Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Interpersonal Skills and Human...

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc.

Interpersonal Skills and Human Behavior

Chapter 5

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 2

Introduction

The medical assistant’s interpersonal skills help to set the tone of the office.

Interpersonal skills and human relations intersect, and the successful medical assistant will work to improve both sets of skills throughout his or her career.


This chapter will examine:

The importance of first impressions

The differences between verbal and nonverbal communications

Spatial separation

The value of touch while communicating

Elements of the transactional communication model

Barriers to effective communication

Defense mechanisms, listening, and dealing with conflict


The Patient’s Perception

The patient’s perception of the physician’s office and the staff members is critically important.

Perception may not be accurate at all times, but what the patient perceives is just as important as what is actually happening.


First Impressions

First impressions are still lasting ones!


First Impressions

First impressions are more than physical appearance or dress.

Opinions formed in the first few moments of meeting last much longer in our thoughts than the actual time we spend with a person we have just met.

The first impression includes attitude, compassion, and the smile!


Introductions

Always introduce yourself to patients

Smile

Wear a name badge

Show the patient around the office

Introduce other staff members to the patient

Put the patient at ease


Communication Paths

Verbal Communication

Depends on words and sounds

Do not interrupt a person who is speaking



Speak clearly and enunciate properly.

Vary the pitch of the voice.

Use appropriate volume.

Speak at an audible level.

Make eye contact.

Speak in an animated fashion.

Show concern.



Tone of voice is very important in communication.

Never be sarcastic.

Never be rude.

Never make an inappropriate remark and follow it by saying “I was just kidding.”

Take care not to hurt anyone’s feelings with words or phrases.


Patients Need Tender Care

Remember that patients are in the office to be cared for.

They may have great concerns.

They may be very apprehensive.

They may be fearful.


Listen to Patients

Allow patients to do most of the talking.

Do not offer personal information about your own life and problems.

Share only positive experiences, and then, only briefly.

Do not burden the patient with your problems at any time!


Nonverbal Communication

Nonverbal communications are messages that are conveyed without the use of words. Transmitted by:

Body language

Gestures

Mannerisms

Eye movement


Body Language

Partly instinctive

Partly taught

Partly imitative


Body Language

Involves: Eye contact Facial expression Hand gestures Grooming Dress Space Tone of voice Posture Touch


Appearance

Appearance is a vital part of nonverbal communication.

Appearance can present conflicting nonverbal information.


Appearance

The successful medical assistant expresses:

self-esteem

confidence

pleasant facial expressions

caring attitudes


Conservative Appearance

In the medical profession, patients expect professionalism, and conservative appearance is preferred to avoid blocks in communications.


Proxemics

Proxemics is the study of the nature, degree, and effect of the spatial separation individuals naturally maintain and how this separation relates to cultural and environmental factors.


What Can Touch Mean?

Touch, in the medical profession, can be comforting or can promote a sexual harassment lawsuit.


Avoid Claims of Battery

Be very careful when touching a patient.

Non-consensual touching can be considered battery in today’s litigious society.


The medical assistant should not be afraid to touch patients in an appropriate manner.


Posture and Positioning

Can signal:

Depression

Anger

Excitement

Fear

An appeal for help


The Process of Communication

To communicate well, we must have a general understanding of the process of communication.

Usually when two people interact, they both function as senders and receivers.


Channels

Channels can be:

Spoken words

Written messages

Body language


Encoding

Senders encode a message, which means that they choose a specific method of expression using words and/or other channels.


Decoding

The receiver decodes the message according to his or her understanding of what is being communicated.


Noise

Noise contributes to the misunderstanding of messages. Noise is anything that interferes with the message being sent.


Feedback

Verbal expression

Body language

Nod of understanding


Transactional Communication Model


Listening

Listening is paying attention to sound or hearing something with thoughtful attention. Listening is an important skill that the medical assistant can develop.


What Prevents Us from Listening?

Our own thoughts distract us.

Situations in our lives make it hard to listen.

Conversation seems meaningless and unimportant.

Too many messages are coming in at once.

Emotions, such as anger, render us unable to listen.

Exhaustion makes listening difficult.

We have prejudged the speaker and feel there is no need to listen.


Listening to Patients

Patients must know that we are listening—not only hearing the words that are being spoken, but attempting to interpret what the patient is trying to communicate.


Paraphrasing

Paraphrasing:

Listening to what the sender is communicating

Analyzing the words

Restating them to confirm that the receiver has understood the message as the sender intended it

Clarifies speaker’s thoughts

Helps to indicate that there is common understanding


Ask Open-Ended Questions

Can you explain what the pain feels like?

When did you first notice these symptoms?

What are you usually doing when you have symptoms?

What do you think is causing the symptoms?


Observing Carefully

Watch for signals from patients, such as tears, sad expressions, or volatile temper.


Defense Mechanisms

Verbal Aggression—A person attacks another without addressing the original complaint or disregards it inappropriately.

Sarcasm—A biting edge added to words that a person states with the intent to cause pain or anger.

Rationalization—Attributing actions to rational and credible motives without analyzing underlying methods.


