way in which communication models can be implemented will be discussed.
Main Body
The NHS was set up on July 5th 1948 by the minister of Health who at the time was Aneurin Bevan. It was created so that there could be a range of good health care given out to everybody no matter how wealthy they were. The NHS was based on three core principles which had to be followed to ensure that the NHS could meet the needs of everyone. The core principles are meeting everyone’s needs, free delivery and that it does not focus on payment but patient needs (DoH, 2016). In order to fulfil the core principles, there is need for effective and adequate communication.
When working within the NHS, one of the basics of good care is good communication skills with patients. Being unable to communicate efficiently with a patient is one of the factors which can immediately destroy the relationship between a carer and a patient therefore the patient may not trust the nurse (anon 2007). The purpose of this assignment is to realise the importance of communication within Radiography. Without communication, radiographers would be unable to provide sufficient care, improving any communication is a lifelong development process (Ewles and Simnet 2003).
What is communication?
Communication in healthcare takes different forms to include verbal, non-verbal and visual (Ramlaul & Vosper, 2013:4; O'Toole, 2008:4). Ramlaul & Vosper (2013:4) state that verbal communication refers to the use of vocal cords to produce sound and spoken words. These authors are of the view that words require interpretation of their meaning through the sharing of the same language and internal references by the speaker. However, it is difficult to guarantee shared meaning in communication as the people communicating maybe of different backgrounds and cultures. In addition, language is not always verbal as it can also take forms of sign language or written channels of communication.
Non-verbal communication can take the form of gestures, facial expressions, tone of voice, eye contact, dress code and posture (O'Toole, 2008:4). These elements are filters through which communication is interpreted. However, these filters can mean different things to different people depending on their cultural background. In addition, non-verbal communication can be limited by any impairment to normal communication such as blindness, deafness, mental incapacity and for those under sedation (Ramlaul & Vosper, 2013:4-5).
Communication can be expressed through visual forms. Visual communication includes the use of images, charts, graphs and diagrams. The use of visual can help in making the presentation of complex information easier to understand, more attractive and it can also be used to reinforce written or spoken health messages. Visual communication can be helpful to patients with lower literacy and numeracy skills (Centres for Disease Control and Prevention, 2017).
Communication is the imparting or interchange of thoughts, giving out opinions or information by speech and implementing the use of writing or signs (American College Dictionary). Communication plays a great role in the sense that it allows people to clarify doubts. There are different types of communications which can be used within the day to day life and these are verbal, non-verbal, written and visual communications. These are all used within the NHS due to the fact that we come into contact with many types of patients who either choose or have to communicate in their own way. Within the NHS today, healthcare professionals have an array of different resources, technology and expanding knowledge of the way the human body, but one of the key effective tools is communication. This is the healing human relationship which is between the patient and healthcare professionals. Dr Osler stated that, as professionals, you should “Listen to your patient, he is telling you his diagnosis” (Dr William Osler, 1849-1919). Every healthcare interaction will begin with an exchange of information and the quality of the way in which the communication is exchange will be critical when it comes to diagnosing the patient. Professionals always have to ensure that different steps are taken into consideration for example, do we have enough information in order to make a diagnosis? Does the patient feel as if we’re taking them seriously? Is there respect and trust within the diagnosis? And is there effective communication within the healthcare team? If there is a positive answer to all of these questions, it helps the future of the healthcare systems.
Basic communication components are sender, message and receiver (Ellis et al., 2003). The sender is the one who will have the information and the receiver will be the one who wants to receive the information; within the NHS, both the patient and the colleague can be either the sender or receiver. This is due to the fact that the colleague will give out information to the patient as well as listening to the needs of the patient; Vice versa. In order to communicate effectively with patients, it is very vital to ensure that patients are informed of the kind of treatment which is going to be practised as well as options of what treatments can be carried out relating to their care. When radiographers are competent with effective communication they are then able to provide the patients with enough knowledge for them to make an informed choice with regards as to what treatment they can receive. (NMC 2008, DoH, 2006). This is an example of person centred care, endorsing the use of person centred care values within practise means that care which is focussed on an individual is being provided. This will demonstrate to the patient that care and support is being given to them. As well as giving the patient what they want and being able to provide information it also takes the person’s desires, values, family situations, social circumstances and lifestyles into consideration. When it comes to working one on one with patients, professionals should work as a team in order to ensure that patient centred care is incorporated as well as the right kind of treatment. It is very vital for professionals, patients and the organization which is providing care to incorporate good communication.
Evidence from research (Asani 2009):Peplau (1952) shows that professionals dealing with patients use therapeutic communication in order for them to obtain information from patients and to gain trust from the patients to ensure that they are treated with dignity as a majority of the patients will be meeting the professionals for the first time.
