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Continuing Development


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Continuing Development

  1. 1. NQF level 5: BTEC Higher National — H1 HND Health and Social Care (Management & Care Practice) In Course Completion of Unit 4: Continuing Development A Submitted this 7th of May 2010 Submitted to: ______ Submitted by: ______ 1
  2. 2. Contents Answer to Question 1 – 1.1 3 Answer to Question 1 – 1.2 4 Answer to Question 1 – 1.3 4 Answer to Question 1 – 1.3 5 Answer to Question 1 – 1.4 5 Answer to Question 1 – 1.4 6 Answer to Question 2 – 2.1 6 Answer to Question 2 – 2.1 7 Answer to Question 2 – 2.2 7 Answer to Question 2 – 2.2 8 Answer to Question 2 – 2.3 8 Answer to Question 2 – 2.4 8 Answer to Question 2 – 2.4 9 Answer to Question 3 – 3.1 9 Answer to Question 3 – 3.2 10 Answer to Question 3 – 3.3 10 Answer to Question 3 – 3.4 11 Answer to Question 4 – 4.1 12 Answer to Question 4 – 4.2 12 Answer to Question 4 – 4.3 12 Answer to Question 4 – 4.4 13 Answer to Question 4 – 4.4 14 Answer to Question 4 – 4.5 14 References 15 Bibliography 15 Appendix 16 Appendix 17 2
  3. 3. Answer to Question 1 – 1.1 The individual‟s values and principles are influential in their work performance in the field of health care. Considering that this type of profession requires interaction with different kinds of people, it is very important for the health workers to be aware of their own values. Many of the health care professionals today disregard the importance of personal values, which is why most of the concerns arising today are issues regarding fragmented and unsatisfactory care. Under the benefits portion of the program pamphlet, The Janki Foundation for Global Health Care (2004, p. 3) states: One of the keys to raising morale in healthcare today is to re-emphasise the importance of values in guiding practice at all levels. There are some excellent values statements produced by health care bodies in the field, but for values to be meaningful, they must be owned at a personal level, and then integrated into the workplace. Awareness of one‟s self contributes a lot in the person‟s improvement of qualities, social skills and even in the chosen career. Honesty for instance not only makes an individual a better person but it also helps open doors for improvement and gain the trust of other people. Equality or a fair conduct can also aid health workers on their treatment with the clients especially those who have special needs. Having good spiritual values guides a person‟s acceptance of other people‟s religious belief and showing them respect. There may be a very huge scope in terms of the different values and principles that workers may possess but it is possible to unite everyone. Having a common organisational value can definitely bring the team into unity and differences can be set aside. Depending on the type of values that a health worker holds – that is good or bad, both can either positively or negatively contribute to the institution. Basing from the situation given above, the manager will be faced with certain issues such as the conflicting values and attitudes from the subordinates but with the help of making a common organisational value all of the staff members can be brought into one movement. Some of the common problems that the workers will be facing are miscommunication, misinterpretation and conflict of ideas. All depends on how the manager solves the given crisis and how willing his/her subordinates are to cooperate. Before the start of the goal implementation, moments for personal awareness and getting-to-know may be done first and the manager itself should already be aware of the potential problems that may arise and must have a plan ready to be enacted. 3
  4. 4. Answer to Question 1 – 1.2 My own personal belief is mainly about the importance of quality over quantity. In terms of providing care in my clients when I was still a student nurse I always make sure that during the nurse-client interaction every minute must be centred to the client‟s well being and not just mainly on spending hours in order to ensure that their basic needs were being provided because the whole aspect of the person must be considered. Beliefs are formed as the person lives its life, everyday new beliefs can be formed or can be changed. What‟s important is that people must respect each other‟s beliefs and must not impose their own to others. Personally, base from my place of origin, my country is very rich with cultural values and is known to have very close family ties. Filipinos treat each other like a family even within a group of friends. That is why most of the Filipinos can create instant friends and are mostly labeled as flexible people since we are able to blend in easily. During my clinical exposures I have been bared to different types of people with different cultures including foreigners from our land but there was never an instance where the said differences became an issue. Clients not coming from my country who received my service as their student nurse were even thankful for the extra care we student nurses gave to them and told us “there are no better nurses than Filipinos”. Organisationally speaking, cultural values common in our team as a group of student nurses is the holistic care. It is something that all of us tend to keep since we are aware on how care is not being delivered in every aspect of the person because of issues such as work overload. Due to the united goal that all of us had we were able to successfully supplement the missing portions of care given by the nurse. Answer to Question 1-1.3 The new priorities and legislation guides workers especially considering that the diversity of the culture and ethnics of the area is becoming broader. It helps lessen the collision and tension because one common rule is being laid down. The anti discrimination act preserves the rights of those people having a different race, gender, physical disabilities and those which are placed under vulnerability status due to the risk of identity exposure when undergoing a certain treatment or care. As a care worker, the provision of such rules increases the responsibilities and rights of the care giver to protect its clients from any discrimination. This law also gives 4
  5. 5. knowledge to the workers regarding the rights that the people hold such as quality care and a fair treatment. Whenever an individual is not informed with the rights that he/she possesses, the carer is responsible for this and the involved person must not be left ignorant to his/her privileges. United Kingdom is not the only country that is being protected by this type of law. Other countries such as the United States also implemented the Civil Rights Act of 1991 which supports the prohibition of discrimination (Sack 1998). Whatever opinions or views, attitude, beliefs and anything that is different from the carer that a client may possess must not be influential to the quality of care being given to the service user. Professionalism doesn‟t require a qualified worker whether to like the recipient of care or not. It may seem impossible to avoid conflicts and stick to being what a health provider calls us to be but any negative feelings must be set aside for the client‟s sake. That is why every communication technique has to be learned by heart because it helps a lot in dealing with people and avoids any unnecessary tension that might serve as a barrier in the provision of care. Answer to Question 1 – 1.4 Soul Journey (2010) enumerated three different types of values which are believed to be important since they play a role in maintaining harmony in life. These three values are: universal, cultural, and personal. It was also stated that personal must be congruent to the universal values in order to avoid conflict. From the citation given, it is therefore necessary that before undergoing a change in the personal value an individual must be aware of the two values first to check what must be changed, what must be developed and what must not be altered. As I have looked through my personal values before I have seen a misalignment from my universal value which is cooperation. Each person has their own difficulties in living by a certain value especially when it‟s a universal one because we are personal (Soul Journey n.d.). I do not think that it would be possible to have such alignment instantly but at least opening up to the idea and learning slowly to be involved with it can help change things. I learned the importance of cooperation through allowing myself to be exposed in such situations until I finally accepted this value and incorporated it as my own. I also learned how to interact well with other people and having the sense of unity not just by doing the things which are being set by a team leader but by having a sense of responsibility whenever I am given a task. I found out 5
