Communication skills for pharmacists and their team

17


Communication skills for pharmacists and their team




Study Points



image Elements of communication


image Assumptions and expectations


image What is communication?


image Listening skills


image Questioning skills


image The Calgary–Cambridge model


image Patterns of behaviour in communication


image Barriers to communication in the pharmacy


image Confidentiality


image Communicating with hearing and sight impaired patients



Introduction


Josie is a community pharmacist. At the end of the working day she thinks back to what has happened that day. She has discussed with customers their purchases of medicines; advised patients how to use their prescription medicines; conducted a medicines use review; phoned the local GP about a potential drug interaction; supervised a methadone addict; spoken briefly to the district nurse; negotiated with her boss about a day off; interviewed a potential sales assistant; exchanged pleasantries with the delivery person; and had been introduced to the new chairman of the local pharmaceutical committee at lunchtime.


Ravi, a hospital pharmacist, similarly looked back at his working day. He had spent time on the wards discussing drug-related matters with junior doctors; undertaken medication histories; and talked to a patient about their discharge medication. The latter task involved phoning the patient’s GP and local pharmacist to arrange a continuity of medicine supply. He had given a seminar for fellow pharmacists. Later he had attended a committee meeting, with other healthcare professionals and administrators on developing policies for the safe use of medicines. He had finished off his day supervising the dispensary, and dealing with a complaint from a prescriber.


From the above descriptions of two pharmacists’ very different working days, it can be seen that while each is performing pharmaceutical tasks, all of these tasks required the use of communication skills. In fact, almost everything we do in life depends on communication. Pharmacists spend a large proportion of each working day communicating with other people – patients, doctors, other healthcare professionals, staff and others. Poor communication has the potential to cause a range of problems, from misunderstandings with healthcare professionals to inappropriate or incomplete advice on the use of medication to a patient/customer.


Thus, there is a need for effective communication skills for pharmacists. But how effective is our communication? Good communication demands effort, thought, time and a willingness to learn how to make the process effective. Some people find that good communication is difficult to achieve and an awareness of this fact is an important first step to improvement.


This chapter considers some of the elements of successful communication, looking at our assumptions and expectations of people and at the processes involved in communication, listening and questioning skills. A total model for an effective pharmacist–patient consultation is outlined, followed by the barriers to effective communication in pharmacy. The importance of confidentiality is emphasized.




What is communication?


Communication is more than just talking. It is generally agreed that in any communication, the actual words (the talking) convey only about 10% of the message. This is called verbal communication. The other 90% is transmitted by non-verbal communication which consists of how it is said (about 40%) and body language (about 50%).



The communication process


Argyle (1983) describes the message process as a sender encoding a message, which is then decoded by the receiver:



Pharmacists tend to see contact with patients/customers as either getting information or imparting advice. However, this ignores the vital purpose of communication, which is to initiate and enhance the relationship with their patients/customers. If this can be achieved, then pharmacists will be perceived as more ‘patient friendly’ and more supportive of patients. Indeed, good communication skills will make it easier for a pharmacist to seek information and to advise patients.



Listening skills


Communication is not just about saying the right words; it involves listening correctly. If we do not listen properly, then it means we are not decoding the message that is being sent to us. However good the patient is at telling the pharmacist their symptoms, if the pharmacist does not listen correctly, then the patient may be given the wrong diagnosis, medicine or advice. Listening and hearing are different. Hearing is a physical ability, while listening is a skill. Listening skills enable a person to make sense of and understand what another person is saying. The listening process is an active one that consists of three basic steps, namely:




How to be a good listener


Listening, like other skills, takes practice. Tips for developing good listening skills are shown in Box 17.1.



Box 17.1   Tips for being a good listener




image Always look attentive at the person who is speaking. Maintain eye contact and stand/sit facing them. Try not to fidget or move around too much. Do not stare at the floor or look at some other object in the room


image Focus your mind on what is being said. Do not let your mind wander, even if you think you know what is going to be said or you think you have heard it all before


image Always let the speaker finish what they are saying. Do not interrupt – speakers prefer to finish what they were trying to say. In addition, interruption tends to imply that you were not listening


image Let yourself finish listening before you start to talk. Listening is an active process and you cannot really listen if you are busy thinking of how to reply


image Listen for the main ideas of the message. The main ideas may be repeated several times by the speaker


image Ask appropriate questions or repeat what has been said in your own words if you are not sure that your understanding is correct


image Give feedback to the speaker by nodding to show you understand (but only if you do). It may be helpful to smile, laugh, grimace or just be silent to let the speaker know that you are listening. Leaning towards the speaker may show you are interested in what the speaker has to say and give them encouragement


image Do not forget the non-verbal side of communication. The speaker may be demonstrating many non-verbal clues and gestures, which may indicate their true feelings. So in the listening process, use your eyes as well as your ears.


In a pharmacy, avoid listening across a barrier such as a counter or desk or getting too close and invading a patient’s ‘intimate zone’



Questioning skills


Pharmacists need effective questioning skills to obtain information from patients/customers. Examples of situations in which questioning skills are used include:



Effective questioning skills involve the use of different types of questions, namely open and closed questions.


Effective questioning should be used in assessing a patient’s presenting symptoms. The mnemonic ‘PQRST’ provides key questions which will help pharmacists to obtain an overview of symptoms, although additional questions can be added, for example, ‘Is the patient taking any concurrent medication?’ The PQRST approach to symptom analysis is shown in Box 17.2.



Box 17.2   PQRST symptom analysis



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Jun 24, 2016 | Posted by in PHARMACY | Comments Off on Communication skills for pharmacists and their team

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