Person Centred Care is putting the patient at the centre of care plan to ensure that patients are informed of the kind of treatment which is going to be practised as well as options of what treatments can be carried out relating to their care. In order to use Person Centred Care in their practice, Radiographers need to be competent to ensure effective communication (NMC 2008, DoH, 2006). This model of communication was adopted from Carl Rodgers’ (1963, 1942) Client Centred Model of Care which used in Humanist Psychology. While Person Centred Care is regarded as good practice, it is also important recognise that its effective implementation will depend on the availability of resources and eligibility criteria. Professionals develop an effective care plan which might not meet the threshold.
Transactional Analysis is a framework which is used to recognise and analyse communication between professionals and their patients (Booth (2007). According to Booth, (2007) Radiographers use Transactional Analysis as a model of communication. Results from the study showed that Transactional Analysis appears to be effective when finding and identifying collaborating actions in diagnostic radiography. However, the use of Transactional Analysis could be a barrier to communication as it is regarded as a “Parental style of communication”. Booth (2007) warned that using such models which are commonly linked with a “Practitioner-centred approach”, when communicating with patients can end up being a barrier to communication due to non-adherence.
Caring for others is a procedure which requires humanistic and intellectual approaches in order for professionals the achieve the full competency as well as the ability to provide the best kind of care for the patient. Patient assessment is a process which is multidisciplinary, so consulting with other team members and colleagues is important in order for the best patient assessment to be conducted as some of the other healthcare professionals may be more skilled when it comes to carrying out particular skills which are required for certain assessments and with patients who have certain conditions. Communicating information across will ensure that all of the team become accountable for the care which is provided to the patient and gives individuals the opportunity to suggest other alternatives which may not have been considered previously (Cliford and Robothham). This implements the value of the NHS ‘working together for patients’ due to the fact that it shows that the patient comes first as well as involving them and others around them within their care. It also enables us to get second opinions from others and we can be corrected if other professionals may think something else may be better for the patient. Another example could be when patients are in theatre, everyone will have different roles. The Radiographer will be in charge of taking the images while the surgeon carries out the patients surgery while the nurse will be there to give sterile equipment to the surgeon.
Although group work may be a good thing, sometimes the hierarchies may think that they are more important than other healthcare professionals (Thompson 2009). For example, when it comes to being in theatre, due to the fact that the surgeon may feel like the procedure is mainly controlled by them they may feel like they’re higher than everyone else in the room when it comes to making decisions. Things like this will cause disagreements which will then make the team lose focus on what their objective was. Situations like this leave other team members feeling as if they essentially have no right in commenting during surgeries and this could mean they’re less vocal with their ideas (West, 2012), when less ideas are given it limits patients from getting the best care which they could be receiving which becomes a disadvantage. Communication between professionals is more than just giving more ideas, it gives other professionals new ideas which can possibly be implemented within other procedure in the future which will become an advantage to patients. It is therefore recommended that professionals need to reflect upon their practice and use the power they hold within their positions in a positive way.
When healthcare professionals need to communicate with patients, ‘respect and dignity’ must always be implemented, professionals should always ensure that every patient is valued. Patient dignity is ensuring that the individual receiving care is at the centre of that care, as a registered nurse, midwife or specialist health nurse, you must respect the patient or client as an individual (code of professional conduct NMC, 2004). This should be carried out ensuring that the patient isn’t left feeling patronised or left feeling in distress or in pain. The NHS ensure that they prioritise the use of giving ‘respect and dignity’ (department of health, 2012). An example which is often observed when it comes to the respect and dignity of patients is when patients are asked to change into gowns in order for their procedures to be carried out. After observations were carried out, it seemed as though when patients had changed into their gowns they no longer felt like themselves. It then left the patient clueless and they solely relied on the help of the radiographer for help during their examination for example being put into position physically by the radiographer as they felt unsure about what to do. Therefore, it is the radiographer’s responsibility to ensure that once a patient has changed into a gown they make them feel at ease and direct them through the use of effective communication. Once the patient feels vulnerable and requires the help of a professional, the communication will become verbal as well as non-verbal so things such as eye contact and body language (Thompson 2009) will now become relevant. There is evidence that shows that if there is insufficient communication between professionals and patients there will be serious consequences. (Asani 2009). Peplau (1952) shows that professionals dealing with patients use therapeutic communication in order for them to tease out information from patients in order to gain trust from the patient and they ensure that they are treated with dignity as a majority of the patients will be meeting the professionals for the first time. Healthcare professionals should also ensure that they follow the Data Protection Act (1998) as well as the Human Rights Act (1998) and respect the patient’s rights to confidentiality. After analysing the Observations made during a clinical placement block, it was evident that healthcare professionals should always approach patients in a way which will allow them to feel valued, confident and respected (department of health, 2012). When it comes to communication within practice we always need to ensure that we address our patients how they would like to be addressed, sometimes this allows them to open up to you more. In order for us to help the patient as much as we can and diagnose them it is always a good idea to ensure that the patient is aware of the type of practise that is going to be carried out in a suitable format. In order for us to respect the patient it is always better to ask the patient what they are capable of instead of making an assumption for example if the patient is elderly it doesn’t always mean that their hearing is bad, so always speak to them with care until they tell you they can’t hear as a sign of respect. One of the major factors within helping a patient is allowing them to speak, this gives them the chance to voice any concerns which they are having which could be a crucial factor in helping them get better as well as the fact that sometimes patients need someone to talk to.
