Basic Concepts in Communication,

Customer Care and Information

Technology
It is essential that you develop and maintain an understanding of
the methods and skills of communication in order to meet
the needs of the patient.

The quality of care you can provide is, in many ways, dependent
on the quality of communication that exists between you and your
patient.
Aim

This module aims to equip you with the appropriate knowledge, skills and
attitude in communication, information technology and customer care

Learning Outcomes
At the end of this module, the students should be able to:
• Identify factors that promote and inhibit communications
• Discuss the functions of communications in Nurse/Patient relationship
• Demonstrate skills in providing customer care
• Deal with customers’ ‘special needs’
• Identify the reasons for customers’ dissatisfaction with services they
receive
What is Communication?

• Communication is the process of sharing information.

• In a simplistic form information is sent from a sender or encoder to a
receiver or decoder.
• In a more complex form feedback links a sender to a receiver. This
requires a symbolic activity, sometimes via a language.
• Conveying information through:
➢ Thoughts
➢ Knowledge
➢ Feelings
➢ Ideas
Process of Communication
The essential components of communication
are as follows:
• Sender - the originator or source of the idea.

• Message - the idea.

• Channel - the means of transmitting (either verbally or nonverbally) the

idea.

• Receiver - someone to receive and interpret the message.

• Feedback - the response to the message.

Definition

“communication is the process of passing information and understanding

from one person to another.”
In simple words it is a process of transmitting and sharing ideas, opinions,
facts, values etc. from one person to another or one organization to another
 Albert Mehrabian's Rule of Personal
Communication
Communication
➢ Verbal 7%
➢ Tone of voice 38%
➢Body Language 55%
Communicating with the Patient
• Through your direct contact, the patient must perceive your intentions of
support and your positive expectations.

• You must accurately assess the patient's physical and emotional

symptoms.

• Communication has only taken place if the message being sent was
accurately received.
Purpose of Communication
• To send, receive, interpret, and respond
appropriately and clearly to a message, an interchange of information

• Supportive Purposes.
• To correct the information a person has about himself and others.
• To provide the satisfaction of expressing oneself
Communication Methods
Different forms of Communication can be used to convey a message or
signal understanding.

• Verbal Communication refers to the use of the spoken word to

acknowledge, amplify, confirm, contrast, or contradict other verbal and
nonverbal messages.
• Nonverbal Communication refers to an exchange of information
without the exchange of spoken words (facial expressions, body
language, etc.).
• In Essential Relationship verbal communication is always
accompanied by nonverbal expression. Even no expression tells the
other person something.
Forms of Non-Verbal Communication are as
follows:
• Body Language
• Silence
• Rapport
• Empathy
• Listening
Methods of Nonverbal Communication

Body Language
• Remember that actions speak louder than words. A person will generally
pay more attention to what you do than what you say.

• Think about the other nonverbal communication methods outlined in this

module and their possible impact on your work as a medical practitioner.
Methods of Nonverbal Communication
Silence
• Silence can be an extremely effective communication tool. It can be used
to express a wide range of feelings.

• Silence can be used to communicate the deepest kind of love and

devotion, when words are not needed.

• Silence can be a cold and rejecting sort of punishment, the "silent

treatment" received for coming home late or forgetting an anniversary.

• Silence can be used in an interview or conversation to encourage the

other person to "open up." Conversely, it can be used to intentionally
create anxiety and discomfort in the other person.
Methods of Nonverbal Communication
Rapport & Empathy
• Rapport is the harmonious feeling experienced by two people who have
for each other;
• mutual respect
• acceptance
• Understanding

• Empathy is that degree of understanding, which allows one person to

experience, how another feels in a particular situation.
• Empathy is neither sympathy (feeling sorry for another person) nor
compassion (that quality of love or tenderness that causes one person to
suffer along with another).
Methods of Nonverbal Communication
Listening
• As a patient speaks, think about what he must be feeling. Sometimes, as
a listener, you must cut through layers of words to get to the real message.
You must read between the lines.
• Pick up the underlying meaning of the message (intent); don't rely
entirely upon the obvious or superficial meaning (content).
• Facial expressions (smile, frown, blank look, grimace).
Methods of Nonverbal Communication
Listening (Gestures and Body Movement)

• Gestures/mannerisms (fidgeting, toe tapping, clenched fists)

• Eye behaviours (avoiding eye contact, staring, wide eyes)
• Use (and avoidance) of touch or physical contact
• Posture (erect, slouching, leaning toward/away from someone)
• Walk
 Guidelines for Communicating with their
Patients and Families
• Convey to the patient and family that they are
important to you and that you want to help them.