  6. 6. that by learning one value other values are also discovered and the cycle can continue or will keep on going only if an individual allows him/herself to be involved in it. Personal development will always reflect on its career or professional growth. That is why it is very crucial for care workers to be involved in every personal development programs and trainings or even by giving one‟s self a rain check time to time. Self monitoring helps one to be aware of any possibilities such as diversion from the main goal and main purpose, overshadowing effect of other factors that jeopardizes one‟s career and zeroing of motivational factors which lead to decreasing level of performance. An individual must learn unique ways in order to continually develop one‟s personality and avoidance of stagnation of energies by sticking to what has been learned must be done. In every way there is always a possibility of learning and once the person has achieved a good level of personal traits and values everything will mirror on the individual‟s career performance. In everything that people do all starts from within and the rest will follow when self awareness is already completed. Word Count: 1,505 words Answer to Question 2 - 2.1 Learning styles has already been introduced way back during my intermediate years. They actually existed for a very long time but I wasn‟t conscious with them. It‟s a good thing that they were introduced because knowing the different styles can surely help in developing one‟s abilities and potentials. As for my own learning styles these are: solitary, logical, visual and aural. What works best for me is the solitary: I prefer to understand and analyze things on my own. Contrary to solitary is the social learning style, this explains why I cannot learn well with the presence of other people. Brainstorming and group studies were never helpful to me that is why I never used the social learning style, I found them ineffective and a waste of time. Although I benefited much on my favourite knowledge acquiring technique, I still think that it poses several disadvantages too. I am prone to information misconception and too much self reliance made my learning restricted because chances for clarification and catching important missed key words are slim due to my preference. 6
  7. 7. When I was still studying associate in health science and education, the logical learning style also aids a lot especially in understanding the disease processes of each disorder. It‟s impossible to memorize everything and I figured out that comprehension through logical reasoning is much more effective. Not only do I get to understand them better but the duration of my comprehension is a lot longer compared to plain memorization. Visual and auditory learning styles are common especially when instructors do their lectures and have their slides shown through the projector. I think most of the students learn on both of these styles more often compared to the other techniques which require more recognition and development. The knowledge of the different learning styles in the health and social care field makes it easier for workers to identify their client‟s preference of learning when there‟s a need for the care provider to impart information. Aside from that advantage, the transferring of right details is also ensured and digestions of new inputs are easily handled by the clients. Answer to Question 2 – 2.2 The justification of my personal development plan is explained here while the graph is shown in the appendix [page 17-18]. The personal development plan being produced is based on my own skills, abilities and the areas where improvement is needed together with its planned goal, actions and outcomes. Normally, every plan must have content for the evaluation part but since they were not yet implemented I opt to leave it blank. For the purposes of discussion, I‟d like to give emphasis on the evaluation part of the plan. Evaluation is the portion where the planner can implement on-the-spot modifications, draw conclusions, monitor progress and effectiveness of the plan (Kozier et al. 2004). Its importance is equal to the rest of the sections included in the table, each part play a major role towards the achievement of the goal. When one is to be removed, it will be impossible for the whole process to be understood and even be implemented. Before producing such plan, knowing each sections or parts and understanding them is important. The goals/objectives which I have set were based on the areas which improvement is needed or the areas where I find as part of my weakness, being aware of these areas entails self assessment first. The action plan section or the intervention which I intend to do were also based on my objectives. Same goes with the outcomes section, this part explains the things that I expect to 7
  8. 8. see after doing the interventions. One important consideration in order to have a consistent personal development plan is through checking whether the mentioned parts of the plan were all leading to one goal. Through this way, a plan doesn‟t stay as a “plan” but chances of reaping the purpose out of producing it is high. Answer to Question 2 - 2.3 Monitoring the progress of my personal developmental plan can help towards the success of the whole improvement of the targeted weak areas in my duties as a health and social care giver. As the plan becomes ongoing it is crucial to be mindful whether the actual situation is in accordance to the plan, certain modifications can be made to the plan when necessary. Each goal being set must be checked whether or not they were already met or whenever the termination of such goal is necessary. When the goal was just partially met and requires further revision, the goal must not be left hanging. Continuation of the goals can be done given that the action and the outcome sections are reviewed thoroughly to prevent unsatisfactory results. Progress monitoring can also be done by securing a separate time frame plan where it focuses on the action plan and the time given. This is most especially helpful for beginners who are still trying to get used to the idea of having to plan their goals. The more specific the plan is, the more it becomes easy for the planner to trace the progress that the individual is experiencing. Answer to Question 2 – 2.4 My personal development plan was designed to help promote my skills and abilities as a health care worker. All of its goals were directed to one purpose and that is to fully give out the best services that clients must receive. In the context of health and social care, a client directed approach is always the top priority of workers. Though this plan was labeled as “personal” which meant that this was supposed to be for the welfare of the planner, once personal development is attained the professional improvement comes next automatically. In my previous answers I have already mentioned that everything starts from one‟s self and what shows within will mirror the individual‟s career performance. The development plans which I have designed were basically targeting the necessary values, skills and abilities which a health and social care worker must possess. Learning how to 8
  9. 9. effectively make a personal development plan is also a good opportunity for self improvement and self awareness. Word Count: 1,006 words Answer to Question 3 – 3.1 Professional relationship is generally followed to assist clients on the services they need but at the same time putting boundaries or limitations. There have been issues today that there are instances where professional turns into personal. To differentiate the two, Leekley (2010) listed the comparison between the two relationships: (1) in a professional relationship clients pay for the services that health workers give while no one gets to be paid for having a personal relationship (2) the relationship between a health worker ends when the client doesn‟t need help anymore, possibility of a lifetime relationship is present for personal (3) client-worker relationship takes place in a health care setting, personal relationships can occur anywhere (4) the health care worker is the only one responsible for maintaining a professional relationship while both parties are responsible for personal (5) a special training is done for health workers in taking part of the care for the involved clients, in personal relationships no such training is required (6) the time spent for the care of clients depends on the type of care that is to be given, partners in a personal relationship gets to choose the amount of time they want to have for each other. In some instances, breaks on the rules for maintaining a professional relationship happen because the health care worker is either not well acquainted to this or doesn‟t have a strong holding ground for such rules. Implementing professional boundaries helps both the client and the health worker to be in line with the type of relationship that is only needed. On the College of Psychologists of Ontario BULLETIN (1998 cited in College of Alberta Psychologists 2000), it was stated that „[b]oundaries make the relationship professional, and safe for the client, and set the parameters within which psychological services are delivered‟. Maintaining the right relationship required also maintains adherence to professional ethics thus promoting respect and dignity of one‟s self. 9
