Communication is important in every aspect of life, especially in the health and social care setting. There are 4 main categories that explain why people communicate.
Instrumental communication- is when we communicate in order to ask for, or choose something, or to tell someone what we need.
Informative communication- communicating in order to obtain information, describe something or give another person/people information.
Expressive communication- when we communicate to express our thoughts, feelings and ideas.
Social communication- communicating to attract attention, maintain and build relationships.
Effective communication in the health and social care setting is the key aspect to everyone’s learning. If you can communicate effectively to service users, colleagues and even family members, you will portray a professional and confident outlook of yourself. Face to face communication is the most important, especially if you are addressing sensitive or medical subjects. The service user (and possibly advocates/family members) will want to receive professional conversations/discussions about their care.
You wouldn’t talk to service users/relatives in the same way you would talk to your friends on a Saturday night. You would (should) use different, professional language at work and should be careful not to offend. You should also make sure that you are fully understood and using communication which is their first choice. If the individual has learning or hearing impairments, you should act on this and make sure they fully understand what is being said. It may be relevant to talk softly, allow the person to take in the conversation.
You can usually tell by the individuals body language and reactions, if they fully understand or are actively participating in the conversation/discussion.
Active listening is-
• giving individuals time to speak,
• let them say their point/finish telling their ideas,
• ask questions to confirm you’re on the same wavelength and that you’re listening,
• waiting when appropriate, pauses and silences to allow yourself and others to fully take in the information,
• repeating their important points- showing understanding,
• using empathetic information, especially if the subject is emotional,
• show you have understood their feelings/ideas by nodding and smiling,
• maintain eye contact- so they know you are listening and concentrating/not distracted,
• showing appreciation- thank for contributions.
If an individual is not showing or demonstrating that they’re actively listening, you should pause the conversation and ask them if they’re okay, and are understanding. If they are struggling or need to take a break, you must appreciate and accommodate that. The individual may look distant, confused or distracted. This could be because they do not understand some of the medical jargon used, or that they feel overwhelmed over the conversation. This could also be because of a communication barrier.
One barrier is aggression, or attitude. People may become aggressive or withdrawn if they feel their self-esteem is being threatened or they feel strong emotions. This creates barriers to communication. When a person feels angry or aggressive, they will be wanting their own way, and making demands; this could put people down. People may be feeling these emotions as they feel powerless or out of control. This often occurs in health and social care situations as there is high amounts of stress; which could trigger the aggression. Aggression can also be the result of frustration. An example of an aggressive person within a health and social care setting is a patient getting angry with a professional, such as a doctor or nurse in a hospital. The patient could be getting angry if they are unsure of a specific type of treatment, if they don’t understand how it will work, the confusion will spiral into aggression. This will also be triggered if they are experiencing strong feelings of emotion; which could be possible if they are in the hospital to be made better.
Another barrier is assumptions. The communication could be dismissed if you assume what the person is going to say and not listen to them; therefore creating a barrier as people stop listening and checking understanding of other people’s communication. By using the communication cycle, you can decrease the risk of making mistakes and assumptions, as they check their understanding. Assumptions can be made on disabled people, as they are seen as “damaged” normal people, they might be pitied and ignored. Older people are also affected by assumptions, because if they didn’t answer questions clearly or quickly, they could be seen as demented or confused. Care workers need to be careful when it comes to assumptions, as they could be prejudice and become discriminating if they don’t check their assumptions. An example of this in a health and social care setting could be a receptionist underestimating the ability of a patient in a wheelchair. They could possibly be patronising towards the patient, making them feel belittled or annoyed.
Different people have different belief systems on what is important in life, and how they and other people should live their lives. Values are moralities that we view as being important in terms of how we live our lives. These values and belief systems are easy to be misinterpreted/misunderstood by other people when trying to communicate. Belief systems and values are just as easy to form barriers as assumptions are. It is important; especially in the health and social care system, for people to try understand and accept people’s beliefs and values. They should be respected and learnt in order to make sense of what’s trying to be communicated. An example of this barrier within a health and social care setting could be a professional suggesting the option of abortion to a young catholic woman. Their beliefs are completely against the idea of abortion, so may become offended by this suggestion; therefore, possibly creating a barrier against any other options suggested by the professionals. One way to overcome this communication barrier is to train staff on respect and the different/most popular belief systems that could occur in that particular area. If the staff are trained, communicating effectively and sensitively will be achieved. Skills and theories will be provided in the staff training. Although, the staff shouldn’t just rely on training alone; as experience plays a big part on the most successful and appropriate ways to treat certain patients. The staff must also be re trained if they are moved to a different district which holds different belief systems and values. This could prove to be expensive; especially if the member of staff is on the reserve list, so will visit/work in many health and social care settings within the country.
