Книга_3777_Библиотеки_им_академика_М_И_Перельмана

CHAPTER 10 Common Laboratory Tests

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9. A CBC sample is collected in a _______________________-top

tube.

10. Digoxin is a common _________________________ medication.

11. Electrolytes testing measures include:

a. b. c. d. e.

12. __________________ is a mineral essential to heart and kidney

function.

13. Elevated blood sugar indicates ___________________________.

14. The HIV antibody test is used to detect the presence of the anti-

body to the __________________ virus.

15. Iron is a mineral essential for the formation of ______________

and __________________.

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16. __________________ is a genetic disease that can lead to mental

retardation and brain damage if left untreated.

17. The APTT is a screening test for _________________ disorders.

18. A rubella antibody test sample is collected in a ___________-top

tube.

19. An osmolality test is used to assess ___________________.

20. A cortisol test is used to check __________________ hormone

function.

DISCUSSION QUESTION

1. You are preparing to draw a CBC, a Vitamin B-12, and an Iron

on an outpatient. What diagnosis might the ordering physician be considering? Give an example of test results that may allow for a conclusive diagnosis.

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Professional Success in

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Phlebotomy

PART

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11

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“Communication is

not simply sending a

message. It is creating true

understanding—swiftly,

clearly, and precisely.”

—Hitachi, Ltd.

Communication Skills for the Phlebotomist

After studying this unit, it is the responsibility of the learner to be able to:

1. Explain how speaking and communicating are different.

2. Give several examples of poor articulation.

3. List  ve types of nonverbal communication.

4. Describe the difference between hearing and listening.

5. De ne the difference between listening and re ective listening.

6. Describe good telephone techniques.

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articulation speaking in a distinct, clear

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manner

message any communication, written or oral,

from one person to another

listening paying attention, making an effort to

hear and understand

re ective listening repeating what has been

heard back to the speaker

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P

PART 3 Professional Success in Phlebotomy

hlebotomists interact with a large number of customers every day, including patients, physicians, coworkers, friends and family members of patients, and potential patients. One objective of each interaction should be to establish trust and rapport. Trust and rapport are partially the products of good communication. Research tells us that, on average, people spend 80 percent of their waking hours involved in some form of communication. That is why communication skills are as important for the phlebotomist as venipuncture and capillary puncture techniques.

Communication involves two active participants: the person sending a A message consists of whatever the sender communicates to the receiver. It is sent in the form of symbols, which can be either verbal or nonverbal. Verbal symbols are words. Nonverbal symbols include facial expressions, posture, appearance, tone of voice, and gestures. The receiver of the message is the listener, who must interpret the symbols.

message and the person receiving the message.

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

THE SPEAKER

A common mistake we make as speakers is assuming that when we send a message, communication has taken place. Speaking and communication are not synonymous. We can speak to the listener, but if the message is not received in the manner in which it was meant to be understood, we have failed to communicate. For example, at one hospital’s  tness clinic for persons recovering from heart attacks, a staff nurse gave a speech on cholesterol. “To decrease your cholesterol level,” she said, “you should stop eating red meat.” A few months later, she checked the cholesterol levels of the participants and discovered that one man’s cholesterol level had risen slightly. “Did you stop eating red meat?” she asked. “Yes,” he said. “I used to eat my steaks medium rare, but now I cook them until they are brown through and through.” Communication had failed to take place between the nurse and the participant because the listener interpreted the message incorrectly. As speakers, we are responsible for sending messages that are understood by listeners. We can ensure this by using the appropriate words.

CHAPTER 11 Communication Skills for the Phlebotomist

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Appropriate Words

Occasionally in the medical profession, we are guilty of trying to impress our patients with our knowledge and skills. We do this by using terminology that is meant to impress, not express. Terms that are very common to the phlebotomist—such as hematoma, CBC, and hemolysis—are confusing to many patients. When trying to choose appropriate words, it is important to know something about the person or persons to whom you are speaking. There is no problem with using the word hematoma when speaking with fellow medical personnel. However, patients may be frightened if you tell them that a hematoma has formed and they do not know what that means.

Your goal should be to choose not the most sophisticated word, but the

right word for the right person. Strive to build rapport with your patients by using words appropriate for their age and sex. If you are speaking to a 75-year-old patient, for example, stay away from slang that might not be understood. In fact, popular slang in general is not appropriate in the health care environment.

Use concrete and precise words. If your supervisor asks you for in-

formation about the day’s workload, do not say, “It was really busy today.” Busy is an abstract term that has different meanings for different people. Perhaps the supervisor thinks that busy means you performed 50 venipunctures by yourself that day, while you actually performed 30. Use concrete words to help you create the mental images that you want to convey. Instead of “It was really busy today,” say “I performed 25 venipunctures this morning between six and nine.” If the supervisor asks, “How did you do?” do not reply with something vague like, “They said I did a really good job.” Who are “they,” and what was the “really good job”? Be precise. Say, “The patients complimented me on my ef cient, painless venipunctures.”