  10. 10. Answer to Question 3 – 3.2 The models of care and support can help both in having good relationships with the colleagues and also in clients. Empathy for one can help build a feeling of “someone who can relate” and trust helps building rapport. It takes time for someone to trust a person but sincerity is all it takes for it to develop. Consistency of words and actions in every situation allows people to see that they can truly rely on you. In work, co-workers who trust you are assured that you will be able to perform a duty very well when given a task or when collaboration of care is needed. Another important factor is communication, when good techniques are followed communication can help health workers and clients have a relationship that is helpful in each other‟s goals. A group of health workers are entitled to support each other, it is important that each member of the team are willing to cooperate. Asking or giving out support must not be viewed as something that is ego damaging, it is also important to show the real intentions of a worker who is offering support to a co-worker. When offering help or giving out help, words and actions must come together. Answer to Question 3 – 3.3 As an individual in line with the field of health care, my responsibility in assisting other people see their options and promoting their choice, encouraging their rights for self care and protection is crucial. I consider this as my responsibility since I am aware of the rights they possess and I believe that clients must not be left unaware of these. Giving information on the different choices that clients can choose from including the advantages and disadvantages of each of those options and allowing clients to decide for their own selves allows one to promote the individual‟s choice. Clients are only to be assisted on the services that they need but the main goal must not be left unsaid and that is to promote self reliance. Self reliance preserves the individual‟s integrity and self worth. Protection by any means also prevents clients from abuse and injustice. Individuals who needs a health worker‟s care must always be informed of their rights because this gives them a sense of security. 10
  11. 11. Answer to Question 3 – 3.4 One common dilemma that professionals in health care face is the breaking of barriers of professional relationship which was mentioned in my answer to question number one. This is because it is difficult to give care while drawing a line between you and a client at the same time. Sometimes the line becomes transparent and makes the health worker vulnerable to transforming professional to personal. Before rendering services or even entering the world of health and social care, one must first be oriented and be given with the necessary trainings so that he/she will be fully equipped from the expected common dilemmas. Another problem is the over reliance or dependence that the clients might possess after giving the services. The primary responsibility of the carer is to give assistance but one must always remember that the type of assistance that is given is not towards the dependence of the client but rather towards the client‟s growth and self reliance. In any interaction, everyone must go into the introductory phase, this is the part where the health worker explains its role to the client, the type of care that is to be given and any additional information in which the client must know first beforehand (Kozier et al. 2004). For those care especially when there is already intense interaction due to the length of time spent by the health workers and the client, termination phase becomes harder for them to do. When the termination phase is not successfully handled by the client, the care becomes ineffective since they are more likely to seek assistance whenever they can sense failure of their ability to become independent. One solution to this is to notify the clients as early as during the beginning of the professional relationship. If necessary, constant reminder from the care workers can be done so that the termination phase won‟t be viewed as impossible for the clients themselves. Most of the times, clients think that health care workers are there to assist them for life and they don‟t view it as something temporary because most of them are less empowered since they are not yet aware of their own capabilities – well or unwell patients. Word Count: 1,053 words 11
  12. 12. Answer to Question 4 – 4.1 During my studies in the A.H.S.E. program I have already experienced working in a team since we are grouped according to the dates when we are given our clinical exposure. My personal contribution was more on the success of each program that we do such as feeding and the teaching programs for children studying in public schools. I gave out my full cooperation on those activities and I know that my other team mates did their best too. I was not able to do something special like the planning of the program but merely just by accepting the task and fulfilling them is already a big part for the team‟s success. Answer to Question 4 – 4.2 My contribution to the team when I was still studying was mainly my full cooperation. As what I have noticed, the effectiveness of the group always relies on each member‟s willingness to cooperate too. Another team which I have been exposed to was the time after I joined the medical transcription program. I was exposed to the actual job and we had a team, each of us gets a chance to lead the group. The leader must ensure that all of the files being disseminated must be done after a certain period of time; we call that turn-around-time. I got the chance to become the team‟s leader and it wasn‟t that easy. Having a team leader makes the whole group more efficient in their work because constant monitoring of the group members helps a lot in ensuring the progress of the whole team. Answer to Question 4 – 4.3 Basing on the two roles which I have experienced which is being a team leader and a member has different impacts and limits. First, being a member limits the person‟s ability to control the progress of the team since there‟s already an acting team leader. Its impact is on the overall success of the activity since each member plays a major role. Second, being a team leader limits the ability to perform a greater amount of work since this might lead to overload on the part of the leader. Its impact is on the unity of the whole group that is a good determinant of success in each program that is going to be implemented. 12
  13. 13. Answer to Question 4 – 4.4 The barriers for team effectiveness were enumerated by Chananukul, J. et al (n.d.), they stated that these are „ineffective communication, cultural differences, social loafing, group think, organizational structure and resistance to change‟. Ineffective communication happens when a person does not listen actively, is being judgmental, and does not apply the techniques of better communication. Effects of this type of barrier to the team is very strong since it is impossible to build and keep a good organisation or group when there is no proper channeling of ideas or information. Cultural differences are also a big contributing factor either in the improvement of the team or the other way around. Due to the cultural diversity present in United Kingdom, issues regarding cultural disparity are common. Cultural differences can be set aside by putting up a common goal that is designed not to favor a certain type of culture but to let everyone meet in the middle point. Social loafing as described by Cherry, K. (n.d.) is the attitude of an individual to exert less effort whenever he/she belongs to a team. This barrier is common and usually left unrecognized by the group members but is very visible to the team leader. Social loafing can be contagious since whenever a person who is part of the team sees someone who is doing such barrier there is a tendency that the rest of the members is also dragged down together with the member who is displaying less effort towards the success of the whole group. The team leader is responsible for the task delegation but before delegating such assignments it would be better to know well its members first. Task must match the type of performance that the member is able to do, evaluation of each member is very important because this is where their productivity can be assessed. Group think is another factor that contributes much to the ineffectiveness of the team but still relies on the type of members that one has. For those teams which has members who are non-aggressive in terms of letting others know about their own ideas tend to group think. The decision making of the entire member does not rely on the common thoughts of the group but rather should be based on the amount of effectiveness it possesses. In order to avoid this barrier it is important to impart to the whole team that ideas are welcome and each of the member must be encouraged to have their own thoughts to share. Organisational structure can also prevent a team to perform at its best especially when the members have some objections towards the structure itself e.g. rules and regulations, power and 13
  14. 14. etc. It is better to review how the team is being run including the reaction of the members towards its own team. Impact of change is one factor that every people must know and must understand. Change is not something that can be fully achieved in one day, people who are resistant to this is not plainly over reacting but is expressing its own disappointments because of adjustments. The members of the team must be informed before such change is to take place and must know the advantages of why such change needs to be implemented. Concerns of the group members must also be heard and a transition period may be allowed to give consideration on the involved people. Answer to Question 4 – 4.5 For me to contribute well on the team, I would be happy to receive constructive criticisms so that such weaknesses can still be improved. It is better to secure first my abilities and my weak points before I can give out a contribution which I know would lead to something great for our team. Every other members of the team must also be encouraged to do so too. Currently, I perform well especially when it comes to cooperation and I do my tasks prudently and in a timely manner. More self awareness and self development can help improvements on my own qualities and the rest shall follow easily. Word Count: 1,042 words 14
