Communication in Care Settings

The Croft Nursery school is a chain of day-care centres throughout the Newcastle-under-Lyme area, it takes children from 0-4 years before preschool and has close links with the local hospital with kids need specialised attention for disabilities and medical conditions. Communication is very important in this care setting both between staff and children and there are different ways this communication takes place through oral, written, body language and special communication

Oral communication is by far the most common between staff you can quickly and easily share information and build relationships easily with colleagues- it is also important to use oral communication with the service users as it builds a relationship with them and helps them learn and understand language. The use of oral communication and the language use differs for staff, parents and children-staff may use informal language the bond with each other and clear precise formal directions when exchange information. Calm and welcoming tones would be used to welcome parents and exchange information about their child, it is more informal as it is very stressful for parents to leave their children and they need to feel secure and relaxed. When using oral communication with children it is important to use clear and simple language, speaking slowly using other forms of communication such as body language and signs to help them understand. Listening is also very important as children are not always clear when they speak

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Body language and non-verbal communication links in with oral communication and helps connect with the service users when lack of language is barrier to effective communication- it is important to maintain eye contact, keep your body language open and relaxed and use non-verbal sins such as nodding and smiling to show you are listening-it is very important with children as they are very sensitive as their oral skills are less developed so they rely on facial expression and body language to communicate with you. I observed at the nursery with the younger toddlers they would teach the children certain signs such as patting their mouth to ask for food- so that they could communicate what they needed with the care workers before they learned the words to ask. It is important to watch a child’s body language as they may not verbally express it if they are in pain or discomfort so a care worker needs to have effective communication and pick up on any non verbal signs that a child may be in distress.

Written communication is often used in many care settings-it allows information to be recorded and therefore reviewed later and eliminates the possibility of human error-for example a human may not remember being told of a specific allergy or a medicine that a child needs- and the child cannot communicate it-but written notes support the care workers and allow them to keep a detailed account of the child needs. Written communication is used throughout the day-care- parents, children and staff have to sign in and out of the building to keep track of the children who are there in a emergency and protect the children-as the staff know who is in the building at all times. Written communication can make information readily available to service users through websites, leaflets and posters-they can see what services they are providing and their produces as well as seeing what their child does on a daily basis.As well as being aware of opening times and ways to contact the centre Computerised communication also ties in as they can email or text to communicate with the daycare workers during the day and see how their child is doing.

Sometimes special methods of communications are used especially with younger children who only have a simple grasp on language such as signs to direct them and give them instructions such as diagrams outside the toilet to tell them to wipe and wash their hands and directions on the coat hangers to direct them to how to easily put their coats on. Children can also communicate and express themselves through artistic activities and this allows them to grow and develop their communication skills and learn to express themselves. Children with special needs may need different forms of communication such as sign language or Braille and the centre has employees with skill’s the cater to their needs as they are learning to communicate. Makaton is also a useful for communication with children with learning difficulties as many of the children at the day care have learning difficulties or disability, Makaton uses signs and symbols, on picture cards and ties into to facial expressions to help them understand.

Communication between individuals does not always go smoothly, as there are often barriers to effective communication between people. If part of the communication cycle is unclear things can become confused for example if the person cannot correctly articulate or express what they are trying to say, they may not be listening attentively, they may use terms or colloquial language that the other person is unfamiliar with or try to communicate an idea with someone assuming they already have the relevant knowledge to understand it. There are many barriers’ that can affect communication such as sensory deprivation, foreign language jargon, slang, dialect or cultural differences.

There are techniques to overcome barriers that occur in communication, oral communication is often used in care settings but there can be misunderstandings when people use slang, jargon or are simply not listening but you can overcome this using your verbal skills effectively, by paraphrasing to make sure you received the correct message, speaking clearly using simple English, and using a range of open and closed questions to get the information you need for example using closed questions to get simple and quick answer and open questions for a more detailed and emotional response. Be-aware of cultural differences as certain words e.g. sick which means good to younger people but disgusting or unwell to older people and I gestures that are acceptable in one country can be extremely rude in others for example in Greece the okay hand sign is rude and is insinuating that you think they are a phallus. Sometimes communication is hindered because the service user may have issue’s hearing, seeing or simply understanding language therefore other forms of communication must be employed such as sign language, Braille or lip reading to allow the user to communicate.

The most important things to assure effective communication is making sure that you are both comfortable and attentive taking into note environmental factors and making sure there are no physical barriers between people communicating and they are in a well lit comfortable area. You must be very aware of your body language, too close, eye contact and body language focused on the user can demonstrate interest and concern but can also be seen as aggressive especially in other cultures so be sure to keep a adequate distance but not too far to feel unapproachable or cold. Keep your body at a slight angle therefore leaving your body language open and keep frequent but not constant eye contact. Listening is always the most important aspect and is essential in care settings as you may miss a vital piece of information that could help you treat a patient or treat a service user in a critical situation.

Research has been done into communication and several theories have arisen from this and can provide guidance for care workers. One of the most well knows is the SOLER theory- it follows five basic points

S – Sit attentively at an angle

It is important to sit attentively at an angle to the person who uses the service. This means that you can look at the person directly and shows that you are listening to the person seated beside you and that you are conveying interest.

