Communication and values

The aim of this report is to review and improve my communicational skills in a health and social care setting. I undertook two recorded interactions in different contexts in the care sector. These took place in a local nursery for young children aged two to four years, and in a local secondary school with a group of adolescents aged eleven or twelve years, who have learning difficulties. I undertook both a one-to-one and a group interaction so that I could compare the use of communication and the transmission of values in different care settings and in different contexts.

For confidentiality reasons I have not used the names of the children I have interacted with and I have not identified either the nursery or secondary school. Everyone communicates in some way or another. Nowadays communication is getting even easier due to technology being at its prime; it is now possible to use a telephone or mobile phone for calls to far away places, or to contact someone through email. However, not everyone knows how to communicate effectively. The importance of communication skills and how these skills can transmit values

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To promote non discriminatory practice, support individual rights and choice, acknowledge personal beliefs and identity, as well as maintain confidentiality the most important skill for a health and social care professional to master is the ability to communicate effectively. Effective communication improves ‘quality of life’ because it establishes and addresses the client’s needs. Doing this involves effort from both the sender of the message and the receiver and is a process that can be fraught with error, with messages often misinterpreted and can cause confusion.

In fact, communication is only successful when both the sender and the receiver understand the same information as a result of communication. Interpersonal interaction is how information is communicated between people. In a care setting there are ways this can be done. Undoubtedly the main method of communication used is that of the spoken (verbal) language, which is based on words that are pronounced by one person and heard by another. Language is a type of interpersonal communication that is not simply based on sounds that are heard.

For example non- verbal, written and graphical communication. There are a number of methods of using these types of communication. Sign language is a method of non- verbal communication used by some hearing impaired people, while Braille is a type of written communication used by some visually impaired people. Each of the different types of communication mentioned is used within health and social care settings. The ability to use formal and informal communication is essential in care work. In – formal communication is a relaxed form used often during a first meeting and during assessment.

Informal communication should make others feel respected and valued as long as care workers are working within the care value base. For example, asking others to make choices. It is also important to use words that are not complicated and that are appropriate to the age of the client/ patient. Formal communication is normally used in a more formal setting or context. The language is generally more serious, jargon can be used and the time taken is more organised and purposeful. Different types of communication skills can transmit values.

Care practitioners need to show empathy for their clients; they need to learn about their client’s identities, beliefs and cultures. Health practitioners should use the supportive skills of sincerity, convey warmth and show understanding of the client in order to build appropriate caring relationships; as a result trust will develop. Care workers often focus on encouraging people to be independent rather than being dependent on others. A sense of self grows out of the choices and decisions that we make. Learning to travel, learning independent living skills or learning to operate a computer help to create a sense of self- esteem.

Self – esteem empowers people to value others and build a positive self image. The transmission of the care value base, barriers to communication and how I overcame these. Interaction 1 – group interaction I conducted my group interaction in a secondary school setting. For confidentiality reasons I haven’t used the name of the secondary school and throughout this report I will not use the children’s real names. In this group interaction I have six adolescents all aged eleven or twelve years, who have learning difficulties; these difficulties include poor literacy and numercy skills.

The interaction we carried out was a number of team games. The six of them sat around me in a semi circle. They were seated this way so they could all see me, my facial expressions, body language and gestures. This seating arrangement also allowed all the children to hear me properly and for me to check that they were all paying attention. I sat on the floor so I was at the same height, sitting with an open posture so it was friendlier for them. I introduced myself and asked each person what their name was, I did this because it shows respect and I was treating them as individuals which is part of the care value base.

I asked them individually if they wanted to write their own name on a sticky label or if they wanted me to do it for them this is also a part of the care value base as it is giving them choice. I wanted them all to have their names stuck on them so I could call them by their own names at all times. I also wore a label so they didn’t feel different or stupid in anyway. I explained to them as a group what we were going to be doing. I then explained each game individually and offered them a choice of which game was played first.

