All humans have some basic psychological requirements to feel comfortable. Maslow's Hierarchy is the standard for addressing those concerns. As healthcare professionals, it's our goal to help our patients to feel that they are safe, protected and receiving quality care. 

This is a stair-step process where we move from one level to the next. Each level has to be met in order for us to move to the next. Everyone starts at physiological needs and as those needs are satisfied we'll move to the next. However, if we fail to fulfill the needs we'll stay at that level until we can find a way to meet our needs. 

Culture Acceptable

Touching is an important form of nonverbal communication. However, cultural groups have rules or practices about touching. They relate to who can touch, when and where on the body. Please be sensitive to cultural practices.

Generally acceptable:

Mexico

Poland

Men can touch other men (Ex. Shaking hands)

India

Vietnam

Not acceptable

United Kingdom

China

Facial Expressions

Coldness- a constant stare Face muscles do not move

Fear- eyes open wide, eyebrows are raised, and mouth is tense with lips drawn back

Anger- eyes fixed upper lids are lowered, eyebrows drawn down, lips tightly pressed

Tiredness-eyes rolled upward

Disapproval- eyes are rolled upward

Disgust- narrowed eyes, the upper lip is curled and nose movements

Embarrassment- eyes turned down, face red,

Culture of people from Italian, Jewish, African-American and Hispanic persons smile and have many facial expressions. Irish, English, and Northern European persons have fewer facial expressions.

Eye contact has various interruptions. In some cultures eye contact is impolite. It can be seen as an invasion of privacy. In others, it’s a sign of attention, honesty, and warmth.

Another sensitive area for various cultures is food. Never encourage individuals to eat anything that violates their cultural beliefs   

A great deal of communication is non-verbal. Look professional, being organized and efficient play a large role in the patient's confidence in you and the facility.

These little faces can't communicate with you verbally but I bet you can tell what they are saying.

Be aware of your patient's feelings. Establish eye contact and make the client feel at ease. Treat them like a human instead of an object. The study of an individual's non-verbal communication is called Proxemics. 

Before entering a room check for signs containing information concerning the patient. Signs are typically posted on the door to the patient's room, on the wall or at the head of the bed. Be sure to follow any instruction concerning your circumstance. 

Posted DNR means "do not resuscitate". The patient should not be revived if they stop breathing.

When entering a patient's room, if the door is closed, knock lightly, open the door slowly and something like "good morning" before entering the patient's area.

We recommend the above procedure even if the door is open. 

If the curtain is pulled generally that means that someone is working with the patient or that the patient is using the bedpan or urinal. Make sure your presence is known before opening the curtain.

If someone with more medical certification, then yourself is working with the patient please don't interrupt. 

If a clergy member is with the patient once again please don't interrupt.

If the family member and visitors are in the room its generally a good idea to ask them to step out during the procedure. If the patient agrees and the family member insist on staying it's generally accepted to continue with the procedure.

As a medical professional you have a legal obligation to perform your duty within set boundaries.

A sign or bracelet with the letters DNR means do not resuscitate. Don't start CPR on a patient that is wearing a DNR bracelet.

The most important thing we do in all branches of the medical field is: Identify the Patient

Verify the patient's Name and Date of Birth

Check Identification Bracelet

We suggest using the following pattern:

"Hello, my name is ____________ (first name) and I am a (name of certification). May I have your name and date of birth? (Describe the procedure you're going to perform) Today your doctor has prescribed a blood draw for additional testing. (Ask for their consent) Do you have any questions? If that's OK, which arm would you prefer us to use?(If possible give the patient an option)"

If the patient says no or something like "O.K. but I would rather not". Stop the procedure and ask the patient if they would prefer to talk with someone else. (Do not continue without consent)Do not draw blood until you have consent! (If you continue on without consent you can be charged with assault and if you have a needle in hand, assault with a deadly weapon)

The statement above is part of "formal consent" and "patient rights" and forms a legal contract.

This statement identifies you and the patient. This patter identifies the procedure that you're going to perform. The last question provides consent and provides the patient with the opportunity to participate in their healthcare plan.

Please practice the statement above until it becomes natural and routine. Please develop a presentation to submit to your mentor demonstrating your mastery of this skill.

*****The most important thing your going to do is identify the patient.*************

This communication gives you the opportunity to evaluate the patient. Listen to the response. Is the patient looking confused, or nodding their head in approval without speaking. These are warning signs that the patient didn't understand the communication. 

Do not start the procedure without a positive response from the patient.

If you feel you haven't received a positive response to your request to continue with medical action contact the Nursing Staff or Physician for further directions.