Week 3 DMS 206- Comm., Diversity, Culture

5 Primary Human Needs

• Abraham Maslow described a hierarchy of needs with basics prioritized

• Clayton Aldefer’s ERG (existence, relatedness, growth) theory suggested we can pursue needs from more than one level at a time

• Physiologic→ Security and safety→ Love→ Self-esteem→ Self-actualization

The grieving process in 5 phases

• Elizabeth Kübler-Ross and David Kessler described the grieving process in five phases

• Denial, Anger, Bargaining, Depression, Acceptance

Communication

• The exchange of thoughts, ideas, and information.

• Includes listening, observing, speaking, and writing.

• To effectively communicate, be aware of one’s own feelings, values, and attitudes that cause bias.

Five Elements of Communication

• Sender, receiver, context, message, feedback

• Sender—The person who creates and relays the message

• Message—Can be in the form of words (verbal), actions (nonverbal), or a combination of both

• Receiver— The person who accepts the message from the sender

• Feedback—May confirm the receiver’s message when the receiver feeds the statement or part of the statement back to the sender

• Context—The setting in which the communication occurs, including the mood and the relationship between the sender and the receiver

Forms of Communication

• Nonverbal vs verbal: overwhelming majority is nonverbal.

• Nonverbal includes grooming, clothing, gestures, posture

  • Kinesics (body language)

  • Proxemics (personal space)

  • Touch (task-oriented and affective)

• Verbal communication is spoken and split into 2 techniques.

  • Therapeutic: Aimed/active at accomplishing a particular objective.

  • Nontherapeutic: Blocks or hinders effective verbal communication. Noise is anything that negatively affects the process.

5 Therapeutic Verbal Communication Techniques

• Closed-ended questions— Often quickly answered with a “yes” or “no”

• Open-ended questions— Encourages embellishment

• Paraphrasing— Restate what the patient says to demonstrate listening

• Clarifying— Avoid misinterpretation

• Silence— Allows time for thinking and stimulates more conversation

7 Nontherapeutic Verbal Communication Techniques

• Making false promises

• Using clichés

• Disagreeing

• Demanding an explanation

• Changing the subject

• Patronizing

• Giving advice

Additional Potential Barriers to Effective Communication

• Certain emotional or physical states can act as communication barriers.

• Language differences can also create a barrier.

• 4 Methods for working to overcome barriers:

  • Avoid referring to patients using colloquial terms such as “honey”

  • Avoid using profanity.

  • Avoid overuse of medical jargon.

  • Make note of incongruence in verbal/nonverbal communication and address it supportively, particularly with behavior not in line with consent.

Diversity and Cultural Competence

• Population growth- Hispanic population to expand from 55 mill to 119 mill in 2060, while the Asian population is to double

• Ask patient preference for gender pronouns

• Culture- shared beliefs, values, and behavioral characteristics that provide social structure

• Race- skin color, body structure, hair color and texture, and facial appearance

• Ethnicity- common history or origin

5 steps in becoming more culturally competent:

• Cultural awareness

• Knowledge

• Skill

• Encounter

• Desire

Cultural competence continuum

• Destructiveness

• Incapacity

• Blindness

• Precompetence

• Competence

• Proficiency

Goals for cultural proficiency

• Cultural proficiency- both the integration of cultural knowledge in practice and the application of that knowledge

• Documented evidence that racial and ethnic minorities have a higher death rate than whites from cancer, heart disease, and diabetes.

• Legal complications for refusal to respect a patient’s cultural background.

• Bias, stereotyping, and prejudice contribute to low levels of cultural competence.

• Education can overcome cultural disparity.

The Sonographic Examination: 10 Steps

1. Assessment of relevant documents

2. Examining reports and images

3. Preparing the examination room and protocol review

4. Introducing yourself and patient confirmation

5. Gathering clinical history

6. Patient education

7. Conducting the sonogram

8. Completing the sonographer’s report

9. Sonographer interaction with interpreting physician

10. Discharging the patient

Assessment of relevant documents

In most hospital settings, the sonographer will be supplied with a requisition. Every diagnostic sonogram must have a physician’s order.

Examining reports and images

The major sections of the report include clinical information or history, examination findings, and the overall impression.

Preparing the examination room and protocol review

The fundamental accessories for the sonographer’s job are gel, a stretcher, and an ultrasound machine. Prior to the examination, thoroughly clean the room and make sure supplies are readily available.

Introducing yourself and patient confirmation

Demonstrate a professional and friendly demeanor in front of patients. Be prepared to provide physical assistance if needed.

Gathering clinical history

Gathering clinical history can play a critical role in making a correct diagnosis. Be careful in your use of closed- and open-ended questions as needed. Practice active listening.

• Receive information, do not interrupt, and do not be distracted

• Demonstrating attentive

• Use open body language

• State the person’s key points back to them

• Clarify by asking questions

Patient education

• Sonographers have a responsibility to educate patients about sonography and the medical use of ultrasound. Avoid overuse of medical jargon.

• Health literacy is the degree to which an individual can obtain, process, and understand his or her health status with regard to making appropriate health decision.

Conducting the sonogram

Conduct the sonogram according to the institution’s requirements and in accordance with protocols. Maintain open communication with your patient.

Completing the sonographer’s report

This typically includes a basic assessment of the examination, including stenographic findings and measurements of various normal and abnormal structures.

Sonographer interaction with interpreting physician

Working collaboratively with interpreting physicians requires professional communication skills and respect.

Discharging the patient

After all of the examination requirements and case presentation have been performed, the sonographer should provide the patient with discharge instructions. Be respectful and polite.