Thursday, November 8, 2007

Effective communication in health care

I touched on the idea of effective communication the other day. This is something that we were taught in nursing because a large part of caring for others is being able to truly hear what it is they are saying. This is important in all aspects of life, but particularly in anything health related.

When we go about our daily business, how many times are we asked, or we ask, “How are you?” when coming across a friend or acquaintance? Unless we really have time to chat, we’re usually not expecting any answer other than the standard, “Busy!” or “I’m fine, thanks.” While this is ok in every day quick contact, this isn’t ok when you are trying to find out what really is wrong.

Nurses often hear that response as well, “Oh, I’m fine,” when they ask patients how they are. It’s not the best question to ask, because years of courtesy and convention usually still kick in, no matter how sick a patient is. So, then how should a patient be approached?

How a healthcare professional approaches a patient greatly depends on many factors: Has a previous relationship been established? How long has the patient been on the unit/floor/in the waiting room? What seems to be the problem? Is it an acute situation? The list goes on. So, an important issue is to assess the situation. Asking yes or no questions may have a place sometimes, but it’s not a great way to get information. Asking questions that encourage description are often a better way to go. When asking about pain, you can ask if the patient does have pain (a yes/no question), but then you can probe for clarification. “Can you describe the pain? Can you show me where it is? How long have you had it?” – and so on.

This type of communication may be obvious for the physical issues, but if we are going to go deeper, we can learn about things such as how families are coping with an illness. With good communication, a healthcare professional can find out a lot about a person’s emotional health, living situation, and ability to cope with illness or injury.

Another important issue that healthcare professionals must deal with is suspected domestic abuse; then, we need to be even more careful. We need to help the patient understand that we can be trusted and that we will not judge them. Most importantly, we need to help them understand that we *will* listen. The article Appropriate ER questions can start talk on domestic violence describes a study done in emergency rooms to identify communication with patients who may be victims of domestic abuse. The emergency room is one of the main areas where these people may be seen. While the study has its drawbacks, the main ones being that the people involved knew they were being taped and nonverbal communication was not investigated, it does do a good job of showing the importance of effective communication.

News for Today:

Appropriate ER questions can start talk on domestic violence
Overweight, post-menopausal women have higher cancer risk: U.K. study
Manufacturer restricts use of diabetes drug Avandia
New strain of superbug at Sick Kids' Hospital
Caffeine helps reduce disability in very preterm babies


Crabby McSlacker said...

I can't help thinking that part of the problem is time--you almost get the feeling that because practitioners are so pressed for time, they don't really want to hear "extra" information even if it's important. Whether consciously or not, I think some of them discourage it by the way they ask questions. (At least here in the States).

Terry Sumerlin, The Barber-osopher said...

Good common sense approach. I agree with the comment regarding time.

Terry L. Sumerlin
The Barber-osopher
Author/Motivational Speaker

Marijke Vroomen-Durning said...

Hi Crabby, nice to see you on my side of the blogosphere. :-)
Yes, you are right - a large part of it is lack of time. To be able to get a good conversation going takes time and effort. And, if the answers lead to further problems, then we end up with another time issue.

Welcome Terry, thank you for stopping by.
Oddly enough, good effective communication is common sense. But, it does often go by the wayside when time becomes an issue.