1. Principles of Patient Assessment in EMS By: Bob Elling, MPA, EMT-P & Kirsten Elling, BS, EMT-P

2. Chapter 2 - Listening to Patients © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

3. Objectives List the major components of the communication process. List the major components of the communication process. Describe various methods for communicating a message. Describe various methods for communicating a message. Explain why making a proper introduction and identifying level of training is an important factor for patient communication. Explain why making a proper introduction and identifying level of training is an important factor for patient communication. Provide examples of how the EMS provider can establish trust with a patient. Provide examples of how the EMS provider can establish trust with a patient. © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

4. Objectives (continued) Explain the EMS provider’s responsibility in maintaining the patient-EMS provider relationship. Explain the EMS provider’s responsibility in maintaining the patient-EMS provider relationship. List examples of both positive and negative facilitation. List examples of both positive and negative facilitation. Describe the techniques EMS providers may use to encourage feedback from a patient. Describe the techniques EMS providers may use to encourage feedback from a patient. © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

5. Objectives (continued) Identify two factors that tend to impede verbal communications. Identify two factors that tend to impede verbal communications. Provide examples of special challenges the EMS provider may encounter in communicating with patients and some tips to manage each. Provide examples of special challenges the EMS provider may encounter in communicating with patients and some tips to manage each. Describe verbal and nonverbal factors to consider when communicating with a patient with cultural differences. Describe verbal and nonverbal factors to consider when communicating with a patient with cultural differences. © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

6. Introduction Establishing a rapport with patient and family is important Establishing a rapport with patient and family is important Effective communication between EMS provider and patient takes practice Effective communication between EMS provider and patient takes practice Obtaining a good history is often difficult, yet necessary Obtaining a good history is often difficult, yet necessary This chapter focuses on interpersonal dynamics and communications strategies This chapter focuses on interpersonal dynamics and communications strategies © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

7. Communication is a 2-way process © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

8. The Feedback Loop Sender Sender Receiver Receiver Message Message Encoding Encoding Decoding Decoding Feedback Feedback © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

9. Message is Communicated Verbal – speaking and observing feedback Verbal – speaking and observing feedback Non-verbal – use of body language Non-verbal – use of body language Non-verbal – understanding of one’s personal space Non-verbal – understanding of one’s personal space Listening – adjust the environment so it is possible to listen Listening – adjust the environment so it is possible to listen © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

10. Factors that Facilitate Effective Communication Is the patient comfortable? Is the patient comfortable? Consider your method of approach Consider your method of approach Professional, respectful introductions Professional, respectful introductions Addressing the patient: name and formality Addressing the patient: name and formality Establishing trust Establishing trust Consider the environment, modesty, emotional, and biological needs Consider the environment, modesty, emotional, and biological needs Confidentiality Confidentiality © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

11. Communication Techniques Facilitation – positive or negative Facilitation – positive or negative Open-ended questions Open-ended questions Closed questions Closed questions Reflection – echoing the patient’s words to encourage the flow of conversation Reflection – echoing the patient’s words to encourage the flow of conversation © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

12. Communication Techniques (continued) Clarification of confusing or ambiguous responses Clarification of confusing or ambiguous responses Silence is sometimes helpful Silence is sometimes helpful Explanation to help put the patient more at ease Explanation to help put the patient more at ease © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

13. Barriers to Communication Words and phrases the patient does not understand Words and phrases the patient does not understand Technical terms should be kept to a minimum (unless dealing with a health care worker) Technical terms should be kept to a minimum (unless dealing with a health care worker) © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

14. Special Challenges Hearing impairment Hearing impairment Visual impairment Visual impairment Speech impairment Speech impairment Non-English speaking Non-English speaking Developmental disability Developmental disability Terminally ill Terminally ill © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

15. Special Challenges (continued) Hostile patients Hostile patients Anxious patients Anxious patients Abused patients Abused patients Patients with multiple symptoms Patients with multiple symptoms Asymptomatic patients Asymptomatic patients Overly talkative patients Overly talkative patients © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

16. Communicating with Children Your interview must be age appropriate Your interview must be age appropriate Kneel down to get to the child’s level Kneel down to get to the child’s level Involve the parent or caregiver in the interview Involve the parent or caregiver in the interview © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

17. Communicating with the Elderly Aging rate differs with the person so do not assume all elderly are visually or hearing impaired Aging rate differs with the person so do not assume all elderly are visually or hearing impaired Give the patient time to discuss the chief complaint Give the patient time to discuss the chief complaint Verify information with a family member or caregiver as necessary Verify information with a family member or caregiver as necessary © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

18. Cultural Considerations Recognize cultural differences in your patients Recognize cultural differences in your patients Culture based preferences may conflict with usual medical practices Culture based preferences may conflict with usual medical practices Don’t assume patients with a particular cultural background are different…take the time to learn about the culture Don’t assume patients with a particular cultural background are different…take the time to learn about the culture Consider verbal and non-verbal messages Consider verbal and non-verbal messages © 2003 Delmar Learning, a Division of Thomson Learning, Inc.

19. Conclusion Practice your listening skills Practice your listening skills Do not judge Do not judge Demonstrate kindness, compassion, and empathy Demonstrate kindness, compassion, and empathy Understanding basic communications skills is essential to EMS providers Understanding basic communications skills is essential to EMS providers © 2003 Delmar Learning, a Division of Thomson Learning, Inc.