  15. 15. References Chananukul, J., Cvetkov, A., Greenbaum, B., Ilinykh, M. & Louie, R. (n.d.). Barriers to Team Effectiveness [Online]. Available at: effectiveness [accessed 27 April 2010] Cherry, K. (n.d.). What Is Social Loafing? [Online]. Available at: [accessed 27 April 2010] College of Alberta Psychologists. 2000. Professional Boundaries in Health-Care Relationships [Online]. Available at: [accessed 27 April 2010] Kozier, B., Erb, G., Berman A. & Snyder, S., 2004. Fundamentals of Nursing. 7th ed. New Jersey: Pearson Education, Inc. Leekley, L. 2010. Are Your Nursing Assistants in the Know About Professional Relationships? [Online]. Available at: about-professional-relationships-505e10de07.html [accessed 27 April 2010] Sack, S.M., 1998. The Working Woman’s Legal Survival Guide [Online]. Available at: [accessed 25 April 2010] The Janki Foundation for Global Health Care. 2004. Values in Healthcare: a Spiritual Approach [Online]. Available at: [accessed 25 April 2010] The Soul Journey. 2010. Soul Perspectives On Values And Your Philosophy of Life [Online]. (Updated 26 February 2010) Available at: and-philosophy-of-life.shtml [accessed 26 April 2010] 15
  16. 16. Bibliography Dolye, O., Miller, S. & Mirza, F. 2009. Ethical Decision-Making in Social Work: Exploring Personal and Professional Values. Journal of Social Work Values and Ethics, [Online]. 6 (1). Available at: [accessed 27 April 2010] Human Resources Institute, LLC. 2006. Identifying Core Project Values [Online]. Available at: [accessed 25 April 2010] 16
  17. 17. Appendix Name: Cesar Ramon Causin Student Number: 107579 Educational Strengths Areas for Plan for development Outcome Evaluation qualification, development Goals / Action skills & Objectives Plan abilities  A  Ability to  Improvement Short term: Short term: Short term: graduate of a 2 handle of planning  Day to day  Secure a small  Activities for year degree pressure. strategies. planning of notebook that will the whole course  Open  Meeting activities. serve as a daily day were met (A.H.S.E.). mindedness. planned  Maintenance planner. without delay  A  Ability to goals on provision  Perform an end of care and proper graduate of handle promptly. of care values. check regarding the prioritization. Medical criticism  Performing  Zero hospital values being applied to  Positive Transcription and view different acquired see any deviation. feedbacks program. them as part communicati infections.  Wearing of protective from clients.  Comput of learning. on Midterm: equipments when  Good state er literate (MS  Have good techniques.  Application necessary. of health. applications). interpersona  Observance of at least 10 Midterm: Midterm: 17
  18. 18.  Ability l relation to various communicatio  Review the different  Improved to provide skills. care values at n techniques a communication client- health  Flexibi all times. day and techniques, check and worker education as a lity in any  Safety determination find ways to improve relationship. health care given precautions of areas the areas that need more  Goals met in graduate and situation. in the health which need attention for a timely render basic  Ability to care setting. improvement development. manner. client care think based  Knowledge  Mid care  During the middle of Long term: needs. upon good improvement checking with the care, checking of  Non-culture judgment. with regards attainable the objectives and related to people and goals and interventions are done hindrance to its culture or time frame. to reduce care. behaviour. Long term: ineffectiveness of the  Improvements plan. Set realistic plans in the and time frame. interaction on Long term: clients with  Perform a case study different regarding cultures. communicating with people according to its culture & behaviour. 18
  19. 19. NQF level 5: BTEC Higher National — H1 HND Health and Social Care (Management & Care Practice) In Course Completion of Unit 1: Communicating in Health and Social Care Organisations Submitted this 7th of May 2010 Submitted to: _____________ Submitted by: _______________ 19
  20. 20. Contents: Answer to Question 1 - 1.1 4 Answer to Question 1 - 1.1 5 Answer to Question 1 - 1.2 5 Answer to Question 1 - 1.2 6 Answer to Question 1 - 1.2 7 Answer to Question 1 - 1.3 7 Answer to Question 1 - 1.4 8 Answer to Question 1 - 1.4 9 Answer to Question 1 - 1.5 9 Answer to Question 1 - 1.5 10 Answer to Question 1 - 1.5 11 Answer to Question 1 - 1.6 11 Answer to Question 1 - 1.6 12 Answer to Question 1 - 1.6 13 Answer to Question 2 - 2.1 13 Answer to Question 2 - 2.1 14 Answer to Question 2 - 2.2 14 Answer to Question 2 - 2.3 14 Answer to Question 2 - 2.3 15 Answer to Question 2 - 2.4 15 Answer to Question 2 - 2.5 15 Answer to Question 2 - 2.5 16 Answer to Question 2 - 2.6 16 Answer to Question 3 – 3.1 17 Answer to Question 3 – 3.2 17 Answer to Question 3 – 3.2 18 Answer to Question 3 – 3.3 18 Answer to Question 3 – 3.4 18 Answer to Question 3 – 3.4 19 20
  21. 21. References 20 References 21 Bibliography 22 Appendix A 23 Appendix A 24 Appendix B 25 21
  22. 22. Answer to Question 1 – 1.1 In the situation given above, it was clearly portrayed that the receptionist wasn‟t sensitive to the needs of its client considering privacy, physical disability, language barrier and computer illiteracy. Humanistic learning theory focuses on both cognitive and affective qualities. In this theory, learning is on self development and achieving full potential; it is best when it is relevant to the learner. In other words, autonomy and self-determination are important (Kozier et al. 2004, p.448). Considering the auditory impairment of the client and privacy needs, application of the humanistic theory can be done through empathic approach. Language and technical difficulties can be solved by imparting information and proper assistance. Through this way, clients will feel more empowered and this would lead to self-reliance. In behaviourist theory, it says that a person‟s behaviour (response) takes place after an environmental interaction (stimulus). According to Bastable (2003, p.45 cited in Kozier et al. 2004) in the behaviourist school of thought, an act is called a response when it can be traced to the effects of a stimulus. Behaviourists closely observe responses and then manipulate the environment to bring about the intended change. Thus, to modify a person‟s attitude and response, a behaviourist would either alter the stimulus condition in the environment or change what happens after a response occurs. B.F. Skinner, an American psychologist, introduced the reinforcement processes and this was regarded as the one responsible for shaping ones behaviour. Therefore, a greater probability of response can be highly appreciated when a positive reinforcement is being made. Since behaviourists rely purely on stimulus-behaviour cycle, they are also more likely into trial and error. In relation to the given situation above, application of this theory can be done through allowing enough time for the learning process of the client considering its hearing difficulties and lack of English comprehension, providing an opportunity by exposing the involved person to the indicated barrier which is the computer usage and correct appraisal techniques when the desired learning outcome is being met. Cognitive theory simply involves the thought processes. Since each person has different developmental levels, it is therefore necessary to recognize this. Application of this theory should be congruent to the readiness of the individual to learn and its intellectual level. Under 22
  23. 23. this theory, Bloom (1956 cited in Kozier et al. 2004) has identified three domains or areas of learning: cognitive, affective and psychomotor. These three are also known as the thinking, feeling and skill domain. This is better understood by correlating the scenario given above. When the receptionist chooses to assist the client with regards to his/her concerns, this involves the psychomotor domain. Teaching and providing the necessary reasons why indicating your presence by using the computer screen is necessary is in the cognitive domain. Helping the client adjust to the modern technology, providing privacy and ease on the use of the English language through other alternatives is in the affective domain. Psychoanalytic theory according to Fodor and Gaynor (1950, p.148 cited in Shaffer and Johnson 2004) is in fact built up on the perception of the resistance exerted by the patient when we try to make him conscious of his unconscious. The unconscious mind influences the person‟s behaviour unconsciously since these emotions/feelings and experiences are being repressed. Application of this theory involves observing the client‟s response in accordance to the different defense mechanisms such as repression, reaction formation, denial, projection, displacement, sublimation, regression and rationalization. Sensitive issues must also be put into consideration as this can trigger certain reactions. Appropriate interpersonal communication must also be done to effectively handle each behaviour and ensure a healthy client-worker relationship. Answer to Question 1 – 1.2 There are various communication techniques available that can be used such as listening, talking, use of non verbal messages, understanding cultural differences, effective delivering of questions, and understanding the cycle of communication. Before tackling the modes of communication, it is better to cover first the foundation which is the communication process. There are four components in this process: the sender, message, receiver and the response. Understanding each of these areas is essential in order to have a continuous flow of communication. Application of this communication technique allows social interaction thus making other levels of communication techniques required in health and social work a lot easier since this is considered to be the foundational structure. A graph of the communication process is provided in Appendix B [page 24]. 23
