COMMUNICATING IN THE WORKPLACE: IT’S MORE THAN JUST PATIENTS



COMMUNICATING IN THE WORKPLACE: IT’S MORE THAN JUST PATIENTS



LEARNING OBJECTIVES


Upon successfully completing this chapter, you will be able to:


• Explain the concept of professional etiquette.


• Define the term interdisciplinary communication.


• Explain your role in participating in a case conference.


• Define the terms emergent, urgent, and nonurgent and provide an example of each.


• Describe common communication challenges and the strategies to overcome them when communicating with coworkers, physicians, managers, and regulatory agency personnel.


• Describe the guidelines for communicating with referral personnel.






Test Your Communication IQ


Before reading this chapter, complete this short self-assessment test. Decide which statements are true and which are false.



Results


Statements three and six are true; all the other statements are false. How did you do? Read the chapter to find more information on these topics.



WORKPLACE COMMUNICATION: THE BASICS


The previous chapters have focused on communicating with patients. However, it is essential for you to develop a good rapport and communication pattern with your peers and other members of the health care team. Researchers have estimated that the average health care worker spends about 80% of his or her working hours communicating, and about 60% of that time is spent communicating with other health care professionals. Workplace communication must be professional and courteous and should be based on honesty and integrity.



Professional Etiquette


Etiquette is defined as the standard behavior that is acceptable in a given social, professional, or official setting. Standards of behavior are different for each of these settings. For example, if you meet a physician in a social setting, it would be appropriate to say, “Hi John,” but in a workplace setting he should be addressed as Dr. Banks. Listed below are etiquette guidelines to remember in the workplace:




Interdisciplinary Communication


Communicating with various health care workers is termed interdisciplinary communication. Interdisciplinary is the combination of two or more specialties working together to meet a specific goal. The main goal of interdisciplinary communication is to promote optimal patient care. Each specialty (Box 8-1) provides a unique viewpoint and treatment plan for the patient and family. Interdisciplinary communication also



Box 8-1   Health Care Specialties: Types of Health Care Professionals





































Cardiopulmonary Technologist Pathologist
Crisis Clinician Pharmacist
Dietician Phlebotomist
Emergency Medical Technician Physician
Laboratory Technician or Technologist Physician Assistant
Licensed Practical Nurse Physical Therapist
Medical Assistant Radiology Technologist
Medical Transcriptionist Registered Nurse
Nurse Practitioner Respiratory Therapist
Occupational Therapist Social Worker
Paramedic Speech Therapist/Pathologist



When communication is based on meeting the needs of a particular patient, it is termed a case conference.



Case Conferences


A common method for communicating about a particular patient is through case conferences. A case conference is a cohesive group of interdisciplinary professionals coming together to coordinate patient treatment. Case conferences start with each health care worker giving a brief summary of his or her clinical findings to the rest of the group. Discussion follows. Working together, the team prioritizes the patient’s needs and creates a plan of care.


A case conference can be formally organized or can be an impromptu meeting between professionals from different specialties. Formal case conferences are often planned and organized by the designated team leader. Generally, the team leader is the physician, case manager, or social worker. The team leader invites appropriate members of the health care team. Depending on the situation, a clergy representative, administrative staff, or regulatory personnel may be invited. In most cases, the patient or family is not present. However, depending on the case and the issues, the patient and/or family may be asked to attend a later portion of the conference.


Case conferences can occur anywhere in the health care environment. They occur within hospital settings as well as in ambulatory care settings. The hospital’s ethics committee may hold a case conference to discuss the removal of life support devices. In these situations, nonbiased, objective persons are designated to represent and speak on the patient’s behalf. Legal council may also be invited to these conferences.


There are certain situations in which a case conference must be held. For example, in a long-term care facility, the Centers for Medicare and Medicaid Services (CMS) require an interdisciplinary case conference to be held periodically for any patient who is receiving Medicare benefits. There are specific guidelines for when and how often these conferences need to be held and who must attend. Medicare requires that a family member or significant other be invited to the meeting. Family members may decline to attend the meeting. Failure to hold these conferences and to document them properly can result in fines and potential loss of the right to bill for certain services.


During any case conference, communicate your clinical findings in an objective manner. It is never appropriate to gossip about the patient or family members or to let your own personal feelings or biases affect your clinical judgment. Any communication or discussion occurring in the meeting must stay in the room. It is not appropriate to discuss the meeting with anyone not associated with the case.



COMMUNICATING WITH MEMBERS OF THE HEALTH CARE TEAM


There are five specific groups of professionals with whom you must be able to communicate:



Each group is unique and comes with its own set of challenges. These challenges are discussed below, and some practical tips are also listed for each group.



Coworker/Peer


A coworker or peer is an individual with whom you work. Your job title may be the same, (Licensed Practical Nurse, Medical Assistant) but your roles and responsibilities may differ. This is related to factors such as level of expertise, experience, and seniority.