• There are many ways to do this; you must do what is

comfortable and natural for you.

• However, there are some things everyone can do.

Communicate with each Patient as an
Individual
• Communicate with each patient as an individual. (This is especially
important in a hospital setting, where patients often experience a loss of
identity.)

• In order to do so, you must try to get to know the patient. Listen to
him/her.

• Put yourself in his place.

• Accept and respect the patient despite the symptoms of his illness.
Techniques for
Communicating with Patients
Face the speaker and maintain eye contact.

Provide for privacy: Avoid interruptions and

other distracting influences.
Establishing the Setting

• Provide a comfortable environment

(lighting, temperature, furnishings).
• Establish a relaxed, unhurried setting.
• Sit down when speaking to the
patient. Although you probably have
dozens of things you need to be doing
at that moment, try to relax.
• Don't stand at the doorway or sit on
the edge of your seat, as if you are
preparing to jump and run as soon as
you can get away.
Verbal Techniques for Communicating with
Patients
Verbal Communication Skills
• Let the patient do the talking
• Keep questions brief and simple
• Use language that is understandable to the patient
• Avoid acronyms and medical/nursing jargon if the patient is non-
medical
• Ask one question at a time
• Give the patient time to answer
Verbal Techniques for Communicating with
Patients
Verbal Communication Skills

• Clarify patient responses to questions, not just for your own use, but
also to let the patient know that you are listening (be sure you really
are) and that you understand.

• Avoid leading questions: You want the patient to tell you what he is
feeling, not what he thinks you want to hear. Avoid putting words in his
mouth. For example, it might be better to ask, "How are you feeling?"
rather than "I suppose you're feeling rested after your nap."
Verbal Techniques for Communicating with
Patients
• Avoid how or why questions, they
tend to be intimidating.
• Avoid the use of cliché
statements like, "Don't worry; it'll be
all right." or "Your doctor knows best."
• Avoid questions, which require only
a simple "yes" or "no" response. You
want to encourage the patient to talk
to you.
• Avoid interrupting the patient. If you
need to ask a question, wait until he
has completed his thought.
Interviewing Techniques for Communicating
with Patients
• You must do what feels comfortable and natural to you.
• Even though you may have the best of intentions, if you do not sound
sincere, what are the chances of someone really opening up to you?
• Also, keep in mind that your patients are individuals; if you sense that a
particular patient may not respond well to a certain technique, you are
probably right
• Reflection is repeating content or feelings. You might simply repeat what
the patient has said, to give him time to mull it over or to encourage him to
respond.
Interviewing Techniques for Communicating
with Patients

• you can reflect on what you think the patient

is feeling. "It sounds like you're concerned
about your family." or "I don't think you're very
happy about this.
• By reflecting on his feelings, you may be
encouraging him to talk about something he
may have been hesitant to bring up himself.
• Or you may be helping the patient to identify
his own feelings about something.
Interviewing Techniques for Communicating
with Patients
• Restating is rephrasing a question or summarizing a statement.
"You're asking why these tests are needed?" or "In other words, you
think you're being treated like a child."

• Facilitation allows occasional brief responses, which will encourage

the patient or speaker to continue. A nod of the head; an occasional
verbal cue, such as "go on" or "I see;" and maintaining eye contact
throughout the conversation all imply that you are listening and
that you understand.
 Interviewing Techniques for Communicating
with Patients

Open-ended questions:
• Questions that encourage the patient to
expand on a topic. If you want to encourage
the patient to speak freely, you might ask
"How are you feeling?" rather than "Are you
in pain?"

