Importance of Communication for Paramedics: Analytical Essay

This essay will set out to explore and identify the importance of communication within clinical practice, in relation to the job role of a paramedic. It will identify the attitudes and skills that are required of a paramedic to communicate effectively during their clinical practice. To best discuss the importance of communication for paramedics I will draw upon an example where effective communication was essential during my clinical placement.

The barriers that were faced in relation to my clinical placement will be highlighted, with a discussion on the ways in which these communication barriers were overcome. For the purpose of confidentiality individuals, identities and locations will be anonymized throughout. Communication theories such as Schramm’s Model of Communication and the Linear Model of Communication will be drawn upon. There will be a discussion on the importance of paramedics having a flexible approach to communication by using a variety of communication methods and theories during their practice. Once all these areas are explored, the essay will draw to an end with a brief and informative conclusion discussing the findings made, whilst highlighting the importance of effective communication for paramedic practice.

Good communication in paramedic practice is of high importance as being able to communicate with your patients effectively will better allow the paramedic to ascertain the problems that their patient is facing. Whilst accurately gathering all the appropriate information, good communication will allow the patient to trust the paramedic and become less anxious about their illness, this will overall result in a much greater outcome for the patient and their care (Servellen, 2009). Communication has been a part of human life for as long as people have existed (Littlejohn & Foss, 2011), it is an integral part of human relationships, and it is “one of those everyday activities intertwined with all of human life so completely that we sometimes overlook its pervasiveness, importance, and complexity” (Littlejohn & Foss, 2011, p.3). Communication plays an important role in all forms of healthcare, from diagnostic information gathering to the overall patient experience, all of which have an important role to play in the clinical outcome for the patient (Healthcarecomm.org, 2011). The Health and Care Professions Council released a document, “Standards of Proficiency – Paramedics”, where it stated the importance of communication for paramedics, it highlighted that paramedics should “be able to demonstrate effective and appropriate verbal and non-verbal skills in communicating information, advice, instruction and professional opinion to service users, colleagues and others” (Hpc-uk, 2014, p.9). Without effective communication within healthcare, important clinical details could be missed and patients may be left feeling unsure and uneasy. Good communication should be the most important tool that a paramedic carries because without it the needs and feelings of a patient could easily be overlooked. Patients should always be at the centre of all decisions that a paramedic makes.

There have been theories developed over time to help better understand the relationships between people and how we communicate with each other. Schramm’s Model of Communication is a theory that was developed to highlight the processes in which people communicate; he states that “feedback tells us how our messages are being interpreted. The communicator can adjust his or her message, or provide additional information should the recipient not be clear about the intended meaning” (Steinberg, 2007, p.55). Schramm’s model could be adapted to the role of a paramedic and how they communicate, not only with patients but colleagues and external agencies. It is important to be flexible with your communication approach at all times when working within healthcare due to the diverse groups of people living in today’s society. Its main focus is that communication is not just about the communicator’s message but also how the recipient interprets the message, highlighting that effective communication is a two way process (Steinberg, 2007). In contrast to Schramm’s theory, there is the linear communication model which looks at communication as a one-way process of communication. The model highlights the process where messages are conveyed along a process from the sender to a recipient (West & Turner, 2009). This communication model may be effective in some paramedic practice, for instance at an incident brief at the scene of an RTC where rapid, clear, and precise information and direction needs to be given. However, this model could be at risk of not working effectively in the daily practice of paramedics as the communication that paramedics have with patients, colleagues, and other professionals needs to be a two way process where messages are able to be modified and flexible to enable clear and effective communication.

Adaptability and effective communication has been of paramount importance during my clinical placement, a particular case that required the use of many different forms of communication from non-verbal to verbal was when we had a call to a residential care home late at night. We were faced with an elderly lady who had fallen out of bed, and whilst assessing the patient my PPEd and I faced some barriers in communication. The patient seemed confused and also required the use of a hearing aid to communicate, however, the battery had died. The staff at the care home had minimal information on the patient as she had recently arrived a few days previously. All of these factors created barriers in our communication and made it difficult to ascertain important information to ensure she received effective and appropriate care. This also caused difficulty in our efforts to reassure the patient by not being able to explain what we were doing. By not having the power of verbal communication to assess and reassure the patient it proved difficult and challenging, however by using a variety of communication methods, which are discussed in further detail later on, we were able to overcome these barriers.