  24. 24. There are two modes of communication namely: verbal and nonverbal. Verbal communication is largely conscious because people choose the words they use while nonverbal communication is controlled less consciously because it tells others more about what a person is feeling than what is actually said (Kozier et al. 2004, p.423-424). The application of these two modes is wide may it be in the context of health and social care or not. It also serves as the primary source of assessment, validation by checking the congruency of the two modes and helps in establishing rapport. Cultural differences varies so much that sometimes it‟s hard for the health and social workers to identify the correct interpretation. This is where the importance of the two modes of communication again comes in. Knowing the two aspects can help in the validation process through asking the client in accordance to what the observant has seen. It is necessary to know whether there has been a correct interpretation in order to avoid unnecessary confusions and misunderstandings since trust acquisition is very vital. Listening can be either be done actively or passively, that is why it is better to regard it as attentive listening. On the topic of listening, Kozier et al. (2004, p.428) states that: „[a]ttentive listening is listening actively, using all the senses, as opposed to listening passively with just the ear. It is probably the most important technique to nursing and is basic to all other techniques‟. Attentive listening is also considered to be part of the therapeutic communication and one of the major purposes is for the well fair of the client since it conveys care and interest. To start a conversation, talking is the easiest and the most convenient way to do it. In the field of health and social care, talking must be done the right way by choosing the appropriate words. There are seven considerations in choosing the right words to say or write and these are: pace and intonation, simplicity, clarity and brevity, timing and relevance, adaptability, credibility and humor (Kozier et al. 2004, p.423). All of these can aid in the interpersonal interaction between clients and the health workers. Such interaction is needed in order to carry out the nursing process and all other work related to health and social care. The type of question that is thought to be an effective communication technique is called open-ended questions. This allows exploration of more feelings and emotions and provides longer answers which promote 24
  25. 25. continuity of communication. Aside from the fact that this is considered to be a therapeutic communication technique, this can also be used for assessment purposes. The application of all the listed communication techniques mentioned above on the given scenario can greatly affect and change the outcome of the interaction between the receptionist and the client. In the situation given, the client felt that her concerns weren‟t of importance and that the one who attended to her wasn‟t sensitive enough. If proper communication techniques were used, the client‟s feelings would not have been jeopardized. More importantly, trust and rapport could have been easily established. Answer to Question 1 – 1.3 There are several ways in which communication influences the individual‟s feelings. According to Watson (1985 cited in Kozier et al. 2004, p.419), „[c]aring actions include communication, positive regard, support, or physical interventions by the nurse‟. Through communication, people can feel the sense of care though it still largely depends on the interpersonal attitudes that one conveys. People can also feel their sense of worth when others regard them with respect especially when their own ideas and opinions are accepted and not being judged since this shows their uniqueness or their individuality. Since communication can either be helpful or not, feelings brought to the people can also either be good or bad. Generally, barriers to communication are the factors which can cause the person to feel terrible during an interaction. These nontherapeutic responses could include stereotyping, agreeing/disagreeing, probing, rejecting, and judgmental actions (Kozier et al. 2004, p.432). Relating this to the scenario given, it was clearly shown that the communication barriers did affect the emotions that might even change the outlook of the clients to him/herself. Self confidence could also be at stake and the sense of independence lessened. 25
  26. 26. Answer to Question 1 – 1.4 Dealing with inappropriate interpersonal communication between individuals impose a great skill in managing people. Focusing is not only considered as a way to deal with inappropriate behaviour but also one of the therapeutic communication techniques used to prevent communication barriers. This helps in directing the topic to the topic with utmost importance. Other concerns made by client must also be heard although the health workers must be able to identify the meat of the idea or feeling (Kozier et al. 2004, p.431). Listening, as what I have said earlier, is more actively done when there is attentive listening. This serves as the basic starting ground and covers both verbal and nonverbal cues, both of which must also display congruency. To be an effective listener the speaker‟s whole message must be heard first and must not be interrupted. The listener‟s personal biases must not be taken into consideration and must respond the right way to prevent premature closure of the communication and misinterpretation. Trying to see the client‟s point of view can be achieved through attentive listening. Responding to the person‟s opinion should be done with respect and the listener‟s own views or beliefs should not be imposed on the part of the sender of the message since each person has its own ideas. Another way to deal with inappropriate interpersonal communication is through empathy. Kozier (2004, p.421) defined empathy as „[a]n expression of understanding of “how it is for the client” who is distressed, suffering, or sad‟. An empathic approach can help lessen the tension because there is a sense of understanding being delivered by the listener and this may lead to other doors such as compromising. Empathy is also included as one of the communication strategies for providing comfort. More of these strategies are being enumerated together with its description and examples in Appendix A [page 22-23]. Gately and Gately, F. Jr. (2001, p.42) gave out three developmental stages in the coteaching process and these are as follows: the beginning stage, the compromise stage, and the collaborative stage. Similarly, interpersonal communication can also be viewed like this. In the beginning stage, this is where the interaction starts and the turnout of events can be determined 26
  27. 27. on how well the contact went through. Considering that a barrier took place, compromising can be used in order to allow the give and take process to happen. Extra understanding can be given by the listener to the client and in return trust is being acquired thus permitting the collaborative stage to happen which covers a higher level of relationship. Taking breaks or time-outs may also be used especially when the situation is already becoming intense. This buys more time for both parties to cool things down and start thinking clearly. Time outs are done not to completely abandon the ongoing communication but only to make a temporary pause. A conversation and interaction being started by a health worker must always be finished and never be left hanging. It is never helpful in dealing with inappropriate interpersonal communication by pointing out fingers. Setting general examples are more likely acceptable than stating other people‟s mistake. If this is done the other way around the person involved may perceive this as a judgmental act. Answer to Question 1 – 1.5 People with specific communication needs are those who have language and sensory deficits, cognitive impairments, structural deficits and paralysis (Kozier et al. 2004, p.438). In general, the SOLER technique by Egan (1986) is used by care workers and it helps clients to feel safe and to trust the care-giver, and assists in effective communication. Each letter from the acronym SOLER stands for: sit squarely in relation to the patient, open position, lean slightly towards the patient, eye contact, and relax. This technique may be used for those people with or without special needs and are important factors that could influence good interaction. There are several techniques and strategies that can be used depending on the type of communication impairments they have. Each intervention has to be modified according to the severity of the impairment. As for those who have problems in hearing, British Sign Language or BSL has been introduced and finally accepted by the UK government as an official minority language in 2003. This has led to increased funding for the needs of deaf people (British-sign 2010). Considering the growing need of support of this type of remedy, they are indeed helpful 27