Closed-ended questions:
• Questions, which focus the patient on a
specific topic. If you want a short, straight
answer, ask a question which will allow only
for a direct response, such as "When was
your accident?" or "Do you have pain after
eating?"
Interviewing Techniques for Communicating
with Patients
• Silence: A quiet period that allows a patient to gather his
thoughts. Of course, this would be an occasional practice,
used when you feel that the patient could use a little time to
think about his response to a question or just to think.

• Broad openings: A few words to encourage the patient to

further discuss a topic; for example, "and after that..." or
"you were saying..."

• Clarification: Statements or questions that verify a

patient's concern or point. "I'm a bit confused about...Do
you think you could go over that again please?"
Therapeutic Communication

• Practicing Therapeutic
Communication is in many ways
simply developing a good bedside
manner.

• When your patient asks you a

question or discusses something
with you, be careful to respond in
a helpful and caring manner.
Patient Interaction
When communicating with your Patient:

• Encourage the patient to speak up, you are probably helping him/her to
decrease his level of stress and thereby his recovery time.
• When your patient communicates with you, you must be able
to correctly observe, evaluate, and respond.
• Your knowledge, understanding, and skill in human relations will enable
you to do so.
• Study the techniques discussed and become familiar enough with them
so that they become a natural part of your conversations.
Critical Elements of Therapeutic
Communication
Important points to be aware of in Therapeutic Communication are as
follows:

• Be realistic in your relationships with people; avoid making

assumptions or judgments about your patients' behaviour.

• If you have negative thoughts about something a patient says or

does, try to keep in mind that he is an adult, responsible for
making his own decisions.
Critical Elements of Therapeutic
Communication
• You do not want him to feel he must conceal anything from you. You
want him to see that you will accept him for what he is; you will allow
him his own identity.

• Be emotionally mature enough to postpone the satisfaction of

your own needs in deference to the patient’s.

• Find sources other than the therapeutic relationship to meet your

own needs.
Patient / family complaints
• It’s very important that we listen and attend well when
patients/clients or their families are unhappy about something or
want to complain.
• It’s never easy nor pleasant to be on the receiving end of a complaint,
particularity if the person doing the complaining is upset, angry or
even abusive.
 There are three important things we have to
recognise in this situation:

• In all likelihood, the complaint is not about you: you just happen to be the person
who is hearing it
• Do not take it personally
• If the person is upset or angry, you becoming upset or angry will not help the
situation
• It could, in fact, make it worse; keep clam and composed
• Complaints also help you to develop your own understanding and knowledge of
what is important for patients/clients and families.
Mnemonic – CALM – to guide how to respond
when receiving a complaint
• Compose yourself: relax and remember about good body posture – keep
good eye contact with the person, don’t cross your arms in front of you or
raise your eyes to the ceiling. Show by your posture that you’re interested
and ready to listen.

• Attend: give the person your undivided attention. Don’t be distracted by

thoughts of the 20 other things you should be doing right now – this is
important, so be there.
 CALM
• Listen: really listen to what the person is saying. Many patients/clients
who are unhappy about the way their complaint has been handled tell us
that no one really listened to them. Try to identify the key words – angry,
disappointed, disgusted, hurt – these emotional responses need to be
addressed just as much as the initial situation that caused them. And
please, don’t interrupt or talk over the person – hold your response until
the person has finished what he or she wants to say.

