Discuss the differences between verbal and non-verbal communication.
Communication
Skills
for the
Health Care
Professional
Concepts, Practice, and Evidence
Gwen van Servellen
CHAPTER 15
© 2009 Jones and Bartlett Publishers
Chapter 15
Communicating with Patients in Crisis
© 2009 Jones and Bartlett Publishers
Objectives
- Define crisis response
- Individuals and groups in crisis
- Dysfunctional communication in times of crisis
- Relevance of stress and adaptation in periods of crisis
- Adaptive and maladaptive coping responses
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Objectives Continued
- Stressors, coping resources, and stress resistance resources
- Differentiate between situational and developmental crisis
- Stages of crisis resolution
- Interventions to manage highly anxious patients
- Interventions to manage agitated and/or confused patients
© 2009 Jones and Bartlett Publishers
Definition of Crisis and Crisis Responses
- More change is required of an individual than capable to deal with at the time
- Assumptions
- Not all crises are incapacitating
- Persons experience crisis in isolation of others
- Persons can worsen each others responses through further excitation
- Crisis is not the same as the stressor itself
© 2009 Jones and Bartlett Publishers
Dysfunctional Aspects of Crisis Communication
- Difficulty in perceiving accurately
- Abilities of processing information may be impaired
- Ability to express ideas, thoughts, and emotions may be limited
- Perceived state of disorganization can increase these deficits
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Impact: Over Stimulation and Under Stimulation
- Over stimulation
- Rapid bombardment or excessive stimuli
- Not too much but stimuli are noxious
- Exceed tolerance level
- Inability to hear, speak, and if they do hear, unable to move
© 2009 Jones and Bartlett Publishers
Stress Theories and Understanding Crisis
- Levels of anxiety and effects on patients; mild to severe and panic
- Stress and adaptation
- Lazarus and Folkman (1984) coping always discussed when stress effects are analyzed
- Studies of stress of different kinds; and stress of the same kind across several groups of individuals
© 2009 Jones and Bartlett Publishers
Adaptive Coping Responses
- Seek information
- Seek comfort/support from friends or family
- Search for solutions to the problem(s)
- Self-talk that will help them feel better
- Seek professional counseling or advice
© 2009 Jones and Bartlett Publishers
Types of Crisis
Developmental Crises: interruption or unsatisfactory passing from one psychosocial task and developmental phase that correspond also to physical developmental growth
Situational: Crisis emanates from precipitating events that occur and are typically out of the person’s realm of expectancy.
© 2009 Jones and Bartlett Publishers
Caring for Patients in Crisis
- Do not re-victimize in the process of helping
- Establish an emotional or psychological connection with the patient and family
- Do not challenge the validity of the crisis situation or underestimate its effect
- Practice active listening skills, direct straightforward approach, become aware of personal responses and their impact
© 2009 Jones and Bartlett Publishers
Summary
Crisis is unavoidable; many illness or injury events can be perceived as a crisis to the patient and family. More needs to be known about the unique expression of crisis across individuals and communities.