  28. 28. to the deaf community. Though there is a clear indication that sign language is universal, still it may differ in each place of origin. It must also be kept in mind that not only those with hearing impairments are also learning this type of language but including those who interact with the deaf people e.g. relatives and care givers. Another type of technique that can also be taught for those with or without learning a difficulty is the Makaton. „[m]akaton is much simpler and uses common vocabulary. Unlike BLS, it uses speech as well as actions and symbols (Signed Language 2010). This technique is very much helpful for those with learning difficulties such as cognitive impairment, structural deficits, and paralysis. This primarily aids those who have some ability to communicate but unfortunately limited. The Deaf Direct (n.d.) states that: „Deaf blind interpreters uses a variety of methods including BSL, hands on signing, the manual alphabet, block alphabet and speech to Braille depending on the communication needs of the Deaf blind individual‟. Since this involves two impairments in one body, interventions must consider both areas. A deaf blind individual requires greater needs than a person who is impaired on either of the two areas only. For blind people, One method is being used and that is reading and writing through braille. In this case, individuals are totally dependent of their sense of touch. Lipspeakers make an interaction through their mouth, gestures and facial expressions without making any sound. Lipspeakers must also ensure the clarity of the message being relayed without over emphasizing them. This is also one way of supporting communication with a deaf client. „[s]peech-to-text reporters (STTR) also known as a "captioner", listens to what is being said and inputs it, word for word, onto an electronic shorthand keyboard‟ (Wikipedia 2009). This technique is considered to be the fastest way to convey information to those with auditory impairments. Note takers can be divided into two: manual and electronic. Both of these types of note takers aid the deaf especially students who are going for college. This allows better understanding and reviews can be made. The note taking takes place right during the event. 28
  29. 29. Application of these various methods from the given situation can help in bridging gaps in terms of the communication between the receptionist and the client. Answer to Question 1 – 1.6 In every working area, confidentiality issues play a major role in maintaining good communication and must be observed in order to protect the client and abide on legal matters. If a person decides to have a long-term maintenance attraction, trust must be preserved. This is very vital especially for health workers whose aim is primarily to protect the information that the subject or the client relates. As for the workers and the employer, whenever a concern is being raised by the worker, every effort must be done in order to prevent disclosure of information. Confidentiality is always present in every policy. Consent as a work place policy is given since this is an act of asking permission. This reserves the rights of an employee to an employer. For reasons such as continuity of care, an informed consent is being done to the client and through this way good communication is being practiced. Equal opportunities must also be set in a working area especially when the workers consist of different races. A person who is flexible can handle any type of working environment. Flexibility allows the person to adapt well in any given situation. Furthermore, this serves as a starting point for good working relationships and eventually allowing good communication strategy. Performance management policy is designed to monitor the quality of the employee‟s work. Time to time assessment on performance must be done and appropriate feedbacks are being given. This is to allow growth on the employees and opportunities for recognition. Disciplinary policy contains procedures that are always set according to the rules and regulations placed in the working area. These are necessary as it can help control or minimize disobedience thus promoting order. Under this policy includes several forms of disciplinary actions, these are counseling, suspensions and dismissals (The University of Alabama – Human Resource Policy Manual 2001). Counseling policy is done as part of the disciplinary action. The employer uses this in order to explore and identify the cause of the problem which is considered to be less grave in nature. When all efforts are made but disciplinary measures failed to control the act of an 29
  30. 30. employee then termination will be done. Dismissal is the act of termination of an employee from an employer but with certain rules and procedures being set by the policy itself, this protects the employees from unjust termination. Certain policies and procedures are being followed in order to have a good practice in communication. Harassments and other maltreatments in a work place are not tolerable and must be reported to the responsible personnel so that certain action can be done. Discrimination must not be welcomed since this can hinder good interpersonal relation among the workers and can deter effective communication. The above mentioned inequity can be cured or even be avoided by applying the grievance and bullying policy. Paternity and maternity leaves are also a reserved right coming from the workers and to allow parental bonding to the child. In most cases, days of allowable leave for fathers are shorter compared to the mothers. Similar to paternity and maternity leaves, adoption policy is given for those parents who decide to have a child legally. Adoption policy has two different types, with pay or without pay. For those who are employed by the Civil Service for less than 26 weeks they are not entitled to have a leave with pay. This policy is only applicable for Office of Fair Trading (OFT) and certain eligibilities are being set. “Whistleblowing encourages and enables employees to raise serious concerns within the Council rather than overlooking a problem or 'blowing the whistle' outside” (Lancashire County Council 2010). Such policy welcomes concerns, gives protection and ensures response. A complaint is described as something that is being expressed by the complainant regarding his/her discontent of a certain service. „A complaint is not an initial request for service to be delivered‟ (Tameside 2010). Whenever complaints are being filed, due response must be expected. According to the University of Leeds – Human Resources (n.d): Compassionate leave policy is intended to anticipate the provisions on „Leave for Family and Domestic Reasons‟ in the new Employment Relations Bill (1999). The draft Bill specifies that employees should be entitled to a „reasonable amount of time off during working hours‟. 30
  31. 31. The amount of time to be granted depends on the institution including the number of days that will be paid. In order to file under this type of leave, the seriousness of the situation and the necessity will be examined. All of the mentioned workplace strategies, policies, and procedures can be done directly or indirectly. Direct approach can be through meetings while indirect approach can be done through SMS, emails, memos, and letters. Word Count: 3,335 words Answer to Question 2 – 2.1 There are several methods of communication available to be used today. According to Beckham and King (n.d) these includes: „face-to-face conversations, meetings, telephones in offices, cars and airplanes, memos, letters, telegraphs, electronic mail and fax messages, media methods such as newspapers, television...‟ To further categorize the methods mentioned above, they can be grouped into two: electronic and manual methods. Since several choices are available, these two authors also enumerated three things to keep in mind in selecting a method to be used. First is the importance of the message, second is the effectiveness and third is the kind of feedback that is desired. All of the methods are influenced by factors namely individual values, culture and ability. All of these factors can lead to miscommunication. Values are viewed as the ability of a person to perceive which is right or wrong. Values can be influential if for instance: a supervisor decides to meet all of his subordinates for minor concerns because he/she believes that by doing so, it is less impersonal. Cases like this could have been handled by passing a memo and the supervisor‟s co-workers might question him/her for such poor use of communication method since meetings can consume time and effort on the part of the employees. Another factor is culture; this is mainly built by the place in which a person grew up. If for example a person has been acquainted in a place where there are heavy socioeconomic issues, 31
