Following the end of HCA 100, Interpersonal Communications, I distilled my notes from the module into an essay of the testable material. The only thing that didn’t make it in here was open and closed questions; difference between and use of. Either you know how to talk to people or you don’t is my take. This study was not written for class, although I did get my teacher to look over it. Call me a keener if you like, I got 100% on the test.
Final Exam, Study Essay
Professional communication is the key to becoming a successful Health Care Assistant. Through Active Listening and Therapeutic Communication techniques, which concentrate on enabling and enobling the client in their daily routines, an HCA can have a substantial effect on the working environment. Warmth is defined in Meriam-Webster’s Learner Dictionary as “2 : the quality or state of being kind or friendly ”. Empathetic Listening is a professional technique that conveys emotional warmth to the client and employs verbal and nonverbal communication skills in eliciting specific information, providing feedback and ascertaining that the individual needs of each client are met. Intrapersonal, territorial and extraneous factors distract from or distort the message, often by interfering with our listening process. Listening as compared to hearing involves taking in information, acknowledging the speaker in a way that invites communication and providing limited feedback to encourage continuing communication. Silence allows people to solve their own problems, validates them as individuals, and allows you to maintain a professional distance while offering a friendly ear or even a shoulder to cry on.
Listening involves three parts, taking in information, acknowledging the talker in a way that invites communication and measured responses. The listener provides limited feedback to continue a conversation or to get specific information to benefit care. As compared to hearing, listening requires a conscious interpretation of the holistic person; their physical emotional, spiritual and psychosocial needs.
The acronym DIPPS stands for Dignity, Independence, Preferences, Privacy and Safety. This is a good mantra to achieve a high standard of care. The client must be treated with the utmost respect at all times, including not patronizing them or their families, and being mindful not to use jargon which may confuse the average Jane or Joe.
Active listening is a technique, which makes use of silence, and requires cognitive energy to be applied while the speaker relates their thoughts. It is a non-judgmental communication technique that focuses not only on understanding the content but also on interpretation of the emotion of a message conveyed by the speaker. Active listening encourages rapport, builds trust, and allows you to build a more accurate profile of a client. 65-90 percent of communication in face to face interactions is conveyed nonverbally, making this an important skill to foster. Elements of professional communication include courtesy, assertiveness, the use of names and titles, responsibility and confidentiality. Professional individuals conduct themselves in a calm, confident, composed manner. It comes down to credibility. In discussion with a client, in full capacity as an HCA, you may need to say at some point, “If you’re planning to hurt yourself, I will have to tell someone.” At this time it becomes the HCA’s responsibility to report this conversation if they decide not to continue the conversation at that time.
Therapeutic communication is communication that benefits the client and should be used primarily in healing interactions. A attentive listener will face the client, use eye contact, lean in and employ active listening. Gender differences are recognized, as men often prefer side by side conversation, as compared to women, who also have different preferences regarding physical contact. Empathetic responses can include humor and hope where appropriate, focusing, clarifying, touch and even self-disclosure. The HCA must not give advice and should avoid confrontations, remembering always that perceptions vary widely based on experience.
Listening to yourself allows you to identify flaws and work on them. As you get to know your clients, “allow yourself to conform to the individual needs of your client.” Silence and encouraging para-linguistic responses as well as non-word utterances allows your client to solve their own problems, encouraging continuing independence as compared to a learned helplessness.
Non-judgmental participation is the key to active listening, and essential if one is to listen empathetically. To remain a neutral participant, concentrate on real observable traits and behaviours as compared to your perceptions of their conduct. Listening consists of hearing, which is the physical response; attending, engaging and focusing on the client; understanding, the decoding of the message in context of the speaker’s perceptions; responding, which is feedback; and remembering, which makes it all worthwhile. Empathetic listening is paying attention to the affection or feeling as well as the content of the message.
Listening consists of forty percent of the communication process. Sixty five to ninety percent of communication is non-verbal, and the majority of our time is spent broadcasting these signals; sometimes consciously, often not; these signals are usually trustworthy for this reason; this bolsters verbal communication. Your own non-verbal cues, as well as the ability to read the cues of others can evoke a huge emotional response including apologies and shame so it is important to be sensitive for this reason, especially of your own automatic responses.
Verbal communication is defined by the use of words to convey cognitive ideas, while nonverbal communication conveys affective information by the use of behavioural signals, symbols and para-linguistic kinesic factors like volume, rate, pitch, pausing and silence.
To the extent nonverbal communication can be used therapeutically, there is no limit. Certainly if a client has lost the will to live or is unresponsive, an HCA can offer the best care possible, and talk to their client despite an inability or unwillingness to engage. This conveys warmth empathy and respect. Loss of independence or a loss of control through life events or conditioning can lower self-esteem. Lowered self esteem often results in anxiety, stress, loneliness, depression and vulnerability to addiction. This can impair job performance and lead to under-achievement which in turn bolsters the negative internal feed back which often fuels the vicious cycle. A competent HCA advocates resident’s rights, quality of life, and should refer clients to counseling where appropriate.
Resident’s rights as defined by the Aphasia Society of Ontario include the right to be treated with dignity and respect, to participate in decision making regarding their own care, to know who will help you and to attend care conferences. Resident’s also have the right to information and the right to speak out. They have the right to be free from all facets of abuse and the right to privacy. In the words of the Aphasia Society, because as a resident, “This is your home.” As an HCA remember this at all times.
