Unit 1: Devolving Effective Communication in Health and Social Care Essay

Throughout my assessment I will explain and go into detail about the massive effect that communication has in the jobs of health and social care. For example language barriers or how disabilities change the way we connect. Saying this it’s not just speech, it can also be gestures or movements which show more emotions for example, if someone was telling you sad news but in an angry tone you wouldn’t take what they were saying into account but notice their body language like the tone of their voice or use of gestures in instead. Communication is important for a range of reasons, such as for/to help which helps us need are needs such as eating, drinking etc. Also talking to people builds friendships/relationships and forms bonds with others. There are more ways to communicate now than ever; the main titles they all fall under are verbal, non-verbal, text, written signs and symbols.

There are five contexts in effective communication. The first being one to one, this is usually between people such as your GP, a home carer, doctor etc. When you start a conversation with these types of people and you don’t know them well you both have to try and create the correct atmosphere. At first there would be a sort of tension but once you trust each other then there would be a relaxed and friendly environment. These conversations have to be confidential and private usually documented in some way which will then be stored securely whether that in a locked cabinet or in a computer file. Sometimes you may be close and see this person regularly but even then all conversations are usually formal and eye contact is used. Certain body language will be used so the person confiding in their GP or example feels comfortable and able to talk knowing they are listening and have the time and patience to talk to them. These types of professionals cannot judge no matter what your situation is, if they were to this is highly unprofessional and may make the individual feel uncomfortable and not want to use their service again. Secondly there is a group discussion, in this context there is usually one individually in charger this is usually so there is control, and they can also help encourage other members to get involved in the talking. A good example for a group discussion is a counselling drug sessions such as a drug meeting. These would still have to be formal, private and confidential as it is peoples own personal experiences and they trust you. It is fair and important even if one person is in charge that everyone has a chance to be involved and put there point across, if this doesn’t happen there may be massive mistakes which lead to massive consequences for example in the case of Baby P where he unfortunately died due to social services, the police and doctors failing to talk to each other, I will be going into greater detail about this subject later on in my assessment. Just like a one to one there is eye contact and the body language of people shows a lot including respect for example not sighing or speaking when someone else is. Seating arrangements can also make people feel equal and comfortable, if one person stands and the rest sit in a meeting that automatically shows authority and leadership, in some cases this isn’t wanted. Formal and informal communication is the difference between talking to a close friend, and talking to a boss at work. Formal communication is usually between doctors, work colleges, and for professional roles. There will usually be a greeting possibly a hand shake and most defiantly eye contact. Informal is more of an open communication and used for close friends and relatives mainly. When close to someone you can swear, use a more friendly/unprofessional type of language, gossip and most probably get away with no eye contact. Sometime friends even have some sort slang words that only they understand. For example saying ‘Hiya mate, what’s up?’ would be understood and not took offensively and would even be appreciated. But saying this to a boss or doctor may not be taken in the
correct way and they may be offended. Communication between work colleges can be difficult as if they are on the same level there will be some sort of friendship so you would give each other an equal level of formality. Saying this some situations have to be took more seriously than others for example when a pupil tells a teacher about bullying they would be comforting like a friend but will still take the matter very seriously and also keep this confidential. It is important for work colleagues have to be able to communicate easily especially when the job involves a lot of team work, without communication they may fail in the given task. For teamwork to work you need to demonstrate that you are a good learner and develop trust with fellow colleagues. Although you may still class colleagues as friends your communication between them and closer friends or even colleagues outside of work will be a lot more laid back than in an office environment which is also around higher respected people such as mangers etc. Just like colleges communication between professionals and clients starts formal but once a bond is formed they may become slightly informal, but still respect each other and keep everything private. The terminology and body language used is again formal but may, not always, turn informal after time. For example what once may be a formal surname greeting with a handshake may turn into a simple forename greeting. Sometimes due to the type of language professionals use people aren’t always able to understand them this would create a barrier for both professional and non-professional.