  32. 32. this individual is most likely to possess a frugal trait. This person might be very thrifty in managing the finances of the organization thus instead of using manual methods of relaying information such as letters and memos, he/she might prefer electronic mails even with the knowledge (for example) that not all of his employees have internet access. An individual‟s ability can also affect the methods of communication. Today, it is very important to know how to use the modern equipments but we cannot deny that there are people who are still ignorant to these. If a general manager who has been in place for several years and never bothered to learn the basics of computer, internet and other electronic devices might not want to relay notice through emails despite the fact that his/her employees find electronic mails to be much convenient compared to manual letters. Surprisingly, physical attributes, state of mind and stress level can also affect the person‟s ability to face the members of the organization during meetings because they either get distracted or paranoid on the thoughts of its coworkers. Answer to Question 2 – 2.2 Legislation charters for communication are generally for the purpose of protecting the rights of those who have impairments that serves as a hindrance for them to converse well. Since research has already proved the vulnerability of this group of people, efforts have been made in order to give services and protection. From the situation cited above, there was a clear evidence of disregard on this right. The employer wasn‟t able to provide enough orientation and training to the attendant since the receptionist did not resort to other means of communication in order to properly entertain the client who is slightly deaf. Another reason that made the actions of the help desk employee unacceptable was its inability to provide extra time and attention to the client. Answer to Question 2 – 2.3 The importance of legislation and codes of practice in terms of data recording and relaying of information has long been seen as a helpful tool in protecting the involved people in health care especially the clients from any harm or abuse. This serves as a guide for the workers to be aware 32
  33. 33. of their duties and responsibilities as a health care provider especially in terms of handling information coming from other people. It also provides a working knowledge on how to access, review, evaluate and make use of the gathered data for research purposes while ensuring the confidentiality of the individuals involved. For the sake of continuity of care, endorsements of important data must also be done. Answer to Question 2 – 2.4 The organisational systems policies in relation to good practice in communication ensured the rights of both parties, effectively maintained a healthy client-worker relationship and has proved to provide order especially in dealing complaints or comments. Those people with communication needs have also been provided with the services despite their disability due to the policies that has been set, therefore, preserving their dignity and meeting their rights as citizens of the country. The outcome is generally seen on the operating institutions today, because of these policies every procedure has been made to become organized. Answer to Question 2 – 2.5 There are several ways to improve the communication systems today. What is very important is that communication must be individualized. Before using a certain system of communication, the capability of the receiver to decode the message well must be known. „[t]he goal of any form of communication is to promote complete understanding of a message. But breakdowns in communication can occur at any step in the process‟ Wikipedia (cited in Answers, 2010). The success of every communication relies on the sender and receiver of the message. In any setting, listening is crucial in order to understand the whole message very well. In a care setting, this can be applied by ensuring that the environment is very well conducive for interaction and that the mode of information transfer is suitable enough. On the given situation above, the receptionist failed to do this and even did not consider the communication needs of the client. Sometimes there are uncontrollable factors that can contribute to miscommunication such as language barriers. That is why first hand information recipients must have the necessary 33
  34. 34. knowledge on how to find alternatives to promote understanding. Relating to the scenario, again, the employee failed on this part because of the inability to provide options. In cases of referrals, any information being received must also be reviewed by the second and first hand recipient. This is to clarify any confusion and avoid wrong data entry. Whenever necessary, questions must be raised as soon as possible. Seminars for employees and monitoring of miscommunication cases can also be done and further studies be made in order to determine the unidentified barriers to communication. When awareness has been established proper solutions can be planned and put into action thus preventing repetition of mistakes. Answer to Question 2 – 2.6 There is a presence of proper communication when non-verbal cues are also included during an interaction. This includes expression of feelings and showing emotions according to what the message is all about. Incongruence between the verbal and non-verbal communication can be mind boggling. It can also lessen the credibility of the sender of the message. Building rapport before hand is also helpful since this eases the rest of the communication. It is undeniable that there are uncomfortable feelings whenever a person starts to converse to a stranger. More importantly, rapport can lead to trust. When a person gains an individual‟s trust there is more opportunities for long term worker-client relationship and a more effective care can be made. A non-judgmental response also shows proper use of the communication techniques including maintaining confidentiality on issues tackled between the client and the health care provider. Keeping a state of open mindedness also helps prevent biases. The recipient of the information must put in mind that each person has his/her own ideas and must be respected in any way. Lending an ear to a client and identifying its point of view is essential and must not be taken for granted. There are so many ways to demonstrate how to appropriately communicate with other people. In general, following the SOLER technique by Egan (1986) applies to all forms of communication including those with special needs. Word Count: 1,281 words 34
  35. 35. Answer to Question 3 – 3.1 Whenever a client goes to an institution for the first time, all of the basic information are being encoded and stored in the system. If secondary check-ups are being required by his/her care provider, retrieval of previous record will be done since this can aid for the continuity of care. This is when the IT solutions become very useful. Compared to manual procedures, it takes time, effort and the confidentiality issues are at stake since handling restrictions are not that rigid. There‟s also the probability of loosing or damage of important sheets which contains information and this is considered detrimental to the client‟s care since all interventions given must also depend on the individual‟s health status monitored by the health care provider. Legal issues can also be solved by the use of IT in health care. All information being stored can be used as supporting evidence and can either protect the health provider/worker or the client itself for any breach of law. The modern means can also help relay important reminders or notice to the workers involved and assist in delivering meetings such as the MS PowerPoint or MS Live Meeting. Other purposes such as diagnostics, laboratory, and medication delivery are also being influenced by the IT software. Generally speaking, its application mainly is for the welfare of client and provision of quality care. Answer to Question 3 – 3.2 Benefits to the modern solutions are endless that is why they are widely used and more creators are even finding ways to solve other problems in health care. The list of beneficiaries includes the health care providers, clients, administration, quality assurance team, finance department, the researchers, and the third party sectors. As for the service users, referring to the clients, through IT solutions they can receive utmost safe care, secured billings including time to time update and confidentiality is sustained. Medication stocks are also readily available since they are monitored electronically, this can greatly help 35
  36. 36. especially during emergency cases. Accuracy of records is ensured and the medical equipments are up-to-date. Answer to Question 3 – 3.3 Health care providers can benefit through the lesser effort and time it saves, assistance from the complexity of care e.g. point-of-care diagnostics, prevention of chances of error e.g. medications and the quality of care given. The administrative department is facilitated by the ease of storing basic information regarding the client and managing personnel through the system. While the both the quality assurance team and the researchers relies on the information being stored already since through that way they can monitor progress, changes and even new problems arising. The finance department can monitor and update the client‟s bill easily because of the built in program installed and the third party sectors can monitor the client‟s charges and retrieve this for reasons such as reimbursement or hospital coverage. Every item that is being used by the client is being recorded in the computer and with the help of IT this is can be accessed by the finance department in order for the bill to be summed up. This department is also responsible for the distribution of pay rolls. Standard payment and professional fee or charges according to the procedure being performed by the health care provider is being credited automatically in the computer. The medical devices are also being powered up by today‟s technology and they provide better ways to provide accurate diagnostic results, improved equipment performance and assistance to hands-on care givers leading to a better and more efficient care by the health workers. Answer to Question 3 – 3.4 With every advantage comes the disadvantage, the negative health effects in using IT can be prevented by following proper posture and reducing the amount of stress both in the muscles of the eyes and the muscles of the other body parts involved such as the arms and back. Repetitive strain injury have been found to affect people who are having long working hours in front of a computer. These disorders were used to be found in office workers, telecommunication operators, transcriptionists, and for those who work heavily on computers only. After the 36
