As I’m currently working as lead supervisor within my job role, I communicate with a variety of people on a daily basis. These include patients, relatives, renal professionals including nurses and doctors, employees and colleagues within the Interserve/Baxter team. In my job role, I must also communicate with external professionals, head office, branch consultants, my manager and support organisations. I significantly encourage effective communication between all individuals involved, by using numerous methods of good communication within my job role. I understand and embrace that certain individuals prefer to use different methods of communication. I will always try to achieve their wishes for efficiency and ease.
When contacting the renal unit, either to communicate to one of the renal nurses or doctors, I have a direct number to their main office. If there is no one available at the precise time of phoning, I will leave a voice mail. The senior nurse in charge usually deals with the voice mails depending on the importance of the issue in hand. If there is no contact back after 5 minutes, I try again. I also have another renal contact number, which when answered, I can pass on a message through another nurse to find and communicate to the nurse whom I wish to contact. The renal nurses and doctors have my phone number, this enables them to communicate with me when needed. For example, this maybe to quire a patient or to request a change in prescription. Also, if I would like a change in prescription or service, once put in place, usually within the hour, this documentation is faxed to the head office. This is then emailed to my manager and myself, also uploaded onto a patient portal for everyone to have access to, i.e. the renal workers. An email is then sent to all the renal technicians who work in the areas I supervise, prompting a change in prescription and for them to familiarise with before they work with the patient next. I will then have a copy of the documentation, which I will update in the relevant care plans, re-programming the patients’ machines also. If there is a change in stock, I will contact the relevant departments to check they’ve received an update too. This is done through a phone call and logged in the patients care plan of the changes. I will then contact relevant renal technicians and make sure they are aware and understand the changes.
Individuals have the right to communicate through their chosen method and their choice should be acknowledged and respected by supporting them. When there is a change, some renal technicians prefer to be contacted by a phone call. However, if someone has a day off, they prefer emails. Communication is a basic need and a human right. Under the Human Rights Act 1998, this states that all individuals have the right to ‘freedom of expression’. If unable to communicate they would be deprived of these rights.
Often, I must contact the patients directly, this maybe because they want to query something about their health, a time and who will be working on a certain day, knowledge about a stock delivery, requesting a night off, etc. In regard to my patients, they individually require a different level of communication depending on their care needs. For example, learning disabilities, where a member of their family will contact me by phone call. Deaf, a family member may contact me by phone call or through texting. Blind, a family member may contact me by phone call or this patient uses a voice recognition system set up on their mobile phone, which allows speech text, also allows the patient to phone me from their voice command. Good communication will ensure that the company is running smoothly and that everyone works effectively making sure that they stick closely within the guidelines and policies.
I make sure I listen to all the patients’ needs and renal technicians, whom work within the area I supervise.
To support effective communication within my own job role, I must ensure that I first understand everyone’s preferred level of communication. This then enables me to make sure that certain techniques are in place, and the renal technicians are fully aware of the patients’ needs to ensure they are put into practice. I achieve this and start to put communication needs in place from the first day I meet the patient. This is achieved when I go out for a care plan meeting. I also check on their working ongoing care plan needs when I’m on shift, correspondingly undertaking monthly assessments and reviews relating to each patient. When I complete a care plan, this is kept in the patients’ home, if they consent, and I then communicate with my manager. I give copies of the care plan, ensuring that my manager is aware of the patients’ needs too. This includes communication requirements. I ensure handover is given to the relevant renal technicians about the patients’ needs and preferences, which is also carried out every time I have days off. This is very important for keeping good team work and efficiency. I monitor the level of communication used between renal technicians who I supervise and the patients to ensure there’s an effective level of communication being used and patients’ wishes met. If there becomes a change in communication needs, i.e. deuteriation of the patients’ health, this would be documented in the care plan and reported to relevant health care professionals. I would then go out to the patients’ house to re-assess and adapt their care plan taking into consideration their communication needs.
Every few months, I will call a team meeting with the relevant renal technicians, whom are involved with the patients I supervise the care for. This is to have a conversation about any issues, problems, worries, concerns which they may have. I believe that it’s very important to alongside have handover several times a week, but to meet up with face to face meetings and supervisions. Any updates and documentation which needs to be addressed either individually or several individuals’ can also be communicated through emailing or post. This can include a monthly rota for days’ each staff are working and where.
I make sure that the team address the patients with their preferred name, whether it’s by use of their first name, a middle name, a nick name, even by Mrs A or Mr A. This is also reported to the renal department at the hospital for the nurses and doctors, the outside
agencies, renal technicians under my supervision and my manager. I understand and make others aware that patients diverse backgrounds will impact on how they choose to communicate.
