Communication and Cultural Diversity

Communication and Cultural Diversity Define communication • • Communication is the process of exchanging information with others Simplest form: three step process that takes place between two people o Sender, person who communicates first sends a message o Second step, receiver receives message o Providing feedback, receiver supplies feedback Explain verbal and nonverbal communication • • Verbal: use of words, spoken or written Nonverbal: communicating without using words, (body language) Describe ways different cultures communicate • • • • Cultural diversity: different groups of people with varied backgrounds and experiences living together in the world Bias: prejudice Culture: system of learned beliefs and behaviors that is practiced by a group of people Nonverbal communication depends on personality or cultural background Identify barriers to communication • • • • • • • • • • Resident does not hear or understand NA Resident is difficult to understand NA resident or others use words that are not understood NA uses slang or profanity NA uses chiche (everything will be fine) NA responds with Why NA gives advice NA asks questions that only require yes/no answer Resident speaks a different language NA or resident uses nonverbal communication List ways to make communication accurate and explain how to develop effective interpersonal relationships • • • • • • • Be a good listener Provide feedback Bring up topics of concern Let some pauses happen Tune into other cultures Accept a residents religion or lack of religion Understand the importance of touch • • • • • • • • • • • Ask for more Make sure communication aids are clean and in proper working order Avoid changing the subject when a resident is discussing something Do not ignore a residents request Do not talk down to an elderly or disabled resident Sit or stand near the resident who has started the conversation Lean forward in chair when resident is speaking Talk directly to the resident Approach the resident Be empathetic Have time for residents family and friends Explain the difference between facts and opinions • Use facts instead of opinions, more effective and professional way to communicate Explain objective and subjective information and describe how to observe and report accurately • • • • • • • • Objective: based on what a person sees, hears, touches, smells Subjective: something a person cannot or did not observe, but based on something that the resident reported, aka symptoms Observed – signs and what resident reports – symptoms need to be noted Sight: NA should look for changes in the residents appearance Hearing: NA should listen to what resident says about his condition, family or needs Touch: what does skin feel hot Smell: odors Incontinence: inability to control bladder or bowels Explain how to communicate with other team members • • • • Communicate freely with charge nurse, keep nurse informed Refer any doctors questions to nurse Make sure resident cannot overhear Charge nurse first, then chain of command Describe basic medical terminology and abbreviations • • • • • • • • • Runny nose: nasal discharge Cyanotic: blue or gray skin Derm/derma: skin Brady: slow Cardia: heart Pathy: disease A: before Abd: abdomen Ac, AC: before meals • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Ad lib: as desired ADLs: activities of daily living Amb: ambulate, ambulatory AP: apical pulse b.i.d. bid: two times a day BM: bowel movement BP, b/p: blood pressure .c : with C: Celsius c/o: complained of CHF: congestive heart failure CPR: cardiopulmonary resuscitation DNR DX, dx: diagnosis F: Fahrenheit FBS: fasting blood sugar Ft: foot FWB: full weight bearing GI: gastrointestinal H2O: water H, hr, hr.: hour HS, hs, hours of sleep Inc: incontinent I&O: intake and output NKDA: no known drug allergies NPO: nothing by mouth NWB: non weight bearing O2: oxygen OOB: out of bed .p: after Pc, p.c: after meals PO: by mouth PRN, prn: as necessary PWB: partial weight bearing .q: every ROM: range of motion .s: without SOB: shortness of breath STAT,stat: at once, immediately t.i.d, tid: three times a day TPR: temperature, pulse respiration v.s., VS: vital signs w/c, W/C: wheelchair Facts not opinions for oral report Explain documentation and describe related terms and forms • • • • • • • • • • • • • Documentation gives up to date record of each resident's care Medical chart: legal document, if something does not appear, it does not happen Information in a medical chart: o Admission sheet ▪ Protected health information, name address o Medical history o Doctors orders o Progress notes o Test results o Graphic sheet (VS, I&O, BM) o Nurses notes (symptoms and actions taken to address) o Flow sheets (adl sheet) Legal aspects o Only way to guarantee clear and complete communication among all the members of the care team o Legal record of every part of. a residents treatment o Can be used in court as legal evidence o Helps protect nursing assistants from liability o Up to date record for the status and care of each resident Document care immediately after it is given Be as brief and clear as possible Facts not opinions Black ink Make a mistake: draw one line Sign full name and title May be done by code Needs to be done using 24 hour clock Know military timing Describe incident reporting and recording • • • • • Incident: accident, problem or unexpected event during the course of care Incidents must be reported with incident report Report: factual, objective account of what happened Resident falls, na breaks something, makes a mistake in care, na gets injured, exposed to blood Tell what happened, state time, mental physical condition of the patient, describe persons reaction, state facts, do not write anything in the incident report on the medical record, describe action Describe effective communications on the telephone • • Always identify yourself Ask for the person with whom you need to speak • Thank the person Explain the resident call system • • • • • • LTC is required to have a call system Call lights In rooms an bathrooms Signal is a light outside the room and a second sound can be heard in the nurses station Respond immediately It is important for the nursing assistant to check each time before leaving a room to make sure the call light is within reach of the residents stronger hand and the resident knows how to use it List Guidelines for communicating with residents for special needs • Impairment: loss of function or ability; can be partial or complete loss • Hearing impairment o o o o o o Speak loudly, lean forward, cup ear to hear better, responding inappropriately, ask to repeat, speak in monotone, avoid gatherings, ect Make sure hearing aid is on Hearing aid needs to b cleaned daily: special cleaning solution and soft cloth Remove it before showering Reduce background noise Get residents attention before speaking • Vision impairment o o Farsightedness, hyperopia: ability to see objects in the distance better than objects nearby Nearsightedness, myopia: ability to see things near but not far ▪ Younger persons ▪ Encourage use of glasses, clean glasses with water and soft tissue, knock on door and identify yourself, proper lighting, avoid words like see look and watch, tell resident what you are doing, use imaginary clock • CVA, stroke o o o o Cerebrovascular accident: cva or stroke sometimes called brain attack occurs when blood supply to a part of the brain is blocked or a blood vessel leaks or ruptures withing the brain Ischemic stroke: most common type of stroke, blood supply is blocked, without blood, part of the brain does not receive oxygen Brain cells begin to die, and additional damage can occur due to leaking blood, clots, and swelling of the tissues. Swelling can cause pressure on other areas of the brain Paralysis on one side: hemiplegia o o o o o o o o o o o Weakness on one side” hemiparesis Ignore one side of the body Loss of ability to tell where affected body parts are Trouble communicating through speech and writing, called expressive aphasia Difficulty understanding spoken or written words called receptive aphasia Inappropriate or unprovoked emotional responses called emotional lability Loss of sensations like temperature and touch Loss of bowel or bladder control Difficulty swallowing called dysphagia Cognitive impairments such as poor judgment, memory loss, loss of problem solving abilities and confusion Keep directions simple, phrase questions so they can be answerer with a yes or no, give residents time to respond, use pencil and paper, never call weaker side bad side, keep call signal within reach of residents, use verbal and nonverbal communication, • Combative behavior o o o Combative: violent or hostile, hitting, pushing, kicking, verbal attacks Block blows or step out of the way, allow resident time to calm down, remail calm, stay neutral, ensure resident is safe, be reassuring and supportive, consider what provoked the resident Anger ▪ Natural emotion that has many causes such as disease, fear, pain, loneliness • Stay calm, do not argue or respond, empathize with resident, find out what caused residents anger, treat resident with dignity and prospect, answer call lights, stay safe