  37. 37. invasion of IT in the medical field health workers were now also affected because all of the data entries are now being done through computers, this makes health care personnel one of the major heavy users of computer. Data encoding can go several hours especially in a very busy institution and since all information are required to be entered directly to prevent unnecessary disregard of new data, health workers are tempted to do everything in one sitting. Breaks are ignored or being procrastinated because of other duties which are left to attend to and then finally the day ends without having been able to rest even just for a short period of time. Power naps have long been proven to be more helpful compared to long hours of sleep. „People who regularly take mid-day naps experience decrease in drowsiness. Research has also shown that it increases your level of alertness during the day and reduces stress‟ (Syd 2007). When planning to stay in a computer for several hours or when duty says so, awareness of the time spent in front of the computer is important including the time wherein breaks should be done. Proper posture must also be observed by choosing a comfortable chair that supports the back portion of the body well and a desk high enough for the hands to reach. Touch typing must also be learned since this speed up the typing, saves time and helps lessens hand and arm discomfort. If copying entries coming from a paper to the computer, the paper must be placed parallel to the computer where the eyes can gain easy access to the original source. Word Count: 943 words 37
  38. 38. References: Answers. 2010. Communication Systems [Online]. Available at: [accessed 22 April 2010] British-sign. 2010. What is British Sign Language? [Online]. Available at: http://www.british- [accessed 22 April 2010] Deaf Direct. n.d. Language Service Professionals [Online]. Available at: [accessed 22 April 2010] Gately, S. & Gately, F. Jr., 2001. Understanding Coteaching Components. Teaching Exceptional Children [Online] 33 (4). Available at: eCenter/CoTeaching/VOL.33NO.4MARAPR2001_TEC_Article6.pdf (Council for Exceptional Children) [accessed 22 April 2010] Kozier, B., Erb, G., Berman A. & Snyder, S., 2004. Fundamentals of Nursing. 7th ed. New Jersey: Pearson Education, Inc. Lancashire County Council. 2010. Whistleblowing policy [Online]. Available at: 6877 [accessed 23 April 2010] Office of Fair Trading. n.d. Adoption leave and pay – policy and procedure [Online]. (Updated September 2009) Available at: [accessed 23 April 2010] Shaffer, J. & Johnson, V. n.d. Psychoanalytic Theory: “conscious becoming aware of the unconscious. [Online]. Available at: [accessed 21 April 2010] 38
  39. 39. Signed Language. 2010. Makaton [Online]. Available at: [accessed 22 April 2010] Tameside. 2010. Complaints Policy [Online]. (Updated 21 January 2010) Available at: [accessed 23 April 2010] The University of Alabama - Human Resource Policy Manual. 2001. Employee Counseling and Progressive Discipline Policy [Online]. Available at: manual/counseling-discipline.htm [accessed 23 April 2010] University of Leeds - Human Resources Corporate Services. n.d. Compassionate Leave [Online]. Available at: Leave.doc [accessed 23 April 2010] Wikipedia. 2009. Speech-to-text [Online]. (Updated 13 December 2009) Available at: [accessed 22 April 2010] 39
  40. 40. Bibliography: Happ, M.B., Roesch, T. & Kagan S., 2004. Cancer Nursing. Communication Needs, Methods, and Perceived Voice Quality Following Head and Neck Surgery: A Literature Review, [Online]. 27 (1). Available at: (Medscape) [accessed 22 April 2010] Lieu, C., Sadler, G., Fullerton J. & Stohlmann, P., 2007. Dermatology Nursing. Communication Strategies for Nurses Interacting With Patients Who Are Deaf, [Online]. 19 (6), p. 541-544, p. 549-555. Available at: (Medscape) [accessed 22 April 2010] Masys, D., 2002. Health Affairs. Effects of Current and Future Information Technologies on the Health Care Workforce, [Online]. 21 (5). Available at: (Medscape) [accessed 23 April 2010] 40
  41. 41. Appendix A Communication Strategies for Providing Comfort Characteristic Description Examples of Nurses Response Empathy An expression of “I hear how this is for you.” understanding oh “how it is “I understand how hard this is for the client” who is for you.” distressed, suffering, or sad. “Your feelings are very normal in this situation.” Positive Talk Nurse has a positive impact by “You are doing really well; keeping the client informed, this is a very difficult encouraged, or coached. procedure.” “Taking these steps is hard, but you are improving. Good work!” “Most families in this situation have these types of feelings and thoughts.” Therapeutic Touch The nurse, when appropriate, “How about if I hold your maintains physical contact hand during this procedure.” with the client, and reassures “I am just going to rub your and comforts the client. shoulder for a minute until the pain medication starts to work.” Competent physical and The nurse‟s level of “This will just take a second technical skills professionalism and efficiency with a little pin prick to start decreases the anxiety and this IV. You have excellent promotes comfort. veins.” “We do this procedure frequently. Do you have any 41
  42. 42. questions we haven‟t answered yet?” Vigilance The client trust that the nurse “I am back to check on how is involved in his/her care. you are doing.” “I will not be gone for more than 30 minutes and if you need me before, use the call light and I will come. Does 30 minutes sound doable to you?” (Kozier et al. 2004, p. 421) 42
  43. 43. Appendix B Sender Message Encode Encode Message Decode Decode (Kozier, B. et al. 2004, p. 422) 43
  44. 44. IRISH MEOLYN E. TURNO Phone: +639393735192 Zone – 1 San Roque Street Email: Bayabas, CDOC 9000 Personal Data: Age: 23 years old Sex: Female Date of Birth: February 28, 1987 Place of Birth: Cagayan de Oro City Nationality: Filipino Education:  Bachelor of Science in Nursing (BSN) Xavier University Ateneo de Cagayan Cagayan de Oro City March 15, 2008  Associate in Health Science Education (AHSE) Xavier University Ateneo de Cagayan Cagayan de Oro City March 18, 2006 Organizations:  Philippine Nurses Association (PNA) Manila, Philippines License:  Registered Nurse in the Philippines License Number: 0554073 Work Experience:  RX Secure, Inc. Medical Transcriptionist Cagayan de Oro City March to April 2009  MT Gateway General Transcriptionist 44
  45. 45. Cagayan de Oro City May to October 2009  Garmones Marketing and General Services Data Encoder Kauswagan, Cagayan de Oro City October 1, 2009 to April 5, 2010 Clinical Rotations:  Bukidnon Provincial Hospital of Maramag D.R., O.R., E.R. Student Nurse Maramag, Bukidnon May 2008  Oro Doctors General Hospital D.R., Medical – Surgical Unit Student Nurse Cagayan de Oro City November 2007 – March 2008  Xavier University Community Health Care Center E.R., O.R., OPD, Medical – Surgical Unit Student Nurse Cagayan de Oro City September – October 2007  Madonna and Child Hospital O.R., P.A.C.U., Pediatric and Maternal Unit Student Nurse Cagayan de Oro City June – August 2007  Maria Reyna Hospital Medical – Surgical Unit Student Nurse Cagayan de Oro City November 2006 – March 2007  Northern Mindanao Medical Center E.R., O.R., D.R., Orthopedic Unit Cagayan de Oro City September – October 2006  J.R. Borja Hospital D.R. 45
  46. 46. Student Nurse Cagayan de Oro City July – August 2006 Training:  Medical Transcription Informatics Computer Institute, Philippines Cagayan de Oro City April 17, 2009 Seminars Attended:  “In Hell? Ex-HAIL...”: A Seminar on Acute and Chronic Respiratory Failure. Xavier University BSN Integrated Seminar February 15, 2008  “D.O.T.S. the way TB free”: A Seminar on Directly Observed Treatment Short- course. Xavier University BSN Integrated Seminar February 8, 2008  “The Renal Affair: Betray Me Not My Kidneys”: A Seminar on Renal Failure. Xavier University BSN Integrated Seminar February 1, 2008  “Mommy I Am Sick”: A Seminar on Integrated Management of Childhood Illness. Xavier University BSN Integrated Seminar January 25, 2008  “C.A.U.T.I.O.N.: SMOOTH CRIMINAL, is it in you?”: A Seminar on Oncology: Cancer Nursing. Xavier University BSN Integrated Seminar January 11, 2008  “A light in the Pit of Darkness”: A Seminar on Invasive Pneumococcal Disease. Xavier University BSN Integrated Seminar January 4, 2008  “Enough! I Can‟t Take This Anymore”: A Seminar on Violence Against Women and Children. Xavier University BSN Integrated Seminar December 21, 2007  “Feels Like Heaven, Burns Like Hell”: A Seminar On Drug Addiction, Substance Abuse, and the Importance of Dual Diagnosis. 46
  47. 47. Xavier University BSN Integrated Seminar December 14, 2007  “A Deceitful Heart”: A Seminar on Congestive Heart Failure. Xavier University BSN Integrated Seminar December 7, 2007  Red Cross – Basic Life Support Training Xavier University Ateneo de Cagayan December 4, 2006 Skills:  Basic computer applications (MS Word, Excel, Powerpoint) Character Reference:  Adona M. Corpuz Pharmacist II King Khalid National Guard Jeddah +639084124868  Phyllis Marie B. Jimenez Proprietor ROPHYKA Marketing Cagayan de Oro City +639177064160  Carla F. Medrano Medical/General Transcriptionist MT Gateway Cagayan de Oro City +639214055448 Note: On my attached works please be aware that I chose to put a blank line rather than disclosing the information of my previous client and its instructor. 47