The first game that we played involved the winner to eat chocolate, I asked everyone if they have any allergies, but I had no reply. I assumed from this response that everyone was fine with the activity. As the game began I was approached by one of the girls, I assumed she found communication in a group difficult and possibly intimidating which is why she approached me. She told me quietly that she couldn’t eat chocolate. I didn’t want her to feel different to anyone else in anyway so I told her ‘I can’t eat chocolate either’. I didn’t want her to be excluded from the rest of the group as this would block communication.

I told her she can still join in the game and that it’s the taking part that matters, but it was her choice. The second game involved breaking the group up into two teams. Each team had to work against each other constructing a human mummy using only toilet roll and a member from their team. This was to improve their team building and interaction skills. All through this activity I praised them by saying ‘well done that’s great’ and ‘that’s a good idea’. I made sure I praised both teams in the same way so none of them felt left out. I also smiled at them during the activity to encourage them.

I could see that effective communication and group cohesion was developing through the relationships built up within the group. I showed respect and support of each individual, and I used humour to develop conversations and make people feel comfortable. Throughout, I continually observed the dynamics of the group. At the start of the interaction everyone was quiet and the atmosphere felt really uncomfortable. As time past everyone was getting involved and enjoying themselves. However, my observations of the group show that people don’t always put the needs of the group first.

This is why some group members were behaving in a competitive way. When we communicate, our ability to get our message across effectively to others can be weighed down by a number of barriers. As a care worker it is important to recognise barriers to your/our own communication and learn how to over come them. We carried out this interaction in an empty classroom which was more practical as we didn’t have any background noise. However, there was a lot of interaction between the members of the group resulting in a lot of noise. I do not have a very loud voice and I found communicating in a group difficult as a result of this barrier.

I tend to form opinions about people on the basis of how they look and behave. One of the boys looked scruffy compared to the rest of the group. This sent a message to me that he does not think he is worth bothering with or does not take pride in his work. The value of respect for the worth of every individual involves accepting and treating every person as worthy and important in their own right, ‘simply because that person is a person’ (miller 1996). I have learned not to read too much into what people are like on the basis of their appearance.

Appearance does not really tell you that much about the person and I could fall into the trap of stereotyping someone on the basis of a misleading first impression. When one of the girls in the group told me they couldn’t eat chocolate, I wanted to use touch to communicate reassurance that it was ok. However, people don’t always find touch reassuring, so it was important I was sensitive to her response to touch. She may not be comfortable with close physical contact and may regard it as threatening. I gently put my hand on her shoulder.

I was watching her body language very closely; she was not drawing away or showing increased tension, which indicated that she felt comfortable and did not feel threatened. I needed to have a proper understanding of group processes and patterns of group behaviour to interact and communicate effectively in my group interaction. Understanding how groups form and develop is an important part of this. I used Tuckman’s four stages of group formation. Forming- this was the early stage of the group interaction; the group seemed to be anxious and were asking questions about what they were going to be doing.

Storming – This seemed to be a period of conflict in the group, the girls wanted to do one thing and the boys another. I resolved this by letting them roll a dice, the girls got the highest so they got to choose the game the group was going to play first. Norming – the group started to work together. Performing – the relationships had become comfortable and more supportive of each other. The group’s leadership was less direct as everyone equally joined in. Interacting with a group was different from interacting on a one-to-one basis. It was a much less personal situation, although I tried to treat them all as individuals.

I could not keep my voice as gentle and soft, I had to be more assertive, observant and self aware. I was also aware that the proxemics were different during one of the games as I was standing and therefore at a higher level than the children. It was also less easy to give eye contact. Interaction 2 – one – on – one interaction This interaction took place in a local nursery setting. The group I was with were children ages two to four years. For confidentiality reasons I haven’t used the name of the nursery and throughout this I will not use the staff or children’s correct names.