When communicating with a patient, renal technician, nurse, doctor, manager or any outside organisations, I make sure that I speak clearly, remain culturally sensitive, be aware of the use of tone and pitch, make sure I use words that make sense and are meaningful. I remain professional when speaking to anyone being mindful of no slang words, keeping communication as factual as possible. These conversations are logged down in the patients care plan with correct time, dates and whom was involved in the conversation.
It’s very important for effective communication to look at the patient and to talk to them face to face. It’s good to know what their first language is and what language is preferred i.e. English/Welsh. This can be found out by asking the individual, asking family and friends. It’s important to maintain good eye contact, this helps the patient to be aware that I’m communication to them. When eye contact is used during communication, I can assess how they are feeling and reacting to what I am saying. For example, they may smile, this could send out this message that the patient is happy and has understood me. The patient may look away, this could suggest they cannot hear me, or are not happy with what I have said. Good eye contact encourages the patient to have a conversation with you, to open up and talk about any problems or issues they have. However, you do not want to ‘stare’ at the individual, this could come across as intimidating and scary. I must make sure that my body language is open and that I am in no hurry to communicate, the patient l must not feel rushed.
Also, when talking to the patient, I must make sure that the environment is good enough for the both of us. For example, I must ensure that there is suitable lighting, this will help for the individual see my movements, reactions, face, lips and gestures. Meaning that I can clearly see what their movements, reactions, face, lips and gestures are too. It’s extremely important for the patient to hear me, especially if they have hearing difficulties. So, to help with the situation, I would minimise the noise around as much as possible. For example, shutting the door, reducing clutter, turning the radio/television down whilst communicating with them. This helps to minimise distraction and help concentration.
I must make sure I don’t cover my mouth when speaking, as they maybe lip reading to support their understanding. I must never use inappropriate language, offensive language, slang words or any overly complex language. There may be other issues, which could be causing the individual to struggle with communication. For example, the individual may have been abused in the past, resulting with feeling extremely uncomfortable to anyone in close contact with themselves. The individual may prefer to talk to the same sex, i.e. Males or females to communicate with them.
When starting a care plan, it’s very important that the individual is involved as much as possible. It’s their care plan and should be about their best interests. To involve a person in their care plan, I would need to ask them their preferences, what they would like and need. I would make sure that they have choices all the way through. If the individual is unable to answer certain questions or is unable to understand what’s going on, I could turn to their friends and family. Care plans are set out for the individual for their best interests, this is why the person-centred approach is important. The care plan will act as a guide and should be easily read. Care plans should include a brief history about the person and their family history, what activities do they like to do. It will explain how they communicate, their preferred language, i.e. Welsh. The care plan will also look at other areas such as if they have a violent history, what are their care needs, are there any medical issues, how they like to sleep, do they need any equipment to assist them in any way. Religion would be asked about, and even though people don’t like to talk about it, what would they like to happen in the event of death. A care plan must be signed and agreed to. A care plan should be regularly updated and monitored monthly or whenever needed. Care plans are confidential records.
Some of my patients have communication difficulties, due to learning difficulties, hearing loss and blindness. My patient who has learning difficulties, I make sure I use short, clear words which they understand. Being aware of my body language, such as facial expression, posture, positioning of my body, use of eye contact.
My patient who has hearing problems, to ensure good communication, I will attempt the following: If there’s any noise, I will turn the radio/television down whilst communicating with them. This helps to minimise distraction and help concentration. I make sure I don’t cover my mouth when speaking, as they maybe lip reading to support their understanding. I ensure that there is suitable lighting, this will help for the individual see my movements, reactions, face, lips and gestures. I minimise the noise around as much as possible. I make sure I use short, clear words which the patient understands. Being aware of my body language, such as facial expression, posture, positioning of my body, use of eye contact.
I always make sure that the patient has they’re hearing aid in and is working. My patient who is blind, to ensure good communication, I will attempt the following: If there’s any noise, I will turn the radio/television down whilst communicating with them. This helps to minimise distraction and help concentration.
If the individual found communication difficult still, there are many ways to assist with effective communication, such as some of the following:
• Speaking technology, i.e. the iPhone / iPad has this software
• Speaking clocks
• Writing on a piece of paper
• Reading notes
• Sign language
• Hearing aids
• Speech aids
• Electronic sound boards
• Computer software
• Hearing loops
• Word touch pads
• Block alphabet
• Moon (raised dots)
There are numerous barriers and challenges to communication that I must deal with as part of my job role. In my own opinion, this is to ensure that I’m a successful leader and supervisor. I make sure that all care plans are in place and monthly updated to any changes, which includes all communication needs. I make sure that each renal technician in my team, who goes into each patient’s home, they must read the patients care plan thoroughly. Although, beforehand, I give each of my team a hand over about the patient, they’re needs including communication preferences.
In the past, I have experienced a member of my team, whom didn’t listen effectively when I am making certain requests. The best course of action has been to ask them to confirm that they understand.