Paramedics will need to use a variety of communication methods in their clinical practice to deliver optimum care to all patients such as open and closed questioning. An open question will allow the patient to explain in their own words exactly how they are feeling, however, this could leave some gaps in important information and this is where closed questions can work well to ascertain exact details to help build a clear picture of the patient’s condition (Caroline, 2014). Being able to adapt your questioning and communication style throughout a patient assessment is important to ensure the best possible outcome for the patient by taking appropriate actions in their care. This approach was demonstrated in my clinical example where my PPEd and I used a variety of communication methods to ascertain as much information as possible from the patient and the careers. As well as using open and closed questioning and implementing a variety of communication methods, it was also important to be aware of how non-verbal communication can help the patient feel more comfortable and be willing to open up to you. During my clinical example, non-verbal communication played a key part in the assessment and communication process with the patient. In some cases other communication methods work best, however, when faced with a patient where there are barriers in communication, non-verbal communication was initially the best and most appropriate communication method to use to overcome these barriers. It was important for me to remember that not being able to communicate easily with us could also be an added stress for the patient. Swearingen (2016, p.81) has drawn attention to the fact that the “inability to communicate with ease may cause feelings of isolation that can be intensified if patients have difficulty communicating with caregivers”, with this in mind it is important to highlight the significance of paramedics taking an inclusive and flexible approach to communication with each patient that they see, they can do this by treating every patient as an individual, each having individual needs (Nixon, 2013). To best approach this case, alternative communication approaches needed to be used to overcome the barriers in our communication. One of the ways in which this was initially facilitated was that my PPEd wrote down questions for the patient to answer, whilst I tried to replace the battery in the hearing aid so that we could communicate with her verbally. There are several ways in which you can communicate with a patient in a non-verbal way from your body language, facial expressions, posture, touch, and eye contact, for example, your demeanour can influence a patients mood and how much they open up to you (Servellen, 2009). It has been highlighted by Caroline (2014 p.10-11), that a pleasant demeanour is “absolutely necessary when you are dealing with people in crisis because they need to see you as someone who is safe to be with, who does not pose a threat, and who honestly cares”. By using one or more of the communication methods discussed throughout, paramedics will be able to communicate with patients, families, and other professionals in a professional and effective manner. Gaining the confidence and trust in your patients is the most important aspect of a paramedics role to enable them to carry out their job in the best possible way. By treating all patients with respect and listening to what they have to say will help paramedics to gain their patients trust. It has been highlighted by Bos & Blobel (2007) that “trust is a basic commodity. The clinician needs to trust the patient who is telling them all they can about their illness whilst recognising that patients have their own agendas and may only tell them what they feel comfortable with”. By spending a little time gaining a patients trust and confidence in you as a health care professional, will allow for a much greater clinical outcome for all.

Throughout this essay, there has been an exploration and identification of the importance of good and effective communication in paramedic practice. It has not only highlighted the importance of communication between practitioner and patient but also how communication between practitioners, organization, the patients family, and anyone involved in the care of the patient is also of high importance. Whilst referring to the importance of effective communication in paramedic practice, there has been an exploration of communication theories throughout. With reference to the communication theories, there was a discussion on a case during my clinical practice where barriers in communication were faced it was then highlighted how these barriers were overcome using different methods of communication. Professional paramedic communication needs to take a flexible approach, by adapting and changing communication methods to best suit the patient and any needs they may have (wales.NHS.uk, n.d). It has been identified throughout that effective communication plays an important role in the clinical outcome for the patients, whilst also emphasising how good communication skills are one of the most important skills a paramedic will ever hold. Without good communication skills, paramedics will not be able to carry out their job to the best of their ability no matter how good their clinical knowledge and skills are. To move forward with appropriate care for a patient the most important aspect of a clinical assessment is the information gathering through effective communication, and not necessarily just physical examinations (Patientsafety.health.org, 2016). Having explored communication theories and professional communication in the context of paramedic practice it would be fair to suggest that communication plays a highly important role in patient outcomes and that paramedics need to be flexible and professional in their communication approaches, not only with their patients but also any organization or individuals involved in a patients care.

References

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