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The Gift of Gab. What people say about us Most common complaints: 1)Rude 2)Heartless 3)Impersonal Isn’t it surprising how many things, if not said immediately,

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Presentation on theme: "The Gift of Gab. What people say about us Most common complaints: 1)Rude 2)Heartless 3)Impersonal Isn’t it surprising how many things, if not said immediately,"— Presentation transcript:

1 The Gift of Gab


3 What people say about us Most common complaints: 1)Rude 2)Heartless 3)Impersonal Isn’t it surprising how many things, if not said immediately, seem not worth saying ten minutes from now? Arnot L. Sheppard, Jr.

4 Three components of communication Sending messages Receiving messages Barriers to effective communication

5 Sending messages Verbal ▫What we say Paraverbal ▫How we say it Nonverbal ▫How we look when we say it

6 Verbal Trust Get them talking Listen, Listen, Listen Stay neutral Choose words carefully Reflection

7 Paraverbal How we say it ◊ “I didn’t say you were stupid”


9 Non-Verbal Intentional or non-intentional messages that can be interpreted from somebody’s actions or decisions

10 Non-Verbal Emotional impact of a message Words = 7% Voice tones = 38% Facial expressions = 55%

11 Kinesics The study of communication that occurs through body movements, positions and facial expression

12 Appearance Well groomed Proper uniform Proper equipment Look the part!

13 Posture Positive (open) Confident At ease Attentive Professional Negative (closed) Discomfort Anger Disgust Fear

14 Facial expressions The most important conveyor of emotional information

15 Relative level Eye contact Above or over ▫Authority ▫Intimidating Below ▫Best for elderly and children ▫Patient fells in control Even ▫equality

16 Distance Intimate zone – 0 to 1.5’ ▫Visual distortion ▫Assessing breath and body odors Personal distance – 1.5’ to 4’ ▫Perceived as extension of self ▫Common assessment distance Social distance – 4’ to 12’ ▫Impersonal

17 The touch Shows compassion Concern Support Not accepted in all cultures

18 Receiving messages Requires concentration and energy Involves a psychological connection Includes a willingness to see their side Requires that we suspend judgement LISTEN

19 Physical attention Gently lean towards the speaker Face the person squarely Maintain open posture Maintain appropriate distance Appropriate facial expressions and nodding

20 Reflective listening Paraphrasing ▫A brief statement reflecting the speakers message ▫Use your own words Reflecting feeling ▫A statement of the feeling that you heard ▫“You’re worried that…….” Summarizing ▫A statement of main ideas and feelings to show understanding


22 Verbal Barriers Attacking ▫“You wouldn’t be sick if you would take your medicine.” ▫“Did you do what the doctor told you to do?” ▫If you stopped getting drunk everyday you would probably feel better.”

23 Showing power ▫“If you don’t go to the hospital with me, I’ll have you arrested.” ▫“Once you get in my ambulance, you follow MY rules.” ▫“You’re getting an IV if you ride with me.”

24 “You messages” ▫“You don’t understand medicine, I do.” ▫“You don’t realize that if you don’t give your child the medicine on time, he’ll stay sick.” ▫“You have a mental problem.”

25 Nonverbal barriers Rolling your eyes Yawning Closed stance Avoiding eye contact Poor personal care Slow movements Slouching Aggressive stance

26 The Angry Patient Usually a defense mechanism ▫Fear of loss of control ▫Fear of dying ▫Fear of meaning of illness ▫Fear of disability

27 Strategies Active listening ▫Position ▫Posture ▫Eye contact ▫Silence Listen and paraphrase what you’ve heard

28 Empathy Cognitive – enter patients’ perspective but don’t loose your own Affective – put yourself in patient’s place Action – verify emotion so patient can correct and/or feel listened to. Empathy is not the same as agreeing with patient. Empathizing is expressing understanding of how the patient feels.

29 “I’m sorry” If you made a mistake that lead to anger, admit it and apologize. Do not try to excuse, explain or discuss specifics at first… the patient will need to have his or her feelings validated first before they are willing to listen if they are angry. Trying to excuse the problem may lead him or her to feel as if their feeling is not valid and lead to more anger.

30 Questioning techniques Leading questions ▫Guides the patient’s answer ▫“are you having chest pain?” Open-ended questions ▫Spontaneous answers ▫“what seem to be the problem?” Closed questions ▫“did you eat lunch today?”

31 Questioning techniques Continue to ask open-ended questions ▫Keeps them talking ▫May reveal important facts Use closed questions when necessary ▫May help control ‘talkative’ patients ▫Useful when time is limited Ask only one question at a time

32 Questioning techniques Allow for complete response Use language they can understand ▫Never tell a child you are going to “take” their blood pressure ▫Avoid medical terminology Avoid terms of endearment ▫Honey, sweetheart, baby

33 Effective listening techniques Silence ▫Give the patient time to answer Reflection ▫Echo his/her message back in your own words Facilitation ▫Encourage the patient to provide more information Clarification ▫Eliminate confusion

34 Effective listening techniques Confrontation ▫Focus the patient on one particular factor of the interview Interpretation ▫State your interpretation of the information Explanation ▫Share factual or objective information Summarization ▫Briefly review the interview

35 Traps Providing false assurances ▫“Everything will be alright” Giving advice ▫Acceptable  “my opinion is that you should be evaluated at the hospital” ▫Not acceptable  “I think you’re crazy not to be seen by a doctor”

36 Traps Authority ▫It’s not a power trip Avoidance language ▫Changing the subject to avoid something difficult Distancing ▫Standing too close or too far Using “why” questions ▫“why didn’t you call for help 3 hours ago?”

37 Children Three types ▫Oblivious (infants) ▫Uninformed (child) ▫Invincible (teenager)

38 Elderly Decreased hearing Decreased vision Slow to respond Fear of hospitals Do not use terms of endearment

39 Do’s and Don’ts Maintain eye contact Show interest Proper tone Nod Lean forward Positive body language Minimal or no eye contact Tense facial muscles Speaking too fast or too slow Yawning Negative body language

40 Blocks Giving personal opinions False reassurance Defensive responses Arguing Asking for explanations Changing the subject


42 Summary Establish trust Body language Choose words carefully Tone of voice Be attentive Look the part LISTEN!! LISTEN!! LISTEN!!

43 Remember …… It’s their emergency, not yours!

44 QUESTIONS?? Julie Williams, NREMT-P, NCEE Training Coordinator Beaufort County EMS

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