Crisis Management Crisis Management for Paramedicsfor Paramedics

Week 1Week 1Fundamentals of Communication & Fundamentals of Communication & Therapeutic ApproachTherapeutic ApproachConcepts of Crisis & StressConcepts of Crisis & Stress

Good communications!

ServiceService

You all stated you want to help people You all stated you want to help people and that you are people persons...so and that you are people persons...so here is your chance to “shine”here is your chance to “shine”

Patients deserve our best efforts at Patients deserve our best efforts at service – service – they are the reason we existthey are the reason we exist

What the “S” in EMS stands forWhat the “S” in EMS stands for

What makes a good What makes a good communicator?communicator?

Internal FactorsInternal Factors– not about younot about you– ““natural” desire to helpnatural” desire to help

Defecate in our ambulanceDefecate in our ambulance Vomit on our shoesVomit on our shoes Bleed on our uniformsBleed on our uniforms

Heads up – if these feelings are not Heads up – if these feelings are not sincere your patients will sense it sincere your patients will sense it and you will have a short careerand you will have a short career

Effective Effective CommunicationCommunication External FactorsExternal Factors

– Look the part of a professionalLook the part of a professional– Pay attention to you appearancePay attention to you appearance– Inspire respectInspire respect– Consider it an honour to be asked Consider it an honour to be asked

into a patient’s homeinto a patient’s home

Consider the following:Consider the following: How does communication occur?How does communication occur?

What are the components of What are the components of communicationcommunication

How do we as care givers attempt How do we as care givers attempt to communicate with people in to communicate with people in crisis and what can hinder the crisis and what can hinder the communicationcommunication

CommunicationCommunicationTherapeutic ApproachTherapeutic Approach

What is communication?What is communication? The exchange of common symbolsThe exchange of common symbols Written, spoken, signing and body Written, spoken, signing and body

languagelanguage Basic elements: the sender, the Basic elements: the sender, the

message and the receivermessage and the receiver

VerbalVerbalVoice quality, diction, pitch, rate of Voice quality, diction, pitch, rate of

speech and volumespeech and volume Body languageBody language Provide your undivided attentionProvide your undivided attention

LISTEN – don’t just talkLISTEN – don’t just talk

Successful communication Successful communication occurs if, by way of the occurs if, by way of the response, the sender response, the sender believes that the message believes that the message was received accuratelywas received accurately

Effective listeningEffective listening

An active skillAn active skill Requires complete attentionRequires complete attention Focus on the messengerFocus on the messenger Never finish the other person’s Never finish the other person’s

sentencesentence Do not consider your response until Do not consider your response until

the other person has finished speakingthe other person has finished speaking Requires practice!! **Requires practice!! **

Remember:Remember:

A good communicator needs A good communicator needs patience and flexibility!patience and flexibility!

Trust and RapportTrust and Rapport

There is a certain amount of trust There is a certain amount of trust implied in being a paramedicimplied in being a paramedic

You need to earn the trustYou need to earn the trust First you establish the trust, then First you establish the trust, then

the rapport follows.the rapport follows. With good rapport the person you With good rapport the person you

are helping will follow your leadare helping will follow your lead

Developing RapportDeveloping Rapport

Introduce yourself and your partnerIntroduce yourself and your partner Address the patient formally – Mr., Address the patient formally – Mr.,

Mrs., etc.Mrs., etc. Use the patient’s name **Use the patient’s name ** Get to the level of the patientGet to the level of the patient Use a professional but Use a professional but

compassionate tone of voicecompassionate tone of voice Explain what you are doing and whyExplain what you are doing and why

Patient should believe they are your priority

Nonverbal Nonverbal communication skillscommunication skills

Eye contactEye contact Touch and GentlenessTouch and Gentleness PosturePosture Demeanour/SmileDemeanour/Smile Important to look at your Important to look at your

patient’s body languagepatient’s body language

Eye contactEye contact

Can be a very powerful source of Can be a very powerful source of effective communicationeffective communication– Take your sunglasses off!!Take your sunglasses off!!