It’s important in this job role that there’s always good communication between myself, the team I manage, the office, each patient and all health care professionals whom are caring after the patients. This guides the daily needs for the patient in the accurate and most effective way possible. It all starts when I go to visit the patient in their own home to risk assess and start up a care package by the help of a care plan. This may be read by each renal technician when they enter the patient’s property before giving any care. Beforehand, I communicate with each team member with a briefing about the care and communication needs for each patient. This enables the safety and care is kept at the highest level possible at all times. When there is an update in a patients care plan, no matter how small, I will contact the team, my manager, care coordinators, renal nurses and doctors. This keeps everyone in good understanding of the patients care needs and good communication. In each care plan, I include paper work for the renal technicians to write on if they have any contact with the renal unit. They must state the reason for the contact, who they are, date, who they spoke to, the outcome and must also write all in the daily notes. The daily notes in a daily working document, which I collect in once a week. This is to write about the visit they attended that day and what happened whilst there. I make sure that each patient has a daily weighing and their blood pressure taken for medical purpose. All this then should be documented for the following day, whether it’s the same renal technician or not. This is a document where a person can go into read it the following day and understand what’s been happening relating to the patient and if there’s any health concerns. I find this to be a good way of communicating with the team.
If I feel that the communication is not effective enough, I would call for a staff meeting to discuss any matters regarding communication. However, when there is a supervision, I ask each team member if there are any concerns or issues in which they have come up against and if they feel that they could contribute any suggestions or ideas. Each patient has a monthly review done by myself, I assess the care plan and all the documentation regarding communication. I’m always on the lookout of how to improve the systems that are in place and try to identify any problems, which surface and improve them.
I share all my findings with my managers, who sends out a monthly email. In this email, my manager will address any changes which will be taking place and why. This will then go out to the whole company. Often changes suggested becoming a permanent change to how a care plan is formatted or carried out
Within my role as a lead supervisor renal technician, I believe that the communication systems and practices, which I have in place work very effectively. I communicate with my team on a daily basis, mainly for hand over or if I need to discuss any issues, my manager, the care co-ordinators, patient, renal nurses, renal doctors, social workers, district nurses, occupational therapists, GPs when needed. I discuss all patients and their individual case with my manager. I feel that this is extremely important that my manager is keep in the loop about any changes and how the system in place is working. I regularly update and review each patient care plan to make sure their needs are met always. This could be informally where I could be at the office and speak to my manager face to face. I also communicate with my manager by using telephone, which helps if I need an urgent answer. Formal discussions are often used using confidential emails. Examples of communication would be for the following reasons:
• Discuss a patient and acquire guidance and support
• Discuss any complaints which have arisen, regarding a team member or patient
• Discuss and receive new referrals, when will be best to assess the patient and start up a new package and care plan
When I need to communicate with a renal nurse or doctor, I will phone the renal department. This service allows me to speak to nurses and doctors only qualified in this area of expertise. If there is no one in the office, I can leave a voice mail stating who is calling and the reason. I can state whether I request a call back or if it’s just to pass on information. Each renal nurse and doctor has access to my personal mobile number, which they do use often relating to a patient’s care needs. This works extremely well. When there is a new team member who I supervise, I explain all of this to them and explain how important it is on occasions for the renal department to get in contact regarding a patient. I also clarify that it’s their choice if they hand over their personal mobile number of if they wish for me to pass on this information.
It is my responsibility to understand the importance of the duty of care to the team in which I supervise. I understand that each member of the renal technician team has a right to confidentiality and privacy.
If there was a time that I was to become concerned and worried about a member of staff, I would have to take caution about the situation. There are times when, if I was to believe an individual was at serious risk to themselves or others, I could break confidentiality. For example, if they were to become suicidal, harm to others in their care, exploitation, abuse, significant financial gain or loss. I could do this by referring the individual to my local authority and police.
However, there are many legislations in place, such as:
• Data Protection Act 1998
• Deprivation of Liberty Safeguards Act 2008
• Disability Discrimination Act 2005
• Equality Act 2010
• The Freedom of Information Act 2000
• Health and Safety at Work Act 1974
• The Human Rights Act 1998
• Care Quality Commission Act 2009
• Law commission Review of Adult Social Care 2011
• Mental Capacity Act 2005
• No Secrets Act 2000
• Public Interest Disclosure Act 1999
• Safeguarding Adults Act 2005
• Safeguarding Vulnerable Groups 2006
This can be a very complex issue. If I felt the importance to share this information with my manager, local authority, police etc, I would consider the following points:
• Who can access records and who is excluded?
• When is it appropriate to share this information?
• What are the boundaries to an agreement?
If I were to choose to share an individual’s information, it must be for good reasoning. I must always consider and respect their privacy and dignity always. I would make sure that my duty of care was used and have the individuals best interest first always.