Communication Challenges


There are many potential challenges or barriers to communicating with coworkers. Listed below are some of the most common challenges:



• Age: Your coworkers may be younger or older than you. Differences in age may affect your ability to communicate openly and easily. Here are three examples showing how age can affect communication.



• Newer medical terms replace older terms. For example, the term nodal (type of ECG rhythm) has been replaced by the term junctional; rales (type of breath sounds) are now commonly referred to as crackles.


• Newer methods of performing standard skills can create challenges unless the health care provider attends continuing education courses. For example, “In CPR, we always gave five compressions to one breath for two-rescuer adult CPR. Who taught you 15 compressions to two breaths?” In this example, the provider took CPR in school years ago, but the ratios have changed.


• Age differences can limit our ability to feel like a member of the team. For example, if everyone you work with is younger or older than you, and they often socialize after work, your age difference may prevent participation. This may keep you from feeling like you are part of the team.


• Different goals and objectives: Everyone has different goals or objectives for working. Some of your peers may have hopes to become the next manager, whereas others may plan to retire in 6 months. Here is an example of how this can affect communication:



• Different work ethics: Some people do 110%, while others opt to squeeze by at 75%. A statement such as, “When you see the gauze sponges are getting low, you should restock the wound dressing cart,” can lead to a poor working relationship. Again, this may be a valid point, but it comes across as a negative statement and does not engage communication to resolve the problem.


• Best friends: A coworker can be your best friend outside of work, but in the work environment, you may come to resent covering your friend’s inadequacies. Here is an example:




Practical Tips


The remedy to all four of these challenges is clear and open communication. The failure to address or resolve any of these issues can have major effects on the work environment. Poor communication among coworkers leads to decreased productivity, poor patient care, and decreased morale. Below are some practical tips for promoting communication among your coworkers.


Use the acronym PEER.




Notice that throughout this communication the speaker emphasized “I.” Starting a conversation by saying “You are loud,” immediately sets the person referred to as “you” on the defensive. Focus on how it makes you feel and how you perceive the problem.




• Remember: there is a time and place for everything. Avoid any type of communication that may alienate a coworker or patient (Fig. 8-1).


image
Figure 8-1

• Humor can provide stress relief, but be cautious using it in the workplace. Appropriate humor may consist of a funny story or tale but must never include sexual or ethnic content. Practical jokes or setting bets is not appropriate in the workplace.


• Accept everyone. Value individual skills and strengths and accept weaknesses, and in turn, others will accept your strengths and weaknesses.


• Stay within your boundaries. It is not your job to discipline or reprimand another employee. The supervisor must handle these tasks.


• Never criticize or question a peer’s performance or professionalism in front of other colleagues or patients. Instead say, “Before we leave today, I would like to talk with you about something. Can we meet in the lounge at 3 pm?” and bring the discussion into a private area.


Table 8-1 offers suggestions for phrases to use—and to avoid—when speaking with coworkers.




Physicians


Guidelines for Contacting a Physician


All types of health care workers must communicate effectively and professionally with physicians or other patient care providers. Other providers include nurse practitioners, nurse anesthetists, and physician assistants. These professionals are ultimately responsible for patient care. For simplicity, we will refer to only the physician in this section, but keep in mind this includes any patient care provider.


Prioritize the nature of the problem. In certain situations, you should contact the physician STAT whereas in other cases, you may be able to e-mail or leave a voice message. STAT is a situation that requires immediate attention. To contact a physician STAT, the physician is usually paged or beeped. The nature and type of emergencies that you will experience depends on your job title, place of employment, job setting, and specialty. It is important for you to be able to determine the emergent situations in your particular job and the appropriate method of communication. Your clinical supervisor or preceptor will teach you specifics as related to your duties. However, there are some general guidelines that affect every health care worker.


Contact the physician STAT for situations such as the following:



Contact the physician (non-STAT) for situations such as the following:



• Clarification or changes to medications that are not life-threatening. For example, a patient may call the physician’s office and tell you that his morning blood sugar was 210. The patient wants to know if he should increase his evening insulin dosage. This situation is not an emergency, but it must be handled in a timely fashion. If the patient had called the office reporting a very high or low blood sugar or was experiencing symptoms, then the physician would need to be contacted STAT.


• Patient care concerns that require urgent care. For example, a nurse from a skilled nursing facility has called a physicians office and told you that a patient has developed a new skin ulcer. This patient deterioration does not warrant an emergent page but needs to handled in a timely manner (Box 8-2).



Box 8-2   Definitions




Leave a message (e-mail, voice mail, or secretary) in situations such as the following:




Communication Challenges


There are many challenges or barriers to communicating with physicians. Following are some of the most common challenges:


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Jul 12, 2016 | Posted by in MANUAL THERAPIST | Comments Off on COMMUNICATING IN THE WORKPLACE: IT’S MORE THAN JUST PATIENTS

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