The children were gathered together and staff engaged the children with discussions about the day. The children began their topic related activities and all were encouraged to participate. Some children worked in small groups with an adult and the remaining children had the choice of activities such as role play, construction, mark making and painting. My one – to – one interaction was with a four year old girl called Daisy. I asked Daisy ‘what do you want to do? ‘, ‘Do you want to do some painting with me? ‘ Daisy did not reply verbally but she did communicate by nodding her head agreeably.

I gently took her hand and walked her over to the art area; this made it easier for Daisy and me to interact with each other as it was less noisy and out of view from the rest of the children. I sat next to her on one of the children chairs so she didn’t feel threatened by me standing over her. I made sure I wasn’t crowding her space at anytime during this interaction. I kept my voice soft and friendly which is known as ‘paralinguistic feature’. I commented on how beautiful her painting was, which was a positive start to the interaction and the relationship.

I hoped that the praise would help transmit values and therefore encourage self-esteem in Daisy. I made sure I spoke slowly so Daisy could understand clearly what I was saying to her. I sat leaning slightly towards Daisy, maintaining eye contact whenever I could. This is called soler listening. I think my body language was very encouraging for Daisy, showing that I was interested in her, valuing her as a person and therefore enhancing her self- esteem. I used open questions to enhance communication. I asked questions like ‘why have you painted the seaside? ‘ ‘Do you like the seaside? , when she answered I asked her another open question which was ‘why? ‘ I gave Daisy choices of what colours she wanted to use. I showed respect for Daisy by letting her paint by herself; however I did ask her a few times if she needed any help.

I asked her if she could paint me a flower thereby empowering her skills. I showed I valued Daisy when I said ‘that flower is lovely, can you colour it in for me? ‘ I transmitted the care values by promoting support of her picture while respecting her need to do things herself and maintaining confidentiality by not repeating anything she said to me that didn’t need to be passed on.

Whilst carrying out this interaction the potential barriers to communication were the background noise coming from the other children. This distracted Daisy from her painting and made it difficult for her to hear what I was saying. Language was a main barrier; because Daisy is young I had to limit my words so that she understood what I was saying to her. However, there were no problems associated with language differences or culture. Nevertheless, I should not have let Daisy run off and join the rest of the children, but have instead encouraged her to put away her painting equipment.

This would have helped increase her skills of independence. In general, however, I think that I encouraged a sense of empowerment in Daisy, by giving her a sense of worth and showing awareness and sensitivity of her needs. Evaluation Whilst taking part in these interactions I have realised how important effective communication is in improving quality of life. Reflecting back on my practice I feel my attempts to apply communication skills while incorporating and transmitting values of care during interactions were satisfactory.

I have learnt that people behave and communicate differently in group situations compared to how they behave when interacting in one-to-one situations. I also developed my ability to interpret individual’s body language in relation to my own. I have developed my understanding of how factors may affect interaction and how to minimise communication barriers as much as possible. For example, I knew that using closed questions during my one- to -one interaction with Daisy would inhibit communication.

I believe those open questions I used with Daisy were proven to be effective as she became more talkative afterwards. Not all the different types of communication were covered, as Signing; Braille and visual technology were not relevant. Barriers were mainly covered but cultural, language and belief differences were not relevant, although they could have been if there were different participants involved. During my group interaction a girl told me her problem that she could not eat chocolate, only for me to off-load my own experiences back.

Maybe I could have dealt with this situation better if I was more aware of individual differences to be able to accommodate her during our interaction. However, I did not single her out for special treatment in a patronising way. The group interaction felt more a case of management of the situation. However, most of the management of the situation was through personal interaction, such as deciding who would begin the game, whether or not somebody had won and negotiating. I used secondary forms of evidence gathering, as a tape recorder would only record verbal communication and video recorders would be intrusive.

The presence of an observer would also have been intrusive and likely to alter the nature of the interaction. A major problem with this evidence is that notes have to be taken after the interaction. This means some of the detail may be lost. During both interactions I used appraisal to improve the children’s self-esteem. However, this may have sounded as if I was patronising them. Reflecting back on my practice I feel my attempts to apply communication skills while incorporating and transmitting values of care during interactions were satisfactory.