Communicating Principles of Practice

Communication in this book is relating to professional and patient as described by the UK Health and Social Care Act 2008 (Regulated Activities) regulations 2014, and to be focused on achieving the fundamental purpose of communicating in healthcare sector. It is essential to set the context in which this book is written. Communication as mentioned in this book is that which is carried out by the following:

  • Healthcare professional means a person who is registered as a member of any profession to which section 60(2) of the Health Act 1999(13) (regulation of health professions, social workers, other care workers, etc) applies.
  • Personal care means physical assistance given to a person in connection with:-
  • eating or drinking (including the maintenance of established parenteral nutrition)
  • toileting (including in relation to the process of menstruation)
  • washing or bathing
  • dressing
  • oral care
  • the skin, hair and nails (with the exception of nail care provided by a chiropodist or podiatrist)

It is therefore, obvious that Communication in this book is any interrelationship and interaction taking place within the context and environment as described above.

Communication In Healthcare Sector

The common core principles of care as published 2015 by Skills for Care and Skills for Health have effective communication at the centre of care. Communication in this book is based on professional-patient interaction as set out by Department of Health (DoH) United Kingdom. The aim of this book is to achieve customer satisfaction as prescribed in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Communication in healthcare industry is person-centred and this approach governs the tenets of quality care. There are person-centred values that must be followed to achieve positive result in healthcare. These values are:

  • Individuality
  • Independence
  • Dignity
  • Privacy
  • Respect
  • Trust
  • Choice
  • Partnership

The applications of these values ensure good practice and patient satisfaction. All the communications and applications of rules and regulations must revolve around these values of person-centred approach.

Communication is the interaction between two or more people. In other words, communication is the transmission of an idea to another person for the purpose of creating an understanding.  In this case, communication is between:

  • healthcare provider and the patient
  • healthcare provider and the patient’s relatives
  • healthcare provider and their workforce
  • Healthcare provider and other partners
  • healthcare provider and the governing bodies

Communication is about forming an idea and passing it on to someone else with the aim of creating an understanding. For communication to take place there is a process of forming an idea (mentally), encoding an idea, and sending out the coded idea. Communication can be turned into noise or distorted at this stage due to the processes either the mode or channel by which it is sent. The mode or channel must be known and understandable by the intended person, the receiver. The circumstances of the receiver (patient) must be put into consideration. The sending of an encoded message must be received by the intended person, and he, she or they have to decode it or interpreting it meaningfully. This message must be understood for it to be deemed received. Communication could be verbal or non-verbal. The utterances and the body language are all part of sending messages to the receiver. However, if any (utterance or body language) is not composed properly, it may send out the wrong message. Communication is nothing but noise if not understood by the receiver. When a message is received and understood, it triggers response. Response can be positive or negative. Communication is therefore, between sender and receiver, and it must create an understanding. The question then becomes what is the intention of the sender? It must be:

  • To establish dialogue
  • To inform the patient
  • To inform the patient’s relatives
  • To inform colleagues
  • To inform employer or employee
  • To inform partners
  • To inform the governing bodies

According to the principles of care, as published by Skills for Care and Skills for Health in 2015, effective communication is an essential part of care and therefore, include being:

  • Non-judgemental
  • Empathetic
  • Supportive
  • Genuine and authentic
  • Collaborative

Communication in healthcare sector does not necessarily mean talking to or talking at someone. It is a holistic process of understanding and satisfying individual’s needs without prejudice. This means that to achieve customer satisfaction in care, care providers must not be judgemental. They must interact with their service users with open mind, showing empathy and genuineness. To meet a patient’s needs, there must be a collaborative working, involving other partners to achieve a patient-centred outcome of care plan.

Forms of Communication

There are two forms of communication, namely:

  • Verbal
  • Non-verbal

These two forms of communication are used on a daily basis. They are intertwined and inextricable. They are used simultaneously. Verbal and non-verbal communications are consciously and unconsciously practised. One cannot listen to any communication without observing the body language of the communicator.

Verbal Communication

Verbal communication is an interaction between two or more people by the use of sound, spoken through word of mouth. It is an audible interaction where the sender uses sound or pronouncement by the use of voice, such as talking, whistling, groaning, yelling, etc. The sound made is intended for someone to hear and understand it, otherwise, it is classified as noise. This is a system of communication that requires the mouth and the ear. The mouth is the sender and the ear is the receiver.  The sender must be audible enough for the sound to travel the distance to the receiver who lends his ears to receive it. The sound must be decoded or interpreted into message by the receiver to be able to understand its’ meaning. Understanding the decoded message will lead to positive or negative reaction by the receiver. Usually, the intention of the encoder is to create positive reaction however, it is not always the case as some messages are understood according to the interpretation of the message by the receiver. In some cases, the communication maybe deemed ineffective. For communication to be effective, it must be concise and focused. The message must be relevant and timely otherwise it becomes offensive. The right message must be sent at the right time. A message must be concrete and with a purpose. The purpose must be relevant to the receiver.