Can be very important in tense or Can be very important in tense or difficult situationsdifficult situations

Remember, eye contact means the Remember, eye contact means the patient is looking at you!patient is looking at you!

Compassionate touchCompassionate touch

The holding of a hand, touch of an The holding of a hand, touch of an arm or shoulderarm or shoulder

May be awkward at first – watch for May be awkward at first – watch for responseresponse

May help to calm the patientMay help to calm the patient Be careful to touch appropriately – Be careful to touch appropriately –

consider the patient’s age, gender, consider the patient’s age, gender, cultural background and current cultural background and current settingsetting

PosturePosture

Gestures, mannerisms and Gestures, mannerisms and postures by which a person postures by which a person communicates with otherscommunicates with others

Includes distance between you Includes distance between you and the patient, whether you are and the patient, whether you are at eye level or not and your at eye level or not and your stancestance

Demeanour & Demeanour & Therapeutic SmileTherapeutic Smile

Pleasant demeanour absolutely Pleasant demeanour absolutely necessary when you are dealing necessary when you are dealing with people in crisis – they need with people in crisis – they need to feel safe and assured that you to feel safe and assured that you can helpcan help

Smile – can send the message Smile – can send the message that all will be well but consider that all will be well but consider the crisisthe crisis

Interviewing Interviewing TechniquesTechniques

QuestioningQuestioning

Use open-ended questionsUse open-ended questions Use closed questions only when Use closed questions only when

necessarynecessary Ask only one question at a timeAsk only one question at a time Listen to the patient’s complete response Listen to the patient’s complete response

before asking the next questionbefore asking the next question Use language the patient can understandUse language the patient can understand Do not ask leading questionsDo not ask leading questions

Payoff QuestionsPayoff Questions Have you felt like this before?Have you felt like this before? Have you been upset about anything Have you been upset about anything

lately?lately? Are you afraid of someone? [save this Are you afraid of someone? [save this

one for the privacy of the ambulance]one for the privacy of the ambulance] Have you been thinking about hurting Have you been thinking about hurting

yourself?yourself? What happened the last time you felt What happened the last time you felt

this way?this way?

Strategies to Elicit Strategies to Elicit Useful Responses to Useful Responses to QuestionsQuestions Facilitate the responseFacilitate the response Be quiet - Be quiet - never miss a good never miss a good

opportunity to shut up opportunity to shut up Clarify the responseClarify the response Redirect the responseRedirect the response Interpret the responseInterpret the response Simplify and summarize the Simplify and summarize the

responseresponse

Common Interviewing Common Interviewing ErrorsErrors

Assume NothingAssume Nothing Giving Medical adviceGiving Medical advice Providing false hopeProviding false hope Assuming excessive authorityAssuming excessive authority Sidestepping the truthSidestepping the truth Distancing yourself from patients Distancing yourself from patients

as peopleas people

Assessing Mental StatusAssessing Mental StatusObserving the patientObserving the patient

Appropriate HumourAppropriate Humour Timing of Responses to QuestionsTiming of Responses to Questions MemoryMemory Ability to obey simple CommandsAbility to obey simple Commands

Unique interview Unique interview situationssituations

People who are unmotivated to talkPeople who are unmotivated to talk People who are hostilePeople who are hostile People who are very old OR very People who are very old OR very

youngyoung People who live with special People who live with special

challengeschallenges Cross cultural communicationsCross cultural communications

– Manners, gestures and body languageManners, gestures and body language– Cultural sensitivity and cultural Cultural sensitivity and cultural

diversitydiversity

How does failure to How does failure to communicate occur?communicate occur?

Prejudice – do not paint all with Prejudice – do not paint all with the same brushthe same brush

Lack of empathyLack of empathy Lack of PrivacyLack of Privacy External distractionsExternal distractions Internal DistractionsInternal Distractions

Remember to bring closure to the Remember to bring closure to the callcall

Say “good bye”Say “good bye”

Whole messagesWhole messages