• Moving on: respond positively to what the person has told you and lay the
foundations for moving on towards a solution. First and foremost, say
you’re sorry. That doesn’t necessarily mean you’re apologising for a failure
of service – simply that you’re sorry that whatever has happened has
made the person so upset. If you can deal with the situation easily and
quickly, by all means do so. If the situation is more complicated, explain to
the person that you will let your manager/supervisor know as soon as
possible so that he or she can take time to agree a way forward with the
person to identify exactly what went wrong, whether there is any
explanation for its occurrence, and what can be done to remedy it.
Opportunity to learn and to improve your practice-
Ask yourself:
• what happened, and why?
• what factors were involved?
• what elements influenced your decision-making, and how?
• who else was involved, and what part did they play?
• how would you react if a similar situation arose in the future?
Going through this with your manager/supervisor will give you a deeper
understanding of the situation and a clear plan on how to deal with similar
situations in future.
Communication skills for Patients with Special
Needs
Blind Patients
• Always speak to the patient when you enter the room so the patient will
know who is there.
• Speak directly to the patient; do not turn your back.
• Speak to the patient in a normal tone of voice; he is blind, not deaf.
• Speak to the patient before touching him/her.
• Offer to help with arrangements for patients who may enjoy hearing
tapes or reading Braille literature.
Communication skills for Patients with Special
Needs
Deaf Patients
• Look directly at the patient when speaking with him/her.
• Do not cover your mouth when speaking because the patient may be
reading lips.
• If the patient does not lip-read, charts with pictures may be used, or
simply writing your questions or comments on a piece of paper may be
helpful.
• Charts with hand signs are available at the local society for deafness
and/or hearing preservation.
Communication skills for Patients with Special
Needs
Patients Speaking a Foreign Language:
• Obtain a translator if possible.
• Have a chart with basic phrases in English and the foreign language.
• Consider using charts with pictures.
Written Communication
Health services need to keep good written records of the care given to
patients/clients for three main reasons:
• To make sure the care and treatment can continue to be given safely no
matter which staff are on duty, 24 hours a day, seven days a week
• To record the care that has been given to the patient/client
• To make sure there is an accurate record to be used as ‘evidence’ when
there is a complaint from a patient/client about the care they have
received.
Principles of written communication
• Write as near as possible to the time you’ve delivered the care
• Write simply and clearly
• Write legibly (if hand-written) and as error-free as possible if keyed into a
computer
• Insert dates and times as accurately as possible when specific events and
circumstances occurred
• Avoid giving personal opinions
• Avoid writing anything judgemental or which may seem personally abusive
or insulting. Report factually what you have observed.
Record keeping
Reasons for keeping records in health care

• To compile a complete record of the patient’s/client’s journey through

services
• To enable continuity of care for the patient/client both within and between
services.
• The records we keep in health care need to be clear, accurate, honest and
timely
Different means of Record-keeping
• Hand-written records
• Computer-based systems
• A combination of both

• You’ll be expected to be able to comply with whatever requirements your

employer sets for record-keeping, be it hand-written or electronic.
• That means you’ll need to:
• know how to use the information systems and tools in your workplace
• Protect, and do not share with anyone, any passwords or ‘Smartcards’
given to you to enable you to access systems
• Make sure written records are not left in public places where unauthorised
people might see them, and that any electronic system is protected before
you sign out.
Ensure that nothing we write is

• insulting or abusive
• prejudiced
• racist, sexist, ageist or discriminatory in any way.
Principles of record-keeping
• You should always try to ensure that you:
• Handwrite legibly and key-in competently to computer systems
• Sign all your entries
• Make sure your entries are dated and timed as close to the actual
time of the events as possible
• Record events accurately and clearly – remember that the
patient/client may wish to see the record at some point, so make sure
you write in language that he or she will understand
• Focus on facts, not speculation
Principles of record-keeping
• Avoid unnecessary abbreviations – as you’ll find, the health care system
uses many abbreviations, but not all workplaces use the same definitions:
for instance, ‘DNA’ means ‘deoxyribonucleic acid’ in some places, but ‘Did
Not Attend’ (meaning a patient/client who does not show up for an
appointment) in others – avoid abbreviations if you can!
• Record how the patient/client is contributing to his or her care, and quote
anything he or she has said that you think might be significant
• Do not change or alter anything someone else has written, or change
anything you have written previously; if you do need to amend something
you have written, make sure you draw a clear line through it and sign and
date the changes
• Never write anything about a patient/client or colleague that is insulting or
derogatory.
Record-keeping
Record-keeping
Record-keeping
Legal issues in Record-keeping
Two things are clear about the legal aspects of record-keeping in health
services:
• Individuals who work for health care organisations are responsible for what
they write
• Anything an individual writes in relation to their work as a health care
employee becomes a public record.

Clearly, therefore, you must take care about what you write.
Not only will you be asked to formally explain your records in the event of,
for instance, a complaint from a patient/client, but patients/clients will be
able to apply to see what you have written about them through the Data
Protection Act.
In summary, there are as many reactions to illness
as there are patients. Your communication skills,
kindness and understanding will help your patient
to go through the hospitalisation experience with a
minimum of stress and anxiety.