Non-verbal Communication

Non-verbal communication is the opposite of verbal communication, it is not spoken. Non-verbal communication is an interaction between two or more people by the use of body language. As usual, it is also involved sender and receiver of messages. One sends a message to the receiver by movement of the body termed signal. Like verbal communication, messages by signs are also encoded and it is the responsibility of the receiver to decode or interpret it into meaning. The body movements may be by:

  • Nodding the head,
  • Shaking the head,
  • Winking or starring of the eyes,
  • Contrasting or contracting the face (frowning or smiling),
  • Uprightly raising the palm,
  • Waving the hand,
  • Giving a thumb up or thumb down,
  • Positioning the fingers over the ear (sign of telephone),
  • Pulling ear slightly down,
  • Using other known communication signs (sign languages),
  • Shaking the legs and many more.

Unlike the verbal communication, the sender makes a body movement or sign and the receiver has to observe and recognise the body movement or sign to be able to decode or interpret it so as to understand it. As the receiver listens in verbal communication, he, she or they must pay attention to be able to observe and understand non-verbal communication.  The receiver of verbal communication must listen to the sound and the receiver of non-verbal communication must observe the body language. In healthcare industry, the care giver must understand both forms of communication.

Types of Communication

  • Spoken Communication
  • Written Communication
  • Visual Communication
  • Signal Communication
  • Audio Communication
  • Sign Language Communication
  • Social Media Communication
  • Mass Media Communication and many more.

In healthcare industry, it is advisable to use the right type of communication to be able to communicate effectively with patients or clients. One also needs to use the right mode or form of communication in order to build good relationship with clients or patients. Communication is central to any organisation’s success. Developing the right skills will help practitioners to build or mend bridges with their clients or patients.

Characteristics of Verbal Communication

Verbal communication has characteristics intertwined with body language, such as:

  • Body posture
  • Pitch,
  • Facial expression,
  • Eye contact.
  • Tone of voice

These characteristics play obvious part in sending out and receiving messages. These contribute to a message being viewed as positive or negative. The tone of voice, facial expression and eye contact are decoded along with the spoken words. The combination makes a message clearer to the recipient. The clarity may be positive, as well as negative. Most of the intentions of verbal communication are conveyed by its characteristics. The receiver observes and decodes inclusively the spoken words and the body language, so as to discern the meaning of the message. To be mindfully aware of the characteristics of verbal communication will help the sender to achieve its intention. There are also other characteristics that contribute to the understanding of a message or lack of it.

Environmental Characteristic of Communication

The environment plays a vital role in ensuring effective communication. In healthcare industry, the physical condition of the place of communication is important as it contributes to the intention of the sender. Trust and confidence are gained or lost due to the environment. The environment includes:

  • Noise
  • Lighting
  • Proximity
  • Sitting arrangement
  • Temperature of the room
  • Colour
  • location
  • Size
  • Surroundings
  • Timing
  • State of mind, and many more.

These environmental characteristics play important roles in verbal communication, especially, one-to-one with patients and clients. Healthcare workers must be mindful of the environment of the location where communication is taking place. The environment may be intimidating to a patient or it may be shabby to demonstrate contempt to the patient.

Techniques for One-on-One Communication

There are various techniques for one-on-one communication.  However, two techniques are more recognisable in healthcare communication than others, namely:

  • SOLER technique
  • EARS technique

There is also a newly developed techniques that is designed to assist care workers in achieving effective communication

  • SPRINKLE techniques

These three techniques help healthcare providers to communication effectively with their patients or clients. To understand the techniques, one needs to understand the acronyms as follows:

SOLER

  • S stands for Sit upright
  • O stands for Open mind
  • L stands for Lean forward
  • E stands for Eye contact
  • R  stands for Relaxation

EARS

  • E  stands for Explore by asking open questions
  • A  stands for Affirm to show that you are listening
  • R stands for Reflect your understanding
  • S stands for Silence attentively

SPRINKLE

  • S  stands for Soothing words
  • P  stands for Passionate by demonstrating professionalism
  • R  stands for Relate/Reassuringly with the speaker to create trust
  • I stands for Interruption by focusing on the points without interrupting
  • N  stands for Neutrality by maintaining an open mind
  • K  stand Kindness by empathy
  • L  stands for Lead by doing the right thing
  • E  stands for Enthusiasm by being cheerful and show interest in the topic

In the next chapter, the use of these techniques and skills will be used to form effective communication needed in healthcare sector.

(Note: This is an extract of my book. Please criticise it constructively if you can)

By: Oguchi Martins Egbujor