Patient interaction/History Taking (Intro to rad)

Personal understanding

Radiologic technology is a people-oriented profession

interacting effectively is critical to gain the cooperation and confidence of the patient

Emotional intelligence

Simply means the ability to look at yourself and at others to recognize and understand emotions and to use that recognition and understanding to manage those emotions in both

• Emotions are a part of everyones personality

• EI is broadly defined as the ability to evulate, perceive, and control emotions (Creating a bond with others, prep you for challenging exams)

EI (Emotionally intelligence part two)

Very important that the RT recongize the exhibited emotions and communicate with pateint’s in a way that is appropriate for their emotional state

• Empathy plays a role in this part as it is very vaulable in the healthcare professional

• Interacting effectively with diverse patients is critical to the RT and the patient

Personal understanding

These techqunies greatly improve the quality of medical images as well patient care

• Obtaining the pateint’s cooperation is one of the most challenging parts of RT role

• The communication skills of the RT often determine the pateint’s opinions of the radiology department

Personal Drives

Caring techs must have a desire to

• Help people

• Work with people

• Make a difference

• think critically

• Demonstrate creativity

• Achieve results

• When personal needs are met, experiencing increased confidences in technical abilities as well in not unusual

• Patient often perceives this as competences

• The best radiographers and lobe their work and their patient

Maslow’s Hierarchy of needs

Model of Human needs

TO

It suggest that people strive from a basic level of phyical needs towards a level of self actualization

TO

Each level must be met before proceeding to the next level

What do technologist need to care about?

The caring technologist need to understand these levels and how they relate to pateint’s under their care. It is also helpful for the students technologist to be able to relate this structure to themsleves

Patients needs

1. To interact effectively with pateint’s, understanding hat pateints may be in an altered state of conciseness is important

2. They are in an unfamiliar environment, in which they do have control

3. May be fearful of not knowing the exact state of their health

Patient Dignity

Most basic form of patient needs are

Dignity

Self respect

• Being ill or hospilizaed is a very dehumanizing experience

Patient assessment

1. Initial assessment where is usually comes in the form of chart or procedure request or both

2. Second patient assessment usually comes in the form of verbal communication. This includes introducing yourself, obtaining a history and explaining the procedure.

Patient classifcation

Two basic classification (Inpatients and outpatients)

Each has typical characteristic that require different approaches and interaction skills

Inpateints

Someone who has been admitted to the hospital

• Often brought to the x ray department by wheelchair or cart and wait for tests

• They are listening and watching everything (Inpateint comes before outpateint)

Outpateint

Here for tests or treatment, no overnight stay

Often expected to be taken immediately

May expect priorty treatment

Patients Family and freinds

make pt, friends, family feel confident in that they are receiving and the best possible care they can have.

Methods of communication

6 components of communications

1. Message

2. Source

3. Channel

4. Receiver

5. Context

6. Feedback

ALL must be present for effective communication

if one is broken then there would be no good form of communication

verbal skills

• Consist of a proper vocabulary, clarify of voice and organization of senetnce’s

• Must be appropriate for level of patient

• Should occur face to face

• Give them your undivided attention

• Humor can be acceptable to help relax and open up conversation, but you must be extremely careful

Non verbal communication

• Paraluangue

• Body Language

• Touch

Paralanguage

• The “music of language”

• Form of non verbal communication

• Includes pitch, stress tone, Pauses, speech rate, volume, accent and quality of voice

• The sound of speech, not the content

• Not what you say but how you say it

Body language

• The reading of the postion of the speakers extremities and torso during the conversation

• Eye contact

• Smile

• 
  

Touch

There are three types of touch commonly used in radiography

1. Touch for emotional support

2. Touch for emphasis

3. Touch for palpation

Touch for emotional support

Touch for emotional support, a gentle pat on the shoulder or the hand

THEN

Relays that you are trying to understand, be empathetic and care about the patient as a person

Touch for emphasis

Touch for emphasis is used to highlight or specify intructions’s or location

Ex. Touch left shouler when moving pateint from PA to lateral chest X ray

Touch for palpation

Application of light gentle pressure with the fingers to the body to locate bony landmarks when positioning

THEN

Always explain to pateints what you are going to do before you touch them

Professional appearance

A professional appearance says as much about a person’s as their technial abilities say about there competence

• Professionals dress helps the patient feel comfortable and confident in tech abilities

• Follwo Auroroa dress code policy

Personal hygiene

IMPORTANT

Sends a powerful message

Personal behavior is similar to their appearance, neglected and messy

Posture

important because it is perceived as relating to the persons self confidence and self esteem

Facial expression

Give postive or negative reinforcement of you actions

• Six primary emotions, anger, joy, surprise, disgust, sadness, and fear

Visual contact

Eye contact helps ensure that questions, information and instriction’s have been understood

• Also used to monitor pateint’s condition

Various types of pateints

An understanding of the most common special conditions can be available in meeting the needs of the patient

