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Communication at the Bedside

Communication at the Bedside. Presented by: APS HEALTHCARE Southwestern PA Health Care Quality Unit (HCQU). Disclaimer.

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Communication at the Bedside

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  1. Communication at the Bedside Presented by: APS HEALTHCARE Southwestern PA Health Care Quality Unit (HCQU)

  2. Disclaimer • “Information or education provided by the HCQU is not intended to replace medical advice from the consumer’s personal care physician, existing facility policy or federal, state and local regulations/codes within the agency jurisdiction. The information provided is not all inclusive of the topic presented. ” "Certificates for training hours will only be awarded to those who attend a training in its entirety. Attendees are responsible for submitting paperwork to their respective agencies."

  3. Objectives • The participant will: • 1. Recognize examples of people first language within cited examples • 2. Identify at least 3 techniques to improve communication with people with developmental disabilities

  4. HELP WANTED Need someone to assist in the care of a nonverbal female who drools frequently, is unable to feed herself, has no teeth, is incontinent of both urine and stool and wears diapers, sits up with assistance, and is unable to ambulate, requires total assistance.

  5. People First Language • Our words have the power to inspire people but they also have the power to hurt people • Write down at least 5-6 words to describe yourself

  6. People First Language We are all people first: “The difference between the almost right word & the right word is really a large matter--it's the difference between the lightning bug and lightning.”- Mark Twain in a letter to George Bainton, 10/15/1888

  7. Disabled Dictionary: unable to operate; incapable of performing or functioning People with disabilities are not broken!!!

  8. People First Language

  9. Scott • You just got your assignment for the day and you have Scott. Scott had an appendectomy and they decided to admit him overnight for observation. Scott is 22 years old, has Down syndrome and autism. He just got to the floor from the PACU and is screaming, trying to pull his IV out, trying to get out of bed.

  10. Nursing Intervention • What would you do first? • What do you need to know? • What other issues could be affecting his behavior?

  11. Communication • Receptive communication – the ability to understand what someone is communicating to you • Expressive communication - the ability to communicate your needs, wants, feelings, and ideas to others

  12. Auditory Processing • Sometimes people do not respond initially to speech. They may need extra time processing. • Allow at least 15-20 seconds to be sure what you said was heard. Try and repeat what you have said slowly and simply to be sure the other person did hear and understand.

  13. Auditory Processing • There may be difficulty distinguishing words or sounds • A statement like, “Tell me how a chair and couch are alike” may sound like “Tell me how a hair and a cow are alike”

  14. Communication

  15. Respectful LanguageDoes Not Include: • Baby talk • Honey or sweetie • Sweetheart • Baby doll • Hon

  16. Human Rights • Treat others as you would like to be treated

  17. Modes of Communication • Body language • Gestures and nods • Facial expressions such as smiling or frowning • Sounds • Eye contact • Waving • Language

  18. More Modes of Communication • Touching • Proximity • Movement • Pictures or symbols • Silence • Melody, intensity, and volume of speech or sounds • Music • Speech

  19. What’s Wrong Here? Do you need anything?

  20. Jeff • Jeff has just been admitted to your unit with a urinary tract infection. The nurse walks into the room and goes over to Jeff and starts to get the BP cuff to put on his arm. Jeff flails his arms as she has not even spoken to him yet. She backs up like he is going to attack her. She touches him as if he is highly contagious

  21. Jeff • The nurse is trying to tell Jeff how to use the call bell. Jeff flails his arms again so the nurse begins to talk louder saying the same thing over again.

  22. Offensive Language • What things have been said to you that have been offensive?

  23. Offensive LanguageThat Has Been Used to Describe People with Intellectual Disabilities • Retard or spaz • The vegetable; feed and water the vegetables • Sped • The blind leading the blind • That is retarded or you’re so retarded

  24. Right to Life • Quality of life is in the eye of the beholder • It is not for us to judge who deserves to live or die • People with disabilities deserve to live

  25. The Starfish • A person is walking along the beach and throwing starfish back in the ocean one by one • We may not save every single starfish, but for those that we do, it sure does make a difference

  26. Be Proactive • Know the individual • Always talk with the person directly • Treat the patient as you would want to be treated • Be proactive and not reactive • Be respectful • Smile and use a cheerful voice

  27. Helpful Hints from People with Disabilities or Their Family Members • Speech delay or auditory processing problems • They may need instructions more than once and may benefit from some visuals (pictures, models, diagrams) • Try listening to the radio and not quite getting the station in clearly. It may take a few times before a message gets through • Be patient and do not raise your voice

  28. Helpful Hints from People with Disabilities or Their Family Members • Be respectful of space issues • Acknowledge their pain and feelings • “I know this seems scary” • I know it hurts” • May need to use words like hurt or ouch to define pain • Look for the meaning in challenging behavior

  29. Jen • Jen has 3 sons. Her 6 year old has Down syndrome and smashed his toe. Jen took her son to the ER for evaluation. He had x-rays but was never offered anything for pain even though he was crying. • Jen asked the nurse for some Tylenol but he never got any. She finally carried her son out to her car, got her younger son’s infant Tylenol from the car, called her husband and had him Google the correct dose for her son and gave it to him while he was still waiting in the ER • What is wrong with this scenario?

  30. Visual Aids • Use of a calendar • Clock • Schedule of events • 6 am see doctor • 7 am breakfast • 8 am bath • 9am out of bed for a walk • 1 0 am pain medicine • 11 am rest • 12 noon lunch

  31. HELP WANTED • Need someone to assist in the care of a quiet female who needs assistance with some of her personal needs including activities of daily living. Rewarding experience for a caring individual.

  32. Thank You for Being a Caring and Compassionate Nurse!

  33. References • www.thenthdegree.com • www.disabilityisnatural.com • www.nidcd.nih.gov/health/voice/auditory.asp • “Everyday Lives. Making It Happen” Pennsylvania Department of Public Welfare Office of Mental Retardation • “How Can I Have the Life that I Want?”, 2000 OMR/CCI Published through the OMR Statewide Training and TA Initiative

  34. References • “How to Teach People with Profound Developmental Disabilities” YAI National Institute for People with Disabilities.

  35. For more information on this or any other physical or behavioral health topic, please visit our website @ www.hcqu.apshealthcare.com

  36. HCQU Websitewww.hcqu.apshealthcare.com

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