The Importance of Effective Communication in the Health Care Setting

This the importance of effective communication essay will explore the perspective of effective communication in health care setting. For confidentiality purposes, I will refer to the service user as “Celia.” Throughout this piece, I will be talking about an event involving Celia and her daughter whilst on my shift, using theories to explain further.

Before meeting Celia on my first shift as a carer in a care home, I read her personal care plan, which stated that she was non-verbal and she had dementia. When I met her and her daughter who was sat alongside her, I greeted them and introduced myself to them. Celia immediately responded well by smiling at me her facial expression showed that she was happy and soon flung her arms around me as if I was a long-lost friend or someone she was waiting to see. Her daughter appeared upset as she was crying and left the room, so I followed her to try to found out why she was upset so that I can comfort and reassure her.

During this event, I noticed how Celia’s daughter was stamping her feet and making repetitive comments that it was “not fair”, I have been here over an hour you did not showed sign of happiness to me no eye contact to communicate with me, that her mother had been so friendly towards me. Her tone of voice and body language was childlike, suggesting that she was in adaptive child-ego state as states in transactional analysis (TA) by Berne 1969 and wanted me to be her caregiver or a nurturing parent. When I sensed this, I took on this role as I felt it was important to make her feel better after she had broken down. She mentioned that her mother was all that she had, and I felt like she was feeling alone and rejected and needed someone to look after her, so I sat with her in the waiting room until she had calmed down.

Here, I was a nurturing parent, trying to achieve effective communication with her. Berne states that when in the role of a nurturing parent, the individual will provide reassurance to comfort the distressed “child”. It is important to be aware of the channel we use when communicating so that we can ensure we use the most effective method. We may also need to use several channels of communication when dealing with families. During our conversation I was aware of the channel that I was using, I also used my interpersonal and communication skills, and that impacted Celia’s daughter to soon realised that her mum’s sickness was to blame, rather than me, Celia or herself. I succeeded to bring our communication to an adult ego state as she began to calm and told me her family story. Moreover, Berne stated that “complementary transactions equal effective and successful communication”, which are achieved when two people’s ego states complement one another. Although Celia’s daughter wanted her mum to be well, she showed signs of cognitive dissonance when behaviour and beliefs disagree as she appeared upset when her mum was happy towards someone who was not her although she wanted her mum to be pleased.

TA states that human brain acts in many ways like a camcorder, vividly recording events. Both the event and the feelings experienced during the actual event are stored in the brain. The event and the feelings are locked together, and neither one can be recalled without the other. Reflecting on this event, I believe that Celia’s behaviour could be explained by attachment theory. This theory refers to the ongoing relationship which someone has with another person who is able to provide them with comfort and feelings of safety. Bowlby stated that “humans are born with a set of behaviours that help ensure closeness to a comforting, protective figure”. All of these interactions affect people throughout their adulthood.

According to Bowlby, infant to parent attachment is an evolutionary response to an infant’s distress when faced with an inexact world filled with dangers. Seeking comfort, the infant attempts to gain the care of the attachment figure. This responsive caregiver eventually becomes the object of the infant’s primary attachment bond and the one the child turns to in times of uncertainty. The caregiver can be any member of the family or close family friends, for example. This forms the earliest interpersonal experience of a human being. The strength of the attachment bond is based on skills which pointedly impact the navigation of someone’s social world. People develop their own style of communicating with others. Celia was seeking comfort in the time of my visit, perhaps because she felt unengaged with her daughter. I responded to her need by putting my arm around her whilst she leant on me. By tapping her back for reassurance, I created a trustful, affectionate and close relationship with Celia, as mentioned in TA, “A nurturing parent caring, loving, helping”. This non-verbal communication supports and reinforces verbal communication. Ainsworth demonstrated the strange situation procedure which showed how babies express distress the moment when left with a stranger. A strong bond represents a sensitive, responsive and consistent caregiver. However, Wood defines communication as, ‘a process in which individuals interact with and through symbol to create and interpret meaning’. Here, Wood refers to a series of actions or activities that produce something. It was also suggested that we are not just communicating with our selves but also with others by sharing actions with them. In this instance, I was able to reflect my own experiences of communication within my own family upbringing, and use my feelings of security to aid my relationship with Celia and her daughter.

Within a secure relationship, there will be a strong sense of self-worth, consideration of others and trust. Celia lost her speech and gave up all control of her life which made her feel helpless and hopeless. I used effective communication to help discourage these feelings and reassure her that she was still in charge of her own life. Celia’s way of communication is associated with ‘personal values’ with her ‘culture’ and how she ‘value others’ as well as herself, as coined by Littlejohn and Foss in 2005. Reading her personal care plan helped me to achieve an effective, non-verbal communication by using facial expression, gestors, eye contact and body language.

Good communication is imperative to effective care no matter what role you are in. This is important in order to deliver high-quality help and care, regardless of the setting. Effective communication is considered a core condition for all those working in the public service. Donnelly mentioned that good communication is central to everything we do in health and social care. Therefore, maintaining and improving communication skills is a very important part of work.

Overall, there are many theories which can explain the communication within the event discussed above. While TA states that we can better understand ourselves by analysing our transactions with the people closest to us, attachment theory argues that our communication is based on how secure we are within relationships. Due to my secure attachments while growing up, I was able to notice the needs of Celia and her daughter. This meant I could respond appropriately as a nurturing parent to her daughter’s child-ego state. I was also able to recognise and resolve the cognitive dissonance which was apparent in her daughter. Non-verbal communication, such as facial expressions, reactions and posture were also important during my discussed event, because Celia was able to express her feelings and I was able to understand that she was pleased to see me. Through using various techniques as suggested by the discussed theories, I feel I showed effective interpersonal communication skills in order to resolve the situation at hand.

I supported Celia’s daughter by bringing her to her adult ego state, without letting her go to child ego state to prevent the embarrassment. In doing this, the daughter was able to maintain her relationship with her mother. Without regressing to parent ego state, with anger, or the child ego state and feel ashamed.

References

• Berne, E. (1979). Advice from Eric Berne. Transactional Analysis Bulletin, 9(1), pp.44-44.
• Bowlby, J. (1979). The Bowlby-Ainsworth attachment theory. Behavioural and Brain Sciences, 2(4), pp.637-638.
• Pavord, E. and Donnelly, E. (2015). Communication and interpersonal skills. Banbury, UK: Lantern Publishing.
• PENFIELD, W. (1952). MEMORY MECHANISMS. Archives of Neurology and Psychiatry, 67(2), p.178.
• Cuthbert and Quallington (2008) cite Beauchamp and Childress (2001, p. 30) who highlight the values and virtues often associated with healthcare practitioners: compassion and empathy.
• Quallington, J. and Perry, J. (2014). Patient-centred research: a new approach to care. Practice Nursing, 25(2), pp.94-97.
• Wood, J. (2004) communication theories in Action: An introduction. Belmont, CA: Wadsworth/Thomas Learning.
• https://medium.com/@NataliMorad/how-to-communicate-better-with-transactional-analysis-d0d32f9d50da. Assessed online on the 18/12/2019 at 23:12.
• https://www.verywellmind.com/what-is-attachment-theory-2795337