Other communication barriers/difficulties are if an individual has hearing difficulties. They may need the assistance of sign language or maybe a hearing aid to help them fully understand. We should be aware not to rush their decisions or responses to the conversation. Make sure you are sat face to face, making it easier to talk to them and possibly enabling them to lip read if it makes it easier to the individual.
Some individuals may not have English as their first/chosen language. Therefore, they may not fully understand or be able to comprehend the full conversation. We must speak as clearly as possible, using language they understand; not too much jargon. Without being patronising, talking at a slower pace will enable the individuals to allow the information to sink in and create ideas they will understand. Frequently check if they are understanding; and repeat things if necessary. Sometimes it may be possible to create a brief written (in their language) piece of information, including the min points of the conversation. That way they will be able to follow and reassure themselves.
Confidentiality is one of the most important aspects of the health and social care. All sensitive, private and personal information obtained about individuals should only be shared to others on a “need to know” basis. As an employee, it is illegal to share such sensitive and personal date. It is our responsibility to maintain confidentiality at all times.
These things are key to maintaining confidentiality-
o safe storage of information/files, so that it doesn’t get into the wrong hands.
o Password protection for computer logins.
o Only share on a need to know basis.
o Only passing on information with relevant permission.
o Following the restrictions and guidelines provided by legislations relevant to data protection and personal files.
o Don’t ever share personal information about individuals, outside of work.
Sometimes it is within the individuals best interest to share confidential information. For example, an address may be shared for the individuals safety and security. Safeguarding issues such as abuse-in any context; would be a good enough reason for someone to share confidential information with fellow professionals. If a person is likely to harm themselves or others, when a child or vulnerable adult is suffering/at risk or there is involvement in serious crime; is when information should be passed on securely to the correct authorities. If it meant that the individual would be safe from harm, then everyone should work together.
If you are ever unsure on confidential practice, or how to correctly share confidential information, for the safety of an individual, consult your manager. They may well already be involved in the case.
Handle information in the health and social care setting.
The Data Protection Act controls how your personal information is used by organizations, businesses and in the health and social care setting. Everyone responsible for using data has to follow strict rules called ‘data protection principles’. They must make sure the information is used fairly and lawfully, used for limited, specifically stated purposes, used in a way that is adequate, relevant and not excessive, accurate, kept for no longer than necessary, handled according to people’s data protection rights, kept safe and secure and not transferred outside the European Economic Area without adequate protection.
Data protection laws exist to strike a balance between the rights of individuals to privacy and the ability of organizations to use data for the purposes of their business. The Data Protection Act 1984 introduced basic rules of registration for users of data and rights of access to that data for the individuals to which it related. These rules and rights were revised and superseded by the Data Protection Act 1998 which came into force on 1st March 2000.
There are two other acts which play a big part in remaining confidential. The Access to Health Records Act 1990 provides the rights for the provision of extracts or copies of health records to the patient or the authorised representative of the individual. This may be to prove as evidence in court, or if the individual is under age or deceased.
The other piece of legislation is the Public Interests Disclosure Act 1998, and it gives protection to employees whom disclose information reasonably and responsibly in the individuals best interest, and have been victimised because of it.
The Caldicott Standards were developed by the NHS regarding the recording and storage of personal information. They are based on principles of the Data Protection Act 1998. There are “Caldicott Guardians” whom are senior members of staff within the NHS and social services to protect personal information.
The Caldicott Principles-
o Every use/transfer of personal information should be clearly defined or scrutinised, by the appropriate guardian.
o Only use patient-identifiable info if absolutely necessary.
o Use the minimum amount of personal information.
o Only allow access to those whom need the information.
o Everyone with access should be aware of the responsibilities and should respect confidentiality laws.
o Fully understand and comply with the law.
o Information handlers are responsible to ensure the organisation complies with such legal requirements.
Guidance and advice on handling information can be provided by the NHS confidentiality Code of Practice-
1- Be factual, consistent and accurate- written as soon as possible after the event, clearly, any alterations should be dated and signed, and compliant to the Equality Act 2010.
2- Be relevant and useful- identify the problems and the actions taken to solve them, provide evidence of the decisions made and care delivered, include consent by the caregiver/advocate/service user whenever possible.
3- Records should not include- unnecessary jargon, meaningless phrases, irrelevant speculation or offensive statements, irrelevant personal statements.
The storage of information should be taken very seriously. Confidentiality can easily be breached by-
o Notes left unattended.
o Failure o ask if information can be disclosed to others.
o Discussing individuals/service users in public areas.
o Failure to log off computer systems.
o Sharing login/password details.
o Leaving computerised documents open on a screen for others to view.
o Not identifying a persons identity before disclosing information.
o Holding telephone conversations in public areas.
o Leaving personal info in a car for people to see through the window.