Seriouslly ill Or traumatized pateints

• try to communicate and determine their level of coherence

• Work quickly and efficiently

• Watch for changes in the pt condition

• Speak to them, even if they are unresponsive

• Work with them as they are awake/sleep

COVID pateint

RT are at the front line in the diagnosis of pateint’s with COVID and contribute to image them throughout their battle with disease

Pt may be imaged daily

A pt may seem unconscious, due to being ventilated but we must treat them as we would with any other patient

Important to get in and out as fast as you can without compromissing the quality of your images and the care of the pateint

Cancer Patients

Cancer patient fear the unknown prognosis of their disease

Cancer pateint’s are in need of empathy and compassion

Patients will be going through Maslows hierarch of needs, at various levels

Since the pandemic began, cancer pts have had more delays in care

Visually impaired pateint

Give clear instruction and use touch to relay reassure

• Continued verbal communication

• Explain everything as you go along

• move things out the way and see the structure of the room

• ask pt what can you do to help you

Speech and hearing imparied pts

Use written instruction whenever possible

DO NOT talk down to them, do not raise your voice

face them

Pantomime and demonstration

Use normal vice

Face them

Speak up if asked

Non english speaking pateints

Most hospital maintain a list of bilingual employees who act as translators

• The use of telephonic translator has increased nation wide

• generally do not use family members

Mentally impaired pts

• Important to use strong yet reassuring tone of voice

• Continuous conversation may help to keep them calm

• Immobilization may be required

• Good interaction skills are required

Substances Abusers

• Asses their capabilities to understand what is going on and attempt to establish some form of communication

• May be relaxed or hyperactive and irrational

• work quickly

• NEVER leave them unattended in room

(Too much, Illegal drugs, alcohol, tone is important)

Mobile and surgical exams

Usually too sick or injured to some to department

May be unconsusois and attached to tubes lines, ventilator, and other medical equipment

• Under no cirucmantes do not assume that the pateint can be comprehend comments that are being made

Violent banners

Pt who have been verbally or physically violent/sexual will have banners

Attention

Pediatric pateint’s require special attention

“To stand tall in pediatricts, you have to get down on your knees”

Infants brith to 12 months

• Nonverbal communication is required

• Use facial expressions, soothing voice

• Touch is especially important in this age group

Toddlers to 1 to 3 years old

• Speak with simple words that are familiar to the child

• The want to control situation

• No concept of time, concerned only with what you are doing now

• FIND A WAY to make it fun, to get it done

Preschoolers three to 5 years old

• Not yet able to logically reason or understand cause and effect

• Most see or hear something to understand to maintain their short attention span

• Demonstration is good

• Will not hold still for long

School aged childern 5-10 years old

• Begin to think logically and to analyze situations

• Verbal communication is usually effective

• Often develop a fear of bodily injury disease, death, punishment

Adolescents 10 to 25 years old

• begins ealier with girls

• Primary focus is body awareness

• Modesty becomes especially important

• Verbal communication

Young adults: 25 to 45 years old

• Entering new roles of responsibillity at work and at home

• Worned about loss of income, work

• Interactions should be on the same level as that of other adults

Middle aged adults-45 to 65

• most people have found their place in life and tend to be relativity comfortable with their roles and success or lack of it

• Poor health causes considerable stress and concerns

Mature adults-65 years and older

• Do not consider themselves old

• Should be treated like middle aged adults

• Do not speak loudly

• Only 10% of people in this age group demonstrate memory loss

Geriatric

• Study of aging and diseases of the elderly

• This group will continue to increase in size and important in america

• Old denotes fragility, narrow mindedness, incomptences’s, and loos of attractiveness

• Now classifed as young old (65-74), old old, (75-84), and oldest-old (85 and above)

• Cardinal rules when dealing with geratic pateints and pateints and respect

terminally Ill pateint

The RT needs to be familiar with the stages of dyring associated with the grieving process to better understand and the actions of the pateint

Five stages of dying

Delinated by Dr elisabeth kubler-ross

May or may not follow the normal order

Step one of greiving

Denial, defense mechanism

Denial and isolation should be supported by silence and acceptance of the person without discussing death

Step two of greving

Anger- Therapeutic

• Anger is often expressed in terms of complaints about health care

• Avoid situations where there may be long waits

• Rage is their only defense

Step three of greving

Bargaining- Becomes submassive may feel gulity about anger displays

• Hopes if they are good they will be spared

• Supprting the pateints beleifs at this time is important

Step four of greveing

depression- accepts the reality of their pending death, often silent

• Mormons the pas and loss of the future

• Quiet support is best response, let pt express there feeling

5th stage of greving

acceptance- considered the final stage

• Occurs only through time

• Characterized by a near total lack of feelings

• Disenaged from life

Greif

An invdiidual thing. The manner of grieve is based on learned attuides and values that are a result of cultural and environment factors

• A human process and will not always follow in an orderly process

Grief (part two)

• Loss of health

• Loss of independnce and control

• Loss of body image

• Loss of finical security

• Loss of productivity

• Loss of normal daily routines

• loss of praivcy

Patient autonomy

The ability and right of pateints to make independent and desciosn regarding their medical care

RT and other health care professioanl’s should be aware that some of their pt have made these choices and should abide by their pateint’s wishes