Defense Mechanisms

Compensation—Making up for one behavior by stressing another.

Regression—The reversion to an earlier mental or behavioral level.

Repression—Process whereby unwanted desires or impulses are excluded from the consciousness and left to operate in the unconscious.


Defense Mechanisms

Apathy—A lack of feeling, emotion, interest, or concern.

Displacement—The redirection of an emotion or impulse from its original object, such as an idea or person, to another object.


Defense Mechanisms

Denial—A state in which confrontation with a personal problem or with reality is avoided by denying the existence of the problem or reality.

Physical avoidance—Avoidance of any representation of a painful event.

Projection—The attribution of one’s own ideas, feelings, or attitudes to other people or to objects.


Dealing with Conflict

Conflict is the struggle resulting from incompatible or opposing needs, drives, wishes, or external or internal demands.


Conflict can…

Be beneficial to relationships

Be constructive

Allow people to learn about each other

Promote stronger understanding

Promote deeper levels of intimacy


Assertion—Stating or declaring positively, often forcefully or aggressively

Nonassertion—The inability to express needs and thoughts or the refusal to express them


Crazymakers

The Avoider:

Refuses to fight; keeps from facing the problem at hand.

The Pseudoaccommodator:

Refuses to face up to a conflict by either giving in or pretending nothing is wrong.


Crazymakers

The Guiltmaker:

Tries to make his or her partner feel responsible for causing pain.

The Subject Changer:

Escapes facing up to aggression by shifting the conversation when it approaches an area of conflict.


Crazymakers

The Distracter:

Attacks other parts of his or her partner’s life rather than expressing feelings of dissatisfaction.

The Mind Reader:

Refuses to allow his or her partner to express feelings honestly and goes into an analysis of what the partner “really means.”


Crazymakers

The Trapper:

Sets up desired behavior, then attacks that behavior once it manifests.

The Crisis Tickler:

Brings what is bothering him or her almost to the surface but never quite expresses true feelings.


Crazymakers

The Gunnysacker:

Does not immediately respond to anger. Directs pent-up frustrations and aggression on the unsuspecting partner.

The Trivial Tyrannizer:

Does things that will bother the partner instead of honestly sharing his or her own resentments.

The Beltliner:

Hits the partner below the psychologic belt.


Crazymakers

The Joker:

Kids around when the partner wants to be serious, instead of expressing true feelings.

The Blamer:

More interested in finding fault than in resolving a conflict.

The Contract Tyrannizer:

Will not allow relationships to change from the way they once were.


Crazymakers

The Kitchen Sink Fighter:

Brings up things that are totally off the subject instead of dealing with the issues at hand.

The Withholder:

Punishes the partner by holding something back, building up greater resentment.

The Benedict Arnold:

Gets back at partners by sabotage, failing to defend them and encouraging ridicule toward them.


Barriers to Communication

Physical impairment

Language

Prejudice

Stereotyping

Perception


Communication during Difficult Times

During Anger

One of the most difficult times to communicate

Expression of anger is usually healthy

Unexpressed anger causes or contributes to all types of health problems



Anger

Anger is usually not directed toward the medical assistant.

Be a good listener.

Use logic.

Do not use absolutes such as “never” and “always.”

Remain calm.



Shock

Many types of shock can occur.

Usually happens after some catastrophe.

Patient often cannot think or move.

Some scream in agony, others seem almost normal.

We never know how we might react in a deeply stressful situation.

Our reactions may differ from time to time.



Shock

Never leave a person in shock alone.

Do not allow the person to speed off in a car.

Listen!

Watch the person carefully.

Make sure the person is with a trusted relative or friend before he or she leaves the office.


Death and Dying

Elisabeth Kübler-Ross

Dr. Kübler-Ross studied thanatology, the study of the phenomena of death and of psychologic methods of coping with death.


Five Stages of Grief

Denial

Anger

Bargaining

Depression

Acceptance


Multicultural Issues

We sometimes think that people all over the world think and behave as we do.

We often stereotype those from other cultures and think that we understand them.

Those from other geographic areas, even within the United States, may experience culture shock in new surroundings.

Patience is an important trait when dealing with those from other cultures.


Communicating with Those from Other Cultures

Treat them as you would wish to be treated.

Overcome language barriers.

Be patient when communicating.

Encourage patients to bring a translator, if necessary.

Understand the nonverbal communications of other cultures.


Maslow’s Hierarchy of Needs

Physical needs: food, rest, sleep, water, air, sex

Safety needs

Social needs: sense of belonging, interaction with others

Self-esteem needs: feeling good about ourselves

Self-actualization: maximized potential


Maslow’s Hierarchy of Needs


Human Needs

Approval

Acceptance

Achievement


Stages of Sleep

Two Main Phases of Sleep

NREM (non–rapid eye movement)

- Four stages, during which the body slows down and relaxes

REM (rapid eye movement)

- Deep sleep when dreaming occurs

- Brain is highly active

- Eyes move rapidly

- Occurs in the last hours of sleep

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Interpersonal Skills and Human...

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Transcript of Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Interpersonal Skills and Human...