Dr-Emtenan AlHarbi,Mcs

Objectives

Recognize the importance of communication for the pharmacists

Identify common barriers to verbal communication and describe ways to overcome each barrier

Identify patient situations that affect patient-pharmacist communication and suggest ways to deal with each situation

State how to communicate effectively with physicians, nurses, and other pharmacists

What is Communication?

“Communication is not just about talking to people, it covers a number of skills that need to be recognized and understood if we are to achieve behavioral and cultural change that improves patient care.”

Guiding Principles relating to the commissioning and provision of communication skills training in pre-registration and undergraduate education for Healthcare

Professionals (2003)

What is Communication?

Communication is the transfer of information meaningful to those involved.

It is the process in which messages are generated and sent by one person and received and translated by another person.

However, the meaning generated by the receiver can be different from the sender’s intended message

Component of the Interpersonal Communication

Model

Why Communication Skills is important

To meet your patient care responsibility It establishes an ongoing relationship

between the professional and the patient Pharmacists with good communication

skills more successful even if they have an average pharmacy knowledge

Values of Communication Skills in Patient Care Process

Interview patients

Counsel patient

Seek information from different sources

Advise/consult with other health

Values of Communication Skills in Patient Care Process

Values of Communication Skills in Patient Care Process The pharmacist should encourage patients

to share experiences with therapy because:

they have unanswered questions they have misunderstandings they experience problems to therapy they can “monitor” their own responses to

treatment they make their own decisions regarding

therapy they may not reveal information to you unless

you initiate a dialogue

Scenario 1

A patient returning to the pharmacy complaining of side effect apparently cause by his medication.

The patient record showed that he was give 30 days supply of nitroglycerine patches.

Both pharmacist and physician told him to “apply one daily”

Scenario 1

A patient returning to the pharmacy complaining of side effect apparently caused by his medication.

The patient record showed that he was give 30 days supply of nitroglycerine patches.

Both pharmacist and physician told him to “apply one daily”

The patient opened his shirt and revealed 27 patches firmly adhered to his chest!!!

Types of Communication

Nonverbal

physical distance (proxemics) the amount of eye contact use of touch (haptics) body movement (kinesics) use and choice of objects in

communication, objectics) use and quality of the human

voice(vocalics).

Body language implications

Select the picture below which you feel

shows the most approachable clinician

Which image suggests that they may not

understand or do not accept what you have

explained to them about their medications?

Empathy

Empathy Empathy is the ability to see the world

through another person’s eyes and perceive his or her emotions.

It is a neutral process. No judgment or evaluation of the person or

feelings involved. Sympathy

Sympathy is feeling sorry for another. Not neutral.

Active listening

Pay attention to what patient is talking Your non-verbal messages: eye contact,

nodding, leaning forward) Don’t start filling forms off the start

Hear what the patient actually is saying Pay attention to patient non verbal messages

Appropriate respond to what patient is saying

Active listening and Empathy

Elements of effective communication with patients

1-Patient titles Address patient properly .

Ask patient how he/she wants to be addressed Confused, disoriented or sedated persons

better to be addressed by first name

2-Respect for the Patient Respond to patient as a person not a

prescription user Maintain professionalism Avoid exchange of personal information Don’t pass judgment

Elements of effective communication with patients

3-Questioning Techniques Open-ended Rapid sequence of question Don’t interrupt patient

4-Patient Instruction Assess patient need Control the amount of the information given Assess patient learning Determine patient objectives Appreciating differences in an individual's

perspective

Elements of effective communication with patients

Patient may be concerned about:

•The seriousness of their illness •Talking about an embarrassing condition •Undergoing treatment •How the illness will affect their quality of life or their family •Not making themselves understood •Not being able to understand the clinician’s response •Wasting the clinician’s time

Clinician may be focused on:

•Time constraints •Taking a case history •Starting treatment as soon as possible •Their own lack of knowledge •The symptoms, signs and underlying pathology •Assumptions based on previous visits

Elements of effective communication with patients

5.Medical Jargons Translate commonly used pharmacy and

medical terminology to lay terminology Avoid slangs Be sensitive to non-Arabic specific patients Patient with chronic diseases maybe

offended if spoken to in very simple lay-type instructions

Exercise

Identify the medical jargons in the following

„MrJones, I am sorry but you have become febrile, I can hear ralesin your chest and you may be developing pneumonia. I am going to order a chest radiograph, organize an intravenous line and start you on a cephalosporin.'

Rephrase in simple, layman language

Exercise

„MrJones, I am sorry but you have a feverand when I listen to you breatheit sounds as though you probably have a chest infection. I suggest we get a chest x-ray and then I will put in a dripand start you on some antibiotics.‟

Effective communication

Remember the following points when communicating with others.

1.Always anticipate different perceptions in the communication process.

2.Try to be aware of stereotypes you hold that may influence your perception of others and also be aware of stereotypes others have on you.

3.Ask for feedback from the receiver about how well your intended message was received.

4.Provide feedback to the sender to check your perception of the message and make sure you understood correctly.

Barriers to Verbal Communication

Barriers to communication

1-Environmental Barriers

.Physical barriers .Community:

.Large countertops, security bars and protective glass, drive through windows

.Hospital: .Fewer barriers; standing over patient

.Lack of privacy .The telephone

.Identity of the caller and the person answering .Busy atmosphere

Barriers to communication

2-Pharmacist-related Personal Barriers .Lack of confidence .Shyness .Dysfunctional Internal monologue .Lack of objectivity .Cultural differences .Discomfort in sensitive situations .Negative perception about value of

patient interaction

Barriers to communication

3-Patient-related Personal Barriers Patient perception of pharmacist .Belief that health system is impersonal

Negative past experience .Perception that his/her medical problem

.Either as being of minor importance .Anxious and not want to discuss .Feel their doctor told them everything or wrote it

on the prescription

4-Administrative barriers5-Time barrier

.Timing of the conversation’

Potentially Sensitive Communication Topics

cues of patient embarrassments

Vocal indications hesitating when responding to your

questions such as „Er... yes... that seems clear....

.talking in an over-enthusiastic or falsely upbeat voice

.talking too quietly .talking quickly in incomplete sentences

cues of patient embarrassments

Non-verbal indications .looking away, not returning eye contact .fidgeting, fiddling with a ring, tissue, watch strap,

nail etc. .getting up to leave before you have finished your

explanation .remaining silent throughout the explanation .blank or confused facial expression .closed or tense body language (tense shoulders and

neck, arms folded across body, twitching foot, shallow breathing)

Embarrassing Situations

.Anticipate situations of embarrassment and be ready

.Talk to the patient in a private environment .Demonstrate professionalism and talk in a

straight forward manner .Avoid humor .Use clear and accurate terminology .Give the patient a chance to express their

feelings

Communication Strategies to Meet Specific Needs

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