Lastly the third key factor which will be discussed is ‘commitment to the quality of care’ which is being given out when talking to our patients. Quality of care is one of the priorities, it becomes key when delivering the best levels of quality of care. When it comes to quality of care which has been given a patient will always evaluate how they felt when they were in the hospital. It is believed that through previous experiences, quality of care is one of the things which is always mentioned when it comes to satisfaction. Communication is one of the most prominent factors which is always mentioned. Communication helps when it comes to quality of care due to the fact that it allows the two parties to act in an empathetic manner, it allows the patient to become more involved which will then give them a better chance at communicating with us as healthcare providers. The NHS Plan for England states that ….’by 2002, it will be a pre-condition of qualification to deliver patient care in the NHS that an individual has demonstrated competence in communication with patients.” [Department of Health 2000]. This means that as healthcare professionals it is now mandatory for us to deliver excellent patient care whenever we are dealing with them so as we are learning to qualify, learning how to give out good quality care is mandatory. Within the NHS to ensure that quality of care is achieved there must be robust regulations, management changes, standard setting, inspection, community and patient advocacy, and continual assessments of clinical competency (Leatherman and Sunderland, 2003). Quality is based on the effectiveness of care which is received from a clinical procedure which a patient will receive and how their quality of life after treatment is. Patient perceptions when it comes to how well the quality of healthcare they received is, is always dependant on the way in which their interactions which they received from their healthcare team was. When a patient feels connected with his/her healthcare team will improve their health which is medicated through the participation which is in their care, any adherences within their treatment and the way in which the patient will self-manage their self. Ensuring that the communication quality is being given out correctly means professionals should also watch the tone in which they speak to patients, many patients come in and if professionals forget about their message delivery skills. Thompson, (2009) highlighted that; the speed at which a professional verbally communicate with the patient can be a barrier to communication. If the way they’re speaking is too quick, it may imply that the professional is angry; hence making the patient feels as if they are a burden to the NHS and will lower their self-esteem. Speaking too slowly can also be a disadvantage as this may imply that the professional is bored and this may make the patient feel as they’re not being taken seriously as they will feel that they’re not being taken seriously (Thompson, 2009, p.103). In order to give good quality care, everyone working as a professional should have the ability to understand what the term ‘quality of care’ actually means and ensure they are familiar with the main processes which are put into place to make sure that quality of care is always delivered. Sometimes healthcare workers must take into consideration that patients may not be able to vocalise their problems vocally this is where their quality of care must be improved. It is important for them to be able to notice when there is a drastic change with the way in which a patient is displaying their feelings through facial expressions, a typical example could be when a patients mouth and eyes become more open. The patients mouth will now be wide open and their eyes will begin to expand (Ekman, 2003, p.55). Although it is something which isn’t obvious sometimes it maybe that the patient has a fear but they’re trying their best to ensure that it cannot be seen (Ekman, 2003). In response the professional should respond with a calmer facial expression to show that they are not scared and this will indicate that they are confident in what they are doing. An indication of confidence is always better when it comes to quality of care because as a professional if you’re not confident in what you are doing, it could potentially make the quality of care which you are giving to the patient fail.
Conclusion
In conclusion while working within the healthcare sector, communication is one of the most important things which is required to ensure that good practise is enforced within the general healthcare system. When a patient step through the hospital doors they will feel vulnerable and they will rely on you as someone who is there to help them to communicate good instructions while they are in your care. Healthcare workers should always communicate with empathy and be as clear as possible when trying to get the message across the patient. Good communication will allow the patient to comply in an orderly fashion as well as being able to give them the proper care which they need. It is a requirement for professionals to be able to appropriately be able to communicate verbally as well as non-verbally. Communication must be practised with both patients and other professionals, if roles are established between both it gives an advantage as there can be a better quality of care given to patients. However, some professionals could argue that effective communication skills can be difficult to actually implement within practice, sometimes there are barriers which may cause problems and lead to miscommunication such as time constraints, disabilities and miscommunication. If professionals try their best to work beyond the barriers then it’ll mean that there will be coordinated, personalise and collaborative care which is being provided to each of the patients. Ewles and Simnet (2005) argue that, without communication, radiographers would be unable to provide sufficient care; therefore, improving communication in healthcare sector is a lifelong development process.