O – Open posture

It is important for a practitioner to have an open posture. This means not sitting or standing with your arms folded across your chest as this can sometimes signal that you are defensive or that you are anxious. If a practitioner has an open posture the person may be more inclined to elaborate on their concerns.

L – Leaning forward

It important that practitioners lean forward towards the person using the service, this shows that you are interested in what the person is talking about. It is also possible that the person may be talking about personal issues and so may speak in a lower or quieter tone of voice. In addition you may want to convey a message in a lower or quieter tone of voice if you are seated in a public environment.

E – Eye contact

Eye contact is important as this demonstrates that practitioners are interested and focused on the message that the person using the service is conveying. You can also develop a sense of the person’s emotional state by making eye contact, therefore, enabling you to judge the extent to which the person may be experiencing difficulty.

R – Relaxed body language

It is important to have a relaxed body language as this conveys to the person using the service that you are not in a rush. This will enable the person to develop their responses to questions in their own time

Implementing this theory provide multiple benefits to a person using the service they will feel listened to, develop a close relationship with the practitioner and feel that they care, which will make him/her feel less vulnerable and will feel more positive about asking for help if they feel that they will receive it in a non-judgemental and productive manner. It also benefits the care practitioner as they will understand the needs of the person using the service and therefore effectively address the needs of the person using the service and review care plans more efficiently.

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Another theory of communication is Maslow’s hierarchy of needs, According to humanist psychologist Abraham Maslow, our actions are motivated in orderto achieve certain needs He presents this in a pyramid format as you need to fulfil the lower greater needs before you can fulfil higher lesser needs at the bottom of the pyramid is Physiological needs are the physical requirements for human survival, such as water, food, sleep, warmth etc If these requirements are not met, the human body cannot function properly and will ultimately fail. Physiological needs are the most important; they should be met first.

With their physical needs satisfied, the individual’s safety needs take precedence as in the absence of safety people feel stressed and can experience post traumatic stress disorder-people who are being threatened abused or live in a dangerous or war torn environment cannot concentrate on higher psychological needs and it is a basic animal instinct to need to feel safe and secure in their health and well-being.

After physiological and safety needs are fulfilled, the third level of human needs is interpersonal and involves feelings of belonging such as love, family and friendship this need is especially strong in childhood and can override the need for safety as witnessed in children who cling to abusive parents. Lack of love and belonging– due to isolation, abuse, hospitalization or neglect. – can impact the individual’s ability to form and maintain emotionally significant relationships in general, such as friendship, romantic relations or any intimacy with another person and Many people become susceptible to loneliness social anxiety and clinical depression n the absence of this love or belonging element. T

The fourth tier is esteem-All humans have a need to feel respected; this includes the need to have self esteem and self-respect. People often engage in a profession or hobby to gain recognition. These activities give the person a sense of contribution or value. People with low self-esteem often need respect from others, and seek to please others or achieve fame or glory but self esteem needs acceptance from within and is not found in others Psychological imbalances such as depression can hinder the person from obtaining a higher level of self-esteem or self-respect. People need self esteem and it makes them aim to better themselves and achieve things. Without these things low self esteem may lead to an inferiority complex, weakness, and helplessness.

At the top of the pyramid is self actualization this level of need refers to what a person’s full potential is and the realization of that potential.individuals may perceive or focus on this need very specifically. For example, one person may have the strong desire to become an ideal parent, another to build their own business and simply gain great athleticism; it may even be expressed in paintings, pictures, or inventions.As previously mentioned, Maslow believed that to understand this level of need, the person must not only achieve the previous needs, but master them.

Using this theory in care settings help us understand what the patient needs by looking at what they have fulfilled in their life and what they still need-for example a depressed patient cannot be treated for hormonal imbalance’s or issues with intimacy etc. If they are in an unsafe environment or have no shelter or lack of food-those needs must first be addressed before you can address issues further up Maslow’s hierarchy of needs. It helps us better structure our care and help patients more efficiently.

I experience all these forms of communication and issues when I did experience at The Croft nursery. During my time their I circulated between the different ages of children and learned about the communication between the staff with children of different ages and also how they communicate with each other, which helped me better explore communication and understand it rather than simply reading about it. At the nursery, I participated in games with the children, sat them down for dinner, took them for walks and laid them down for naps. I found it very easy to engage with the children and feel this was a strong point of mine I kept my body language open and very positive and was good at getting the children to open up. Sometimes I struggled with the language barriers with younger children as it is hard to understand what they want and can be confusing but I got used to looking for other signs and body language to understand what they wanted from me.

I took direction well from the staff and enjoyed working with them-they were very clear and had good communication all over the building, there was no confusion where I was going and what I was doing and the use of telephones connected in each room made it easy for them to ask for help or anything else they needed from other rooms. The only complaint I would have is some of the staff could be a bit more rude and less welcoming and would discuss topics around the young children that wasn’t appropriate especially as the children were just starting the learn language. I would say that my weak point would have been communicating with the children to make them understand what they couldn’t do- I found it very easy to get them to do things and play with them but when it comes to the negative side such as telling them off I found it difficult as I felt uncomfortable being so negative to other people’s children and would need to work on and research it for next time. I also feel that I could benefit of more extensive training and explanations of techniques to use with the children.