Download Crisis Management of Paramedics

Crisis Management for
Paramedics
Week 1
Fundamentals
of Communication &
Therapeutic Approach
Concepts of Crisis & Stress
Good communications!
Service
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You all stated you want to help people
and that you are people persons...so
here is your chance to “shine”
Patients deserve our best efforts at
service – they are the reason we exist
What the “S” in EMS stands for
What makes a good
communicator?
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Internal Factors
– not about you
– “natural” desire to help
Defecate in our ambulance
 Vomit on our shoes
 Bleed on our uniforms
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Heads up – if these feelings are not
sincere your patients will sense it and
you will have a short career
Effective Communication
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External Factors
– Look the part of a professional
– Pay attention to you appearance
– Inspire respect
– Consider it an honour to be asked into a
patient’s home
Consider the following:
 How does communication occur?
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What are the components of
communication
How do we as care givers attempt to
communicate with people in crisis and
what can hinder the communication
Communication
Therapeutic Approach
What is communication?
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The exchange of common symbols
Written, spoken, signing and body
language
Basic elements: the sender, the message
and the receiver
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Verbal
Voice quality, diction, pitch, rate of speech
and volume
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Body language
Provide your undivided attention
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LISTEN – don’t just talk
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Successful communication
occurs if, by way of the
response, the sender
believes that the message
was received accurately
Effective listening
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An active skill
Requires complete attention
Focus on the messenger
Never finish the other person’s sentence
Do not consider your response until the
other person has finished speaking
Requires practice!! **
Remember:
A good communicator needs patience
and flexibility!
Trust and Rapport
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There is a certain amount of trust implied
in being a paramedic
You need to earn the trust
First you establish the trust, then the
rapport follows.
With good rapport the person you are
helping will follow your lead
Developing Rapport
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Introduce yourself and your partner
Address the patient formally – Mr., Mrs.,
etc.
Patient should believe
Use the patient’s name **
they
are
your
priority
Get to the level of the patient
Use a professional but compassionate
tone of voice
Explain what you are doing and why
Nonverbal communication
skills
 Eye contact
 Touch and Gentleness
 Posture
 Demeanour/Smile
 Important to look at your
patient’s body language
Eye contact
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Can be a very powerful source of
effective communication
– Take your sunglasses off!!
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Can be very important in tense or difficult
situations
Remember, eye contact means the
patient is looking at you!
Compassionate touch
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The holding of a hand, touch of an arm
or shoulder
May be awkward at first – watch for
response
May help to calm the patient
Be careful to touch appropriately –
consider the patient’s age, gender,
cultural background and current setting
Posture
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Gestures, mannerisms and postures by
which a person communicates with
others
Includes distance between you and
the patient, whether you are at eye
level or not and your stance
Demeanour & Therapeutic
Smile
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Pleasant demeanour absolutely
necessary when you are dealing with
people in crisis – they need to feel
safe and assured that you can help
Smile – can send the message that all
will be well but consider the crisis
Interviewing Techniques
Questioning
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Use open-ended questions
Use closed questions only when
necessary
Ask only one question at a time
Listen to the patient’s complete response
before asking the next question
Use language the patient can understand
Do not ask leading questions
Payoff Questions
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Have you felt like this before?
Have you been upset about anything
lately?
Are you afraid of someone? [save this
one for the privacy of the ambulance]
Have you been thinking about hurting
yourself?
What happened the last time you felt
this way?
Strategies to Elicit Useful
Responses to Questions
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Facilitate the response
Be quiet - never miss a good
opportunity to shut up
Clarify the response
Redirect the response
Interpret the response
Simplify and summarize the response
Common Interviewing
Errors
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Assume Nothing
Giving Medical advice
Providing false hope
Assuming excessive authority
Sidestepping the truth
Distancing yourself from patients as
people
Assessing Mental Status
Observing the patient
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Appropriate Humour
Timing of Responses to Questions
Memory
Ability to obey simple Commands
Unique interview
situations
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People who are unmotivated to talk
People who are hostile
People who are very old OR very
young
People who live with special
challenges
Cross cultural communications
– Manners, gestures and body language
– Cultural sensitivity and cultural diversity
How does failure to communicate
occur?
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Prejudice – do not paint all with the
same brush
Lack of empathy
Lack of Privacy
External distractions
Internal Distractions
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Remember to bring closure to the call
Say “good bye”
Whole messages