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Although there around about ten forms of communication not all can be used by all people. Some are formal and some are even physical, saying this no matter what they are they all help the Health and Social job sector in communication with each other and patients. The first being text messaging, usually non confidential and informal and very rarely used in the health and social care profession. When people text they usually don’t use correct grammar or speech so it is unclear and your point may not be understood by the receiver. This form of communication is usually used for short and simple messages or gossiping between friends. Next there is oral, this form of communication is a mixture of formal and informal usually this depends on who you are communicating with. More information can be given and shared when talking, although this is always one of its issues as there may be a
language barrier between people or also people may be partially or full deaf and unable to hear what you are saying. Also people who have speech impediments will struggle using their voice to communicate with others. People who do suffer from hearing or speech issues have the use of signs and symbols to communicate. This is everything from signing for deaf people to road directions or signs for toilets etc. Symbols aren’t as useful as oral but it does help people and makes life a lot easier for some people. Music and drama are a lot like arts and crafts when it comes to communication. This is because they are both a way of expressing your feelings and emotions. Different types of music or different colours can show a person’s feelings. Music is usually the most effective as different music can be used for different types of therapies. People are also able to use music to learn, even deaf people as they can tell how something sounds sometimes by the vibrations on a speaker. Written communication in Health and Social care, has to be all signed, dated and completed information, usually confidential and locked in a cabinet or on a secure computer. All written documents are factual. Although good for references to look back on a later date, written documents are usually shorter than the full conversation had by the doctor and patient for example, they will normally be just bullet pointed and short sentences. Signing is used usually just for deaf people, it makes their lives so much easier as they are able to tell somebody something in confidence, and don’t feel as isolated. Makaton is also another use of signing; with this one the user will also use simple speech. I will go into greater deal later on in my assessment. Touch is another use of communication, mainly used for braille which is a reading aid for blind people, you can usually find this under signs, on tablet boxes and sometimes you can have actual books in it. You can also use touch to show emotion and show comfort to somebody, by giving a hug for example. This would be inappropriate at work but more appropriate with child, family and close friends. Objects of reference are normally used to give people directions, once again helping in a rather big way. An example of this type of communication being used could be around a big hospital “go left at reception, past the labour ward and stop at the lift and go to ward 11” Technology is forever changing but it is used in nearly every part of Health and Social care communication. For example any hospital equipment, calling a
mother from a child care centre or storing files on a hard drive. Not only does it help people in these ways and more there is also a thing such as the voice box which helps people with speech impediments and also the hearing loop which helps people with hearing difficulties.

Now that I have explained all the forms and contexts I will now move on to the types of communication. This is the way you are to use the above. Firstly there is the pitch/tone of your voice, if you are to be talking to a young child but in a low and angry tone, even if giving them a well done; they may think you are in fact angry at them and not happy. This is why it is so important to take in to context who you are talking to and how. As well as tone, pitch and expressions, there are also things like the speed and rhythm and also volume effect your expression in exactly the same way. Only 7% of communication is actually verbal the other 93% is non-verbal. This is because people use their body and movement to describe how they’re feeling. Sometimes you don’t even have to talk to someone for them to know how you are feeling or what you mean, this is non-verbal. This is commonly used for people who have speech issues; usually they will use sign, or write down what they are trying to say. They may even use gestures, especially in the UK we have certain arm and hand movements for the words OK and perfect. Saying this sometimes silence is a person’s choice, they may do this because they feel embarrassed or shy but also that they are angry or in a mood. Silence does not always stop the conversation; sometimes it can even help it. The use of speech isn’t always possible, but nor is signing or writing for example a baby, you can only tell their emotions by crying for example when hungry. Also sometimes people are able to talk just in a different language, this creates a massive barrier if no one can talk the same language a translator will be need and is unavailable at the time this would create a massive issue. Just like a language barrier sometimes there may be an accent issue, different cities have different accents, some harder to understand that others as sometimes they even use different words to describe same things. Like an accent people often use slang quiet often in modern times and this can be very hard to understand as just like accents again they use different words to describe the same thing. Just like the tone of your voice the way you move can also help show the mood you’re in.
This includes your posture also. If you were to sit slouched, arms crossed this would show that you could be moody, bored or tired, all of which aren’t good. This is the exact same as tone and pitch is some ways as if you were skipping around while giving bad news they will concentrate more on your movements than on your bad news. Your facial expression indicates your emotional state, certainly when having a one to one with someone who knows you well. A happy person will have wide eyes and look relaxed, you would be happy to approach this type of person with an issue for example. You can also guess people’s emotions en they give you eye contact, same as being happy with wide eyes, when you’re upset or angry your eyes would be sort of lifeless. Especially in Europe looking away usually means you’re bored and uninterested.