Elements of nonverbal communication include Kinesics, which are body movements; vocal factors, which include tone, pitch, volume, rate and silence; physical appearance; proxemics, which defines an 18” bubble as intimate, and a 36” zone as personal around any person; also haptics; phronemics and personal artifacts.
Kinesics, body movements, is closely related to Haptics, which is touch. Kinesics consists of gestures, body orientation, posture, facial factors which are the most visible but sometimes difficult to read. Posture changes are subtle but significant, and can signify a change in condition. These actions, while often unintentional effect communication for better or worse.
Another element of Kinesics is eye contact. In some cultures eye contact signifies aggression or disrespect, so remember to tailor communication to each client. In those with high self esteem, negative feedback will result in decreased eye contact while positive feed back elicits increased eye contact. In those with moderate self-esteem, any type of feedback at all will result in decreased eye contact and the person may be susceptible to ups and downs based on other’s perceptions. Those with low self esteem will avert their eyes when given positive feedback, but will often increase eye contact with negative feedback. It is important not to examine just one non-vocal factor, but assess the whole person when responding empathetically.
Touch, or haptics is extremely powerful, especially to those who have been deprived. It offers warmth, comfort, support, reassurance, congratulation, acceptance and interest. Genuinity is when a person’s inner thoughts match their outer actions, and this quality is readily apparent in those who posses it. Use the LEARN model of conflict resolution if you are uncomfortable with a level of contact with a client, providing it will not adversely affect their care.
An HCA providing Perineal Care, which is the cleansing of the perineum and surrounding region, must be especially careful to maintain professionality. This is when a client is at their most vulnerable, and small signals can be easily misinterpreted. The successful HCA will recognize gender differences. Women are often more discriminating about where they are touched while men are often more concerned about how. As an HCA responsible for perineal care, it is a personal responsibility to ensure that a client is comfortable receiving care from them in that way. It is important to respect a client’s body as they would respect it themselves, to never “undress a client and just leave them there.”
Never underestimate your client and remember, that touch forms a connection. This can be especially important for those who are disassociated or confused and can be grounding.
When caring for a client’s personal items or artifacts, especially a prosthetic, exercise absolute care. For some clients, an item may hold immense sentimental significance, or may be important to them spiritually. Active listening will enable you to build common bonds with your clients to better empathize with them.
The intimate field is defined as 18” from a person’s body, and their personal space is defined at 3 feet. While haptic touch can be therapeutic, it is important to respect a person’s physical and psychological space. Active listening ensures you are able to provide respectful care.
There are many factors why people fail to listen. These include stimulus overload, preoccupation, distractions, rapid thought, incorrect assumptions, talking may seem more advantageous, or we may never haver learned to listen properly. Stimulus overload can be managed if attention is paid to the environment and there is an active effort to focus. Preoccupations can be managed with mindfulness and non-judgmental self-awareness, stilling the inner environment. Distractions can be minimized and rapid thought can be stilled or focused, as to be fully engaged. Incorrect assumptions are actively abandoned as they arise and the listener must focus their attention on the source, allowing the person to address their own dilemma. This technique promotes effective listening and should be employed wherever appropriate. You have to care for yourself to effectively care for others, and it is important to “Start your day over at any time” with a clean conscious and a clear mind. By constantly refreshing themself, the HCA can avoid the pitfalls of burnout.
To manage personal non-vocal cues, the care professional may employ the SOLER technique. To do this, Square your ShoulderS, Open yOur pOsture, Lean forward, Engage EyE contact, Relax youR postuRe. This shows the client you are genuinely interested and allows you to fully engage.
Empathetic listening requires empathic response. Vocal stroking reassures and validates; it lets the speaker know that if you need to ask a question you will. It is important to allow for full thoughts, but don’t wait until the moment has passed to ask important questions. That said, respond sparingly, for the speaker may answer the query you are about to ask. Take notes if necessary and show a willingness to listen. Restate the essential content and feeling. Clarify using open and closed questions as appropriate. Verify the information through measured feedback, remembering to focus on real observable or conveyed information as compared to your own perceptions of it, to allow as much as possible for a client’s individuality and autonomy.
In the unfortunate situation that a client is offended, humbly apologize and seek to make reasonable restitution or to avoid such personal missteps in the future. Always respect the disease process, and try to make life as comfortable for your clients as possible. Joy and comfort relate closely to the will to live, which is integral to anyone’s survival whether sick or well.
Knowing when to be silent is more important than knowing what to say. Understanding that 65-90% of face to face communication is conveyed nonverbally puts therapeutic communication and active listening into their proper clinical perspective. These important skills which create an empathetic listening environment and convey warmth are integral to a client’s well being. Personal body language, as well as use of healing haptics encourages rapport. Personal management of the primary reasons one may hear and not listen bolster this trust environment. Empathetic responses maintain a professional but ‘real’ space for a client to explore their own emotions throughout their treatment. The HCA is a sounding board, not giving advice but often paraphrasing the client, to fulfill their love and belonging, self-esteem, and physiological needs. Silence and real presence can mean the world to someone, and real communication depends more on what is unsaid, than what is.