For certain disabilities there are certain aids which can help them communicate with people. The first being braille, this is and aid for blind people so that they can read just as much and like we can. Braille is a system of touch reading and writing for blind people in which raised dots represent the letters of the alphabet. It even includes punctuation marks. When reading braille you read left to right along each line, usually using both hands using the index finger. People can usually read approximately 150 words per minute but those who can read at greater speeds can read around about 200 per minute. It was created by a young French boy call Louis Braille and was originally used for a secret code for the French military. Makaton is another form of communication for those with some disabilities, this is very like sign but you use speech as well as signing. Makaton uses instructions involving a combination of speech, signs, and graphic symbols used concurrently. It consists of roughly 450 concepts that are taught in a specific order, there are 8 different stages. For example, stage 1 involves teaching vocabulary for immediate needs, like ‘eat’ and ‘drink’. Later stages contain more complex and abstract vocabulary such as time and emotions. It was originally conducted in 1972, but has been forever changing and becoming more advanced, for example in 1996 the Core Vocabulary was revised was include to cultural differences. Sign language is a very popular aid used by deaf people, it consists of using your hands to create the letters or sometimes words of the alphabet. Sometimes they will also lip
read at the same time, both help deaf people greatly. Just like Makaton, it is also used in different cultures. There are three main groups in sign they are. Firstly deaf sign languages, is the preferred languages of Deaf communities around the world; these include village sign languages, just like accents they use different slang, shared with the hearing community, and Deaf-community sign languages. Secondly signed modes of oral languages, also known as manually coded languages, which are a bridge between the deaf and oral languages. Then there are auxiliary sign systems, which are not native languages, but are, signed systems of varying complexity used in addition to oral languages. Simple gestures are not included, as they do not constitute language. Another type of preference is communication passports. They are usually small personalised books containing straight forward practical information about the carrier and their style on communication; it is usually so that health and care workers can see clearly what sort of need this person needs. They often include pictures and drawings that help the health and care works see clearly what sort of person owns the book and by putting together what is in it they can come up with some sort of mini life of his or hers likes, dislikes and communication skills.

There are two theories involving communication, one being Argyle. Michael Argyle (1972) argued that interpersonal communication was a skill that could be learned and developed in much the same way as learning to drive a car. According to Argyle skilled social skills involves a cycle, which goes like this. Firstly and idea occurs, for example in a health care situation a midwife may think, this woman needs to deliver this baby. She then decided to tell the woman she needs to push; this means the message has been coded. There are sometime barriers such as id the woman was deaf, so the midwife signs or writes down she needs to much, the message is then sent to the woman in labor. The next stage is message received this is simple the woman in labor receiving the signed or written message. Next, the woman understands the message is coded in her brain. Lastly the woman pushes and asks for gas and air. When the woman asked for gas and air the cycle would then go around again and again. Although the six stages seem very long this would take only a matter of seconds. It is called the communication cycle. It includes a code where you have to work out what the other persons
behavior really means. The second communicational theory is, Tucmans. Dr Bruce Tuckman published his Forming Storming Norming Performing model in 1965. He added a fifth stage, adjourning, in the 1970s. The Forming Storming Norming Performing theory is an elegant and helpful explanation of team development and behaviour. Tuckman’s model explains that as the team develops maturity and ability, relationships establish, and the leader changes leadership style. Beginning with a directing style, moving through coaching, then participating, finishing delegating and almost detached. At this point the team may produce a leader, this progression of team behaviour and leadership style can be seen clearly. There are four stages, usually laid out in a square so they are easily visible. The first stage is forming, in this stage there is high dependence on leader for guidance and direction. Little agreement is in the team other than received from leader. Individual roles and responsibilities are unclear and not many will be agreed on. The leader must be prepared to answer a lot of questions about the team’s purpose, objectives and external relationships. Processes are often ignored. Members test tolerance of system and leader. Decisions still do not come easily within group by stage two, storming. Team members will fight for position as they attempt to establish themselves in relation to the other team members and the leader. Clarity of purpose increases slightly but plenty of uncertainties are still present. In the stage norming, agreement and consensus are largely formed among the team, who respond well to facilitation by a leader. Roles and responsibilities are clear now and are all accepted. Big decisions are made by group agreement. Smaller decisions may be delegated to individuals or small teams within group. At this final stage, performing, the team is more strategically aware; the team knows clearly why it is doing what it is doing. Also they have a shared vision and are able to stand on its own feet with no interference or participation from the leader. There is a focus on over-achieving goals, and the team makes most of the decisions against criteria agreed with the leader. Disagreements may occur but now they are resolved within the team positively and necessary changes to processes and structure are made by the team.

Baby Peter is a very well-known health and social care case, as it is the communication between each role that failed and resulted in his death age
just 17 months old. Peter’s mother had split from his birth father and was having a new relationship with a new man who she said was ‘just a friend’. Baby P was first admitted to hospital with injury’s which lead to him being taken away from his mother for three months, his second and third admittance he was sent straight home, which would then lead to his death as it was thought at this stage he had over 50 injuries one which was the cause of death, a broken spine which possibly paralysed him. The doctor failed to see this as he only examined him in his push chair; if he had actually done his job properly Peter Connelly may still be alive today. The mother would cover his bruises with chocolate acting if he was just a messy child, and would talk to Sue Gilmore their social worker, who was in fact in training at this stage, about how she wanted social services to leave her and her son alone so as she has proved she is a good mother and they were getting in the way. Also how her ‘close friend’ was there to help and treated her all the time because she was down. At this stage she should have challenged her about her new boyfriend but instead she had a conversation about how he was a dream boat. If they had done the correct research they would have found out that he was currently on charge for the rape of a two year old. The MDT, multi-disciplinary team which included three social workers, doctors, GPs, accident and emergency staff and police did not work together throughout any parts of this case, the doctors should have told them every mark he has and when he was emitted. The social workers should have shown the police recordings of the mother being interviewed and the police need to have done checks on the boyfriend, and investigated any complaints against noise etc. There was no communication as the doctor turned around and said I can’t give you that information its confidential, which is true but they should have realised that in this case realising certain information to the police and social workers would help greatly. They were more arguing than meeting. Whenever someone did say the clever thing and say they need to get Peter away from the house, the police said they had no evidence; this is because the doctors would not release any. This case has been described as the perfect storm of failure. This is a short part of the biography going into more detail “Peter Connelly was born to Tracey Connelly on 1 March 2006. In November, Connelly’s new boyfriend, Steven Barker, moved in with her. In December, a GP noticed bruises on Peter’s face and chest. His mother was
arrested and Peter was put into the care of a family friend, but returned home to his mother’s care in January 2007. Over the next few months, Peter was admitted to hospital on two occasions suffering from injuries including bruising, scratches and swelling on the side of the head. Connelly was arrested again in May 2007. In June 2007, a social worker observed marks on Peter and informed the police. A medical examination concluded that the bruising was due to abuse. On 4 June, the baby was placed with a friend for safeguarding. Over a month later, on 25 July, Haringey Council’s Children & Young People’s Service obtained legal advice which indicated that the “threshold for initiating Care Proceedings…was not met”.On 1 August 2007, Baby Peter was seen at St. Ann’s Hospital in north London by locum paediatrician Dr. Sabah Al-Zayyat. Serious injuries, including a broken back and broken ribs, very likely went undetected (the autopsy report believed these to have pre-dated Al-Zayyat’s examination). A day later, Connelly was informed that she would not be prosecuted. The next day, an ambulance was called and Peter was found in his cot, blue and clad only in a nappy. After attempts at resuscitation, he was taken to North Middlesex hospital with his mother but was pronounced dead at 12:20 pm. A post-mortem revealed he had swallowed a tooth after being punched. Other injuries included a broken back, broken ribs, mutilated fingertips and fingernails missing. The police immediately began a murder investigation and Baby P’s mother was arrested. So too were Barker, his brother Jason Owen and his 15-year-old girlfriend, who had fled to and were hiding in a campsite in Epping Forest.” On 11 November 2008, Owen, 36, and his brother Barker, 32, were found guilty of “causing or allowing the death of a child or vulnerable person”. Connelly, 27, had pleaded guilty to this charge. A second trial occurred in April 2009, when Connelly and Barker, under aliases, faced charges related to the rape of a two-year old girl. The girl was also on Haringey’s child protection register. Barker was found guilty of rape, while Connelly was found not guilty of child cruelty charges. Their defense lawyers argued that this second trial was nearly undermined by bloggers publishing information which could have prejudiced the jury. Sentencing for both trials together took place on 22 May 2009 at the Old Bailey. Connelly was ordered to be held indefinitely, until “deemed no longer to be a risk to the public and in particular to small children”, with a minimum term of five years. Barker was
sentenced to life imprisonment for the rape, with a minimum sentence of ten years, and a 12-year sentence for his role in the death of Peter, to run concurrently. Owen was also jailed indefinitely, and would serve at least three years. Jason Owen is now free after only three years for playing a part in Peters murder. His mother is currently coming towards the end of her jail time, and says she is sorry allowing his death and she is scared to be released as she may get attached. This case can be linked to Tucmans theory as, they were constantly on the forming stage, and they had no leaders, no agreeing and no helping each other. They failed as a team. They did set goals, therefore didn’t reach the goal of saving peter. They didn’t complete there correct roles and just passed the book to each other, blaming each other. No responsibility was took at the end and again the just blamed each other when it was the whole MDT team. And finally, disagreements which should be easily resolved at this point were not and they created tension and fall outs between each other which then lead them to talk to each other even less. In conclusion the Health and Social care communication has come a long way, with new technology and ways to communicate. Cultural and language barriers are now no issue, also physical barriers hardly even appear.

References : http://en.wikipedia.org/wiki/Death_of_Baby_P