Be brief and concise when giving information. If a patient should ask

you why you are collecting a particular blood sample, say, “Your physician ordered a lab test.” If the patient is persistent, simply say, “It would be best for you to have your physician explain it to you.”

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Articulation

Closely connected to choosing the appropriate word is choosing the appropriate manner in which to deliver the words. Your carefully chosen words deserve attention, to ensure clarity of delivery. Many of us are lazy in our daily conversations. We slur, mumble, drop syllables, and end up delivering poorly articulated messages. Look at the following conversation, for instance:

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PART 3 Professional Success in Phlebotomy

“Watcha doin?” “Gettin ready to get an ASAP.” “Howbout that lass test? Wajagit?” “Gotta red top.” “Can’t ya useit?” “Nah.” While poor

articulation may not hurt us in conversation with our

friends, it can hinder our communication with our patients. Enunciate words crisply and precisely.

Nonverbal Communication

Your personal appearance plays an important part in your communication. Your patients will start forming opinions about you before you open your mouth. You should always be clean, well groomed, and attractively dressed. Your attire should always be appropriate. Don’t wear anything that would distract or offend your patients.

Establish immediate eye contact. Making good eye contact is impor-

tant for three reasons:

•

It demonstrates sincerity and interest. It creates a bond of communication and rapport between you and •

the patient. It enables you to get feedback from the patient. You can tell im-

•

mediately if you have confused, angered, or pleased your patient.

If you are assisting a patient and another is waiting, acknowledge the

waiting patient with brief eye contact and a smile. Do not ignore the pa

tient. Patients deserve and appreciate being acknowledged.

Be aware of your posture. Good posture gives the impression of con-

 dence and competence. Slouching projects inadequacy and disinterest. Do not lean against a bed, wall, or counter. Your patient will think you are too tired to perform your duties in a competent manner.

Smile sincerely at the patient. A warm smile will convey the message

that you are pleased to see the patient and eager to provide a service. A sincere smile will put both you and your patient at ease.

A strong, clear voice will help you assert yourself and convey con -

dence. Research shows that if your tone of voice contradicts your words, patients will take the tone and in ection of your voice as the truth, rather than your words. In fact, 38 percent of your message is the tone of your voice. You should speak loudly enough for patients to understand you, but not so loudly that those not involved in your interaction will hear you.

Make sure your gestures are consistent with your verbal message.

You convey a great deal with your body movements when you are

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CHAPTER 11 Communication Skills for the Phlebotomist

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191

communicating. Drumming your  ngers on a table, crossing your arms, rolling your eyes upward, glancing at your watch, frowning, and casting your eyes down are just a few examples of negative nonverbal messages. In general, the key to an effective use of gestures is to avoid motions that may distract listeners from the message you wish to send.

THE LISTENER

Listening is another aspect of successful communication. Listening is fol-

lowing the thoughts of the speaker and understanding those thoughts as they were intended.

As a phlebotomist, you must be ready to listen at all times. Listening

skills are not easily achieved. Many outside in uences may interfere with your ability to listen effectively, and you may become distracted.

Conveying a message by speaking takes much longer than it takes to lis-

ten to the words. The average person speaks at the rate of 100 to 200 words per minute. However, a person can listen at a rate of 800 words per minute. During your “spare” time while listening, you might  nd yourself rehearsing what you are going to say to the patient, thinking about an argument with a coworker, or worrying about a dentist appointment that’s coming up. But what you should be doing is focusing on what the speaker is saying.

According to Dr. Lyman Steil of the University of Minnesota,

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“Tests have shown that immediately after listening to a ten-minute

oral presentation, the average listener has heard, understood,

properly evaluated, and retained approximately half of what was

said. And within 48 hours, that drops off another 50 percent to a

 nal 25 percent level of effectiveness. In other words, we quite often

comprehend and retain only one quarter of what is said.”

Because we are patient-conscious phlebotomists, we not only want to

listen to our patients, but we also want to listen re ectively. Listening re ectively means listening to the messages communicated by our patients and also letting them know that they are being heard and understood.

Re ective Listening

Re ective listening requires you to respond to a message while focusing

on the speaker’s need or problem. It involves two things:

1. Hearing and understanding through words and body language,

and

2. Re

ecting back what you have heard and seen.

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PART 3 Professional Success in Phlebotomy

There is a big difference between hearing and listening. When we

hear, we experience sound waves vibrating on our eardrums. When we listen, we understand the words and take action accordingly. Many of us pretend to listen at times. Do not make this mistake with a patient. Patients are sensitive to facial cues such as a blank expression, unblinking eyes, or a faraway look. You may miss valuable information as well as send a message of disinterest. Additionally:

Do not allow distractions to prevent listening. Do not focus your

•

attention on the child crying in the next room or the sun shining through the window. Watch the speaker’s face and take mental notes on the message. Do not form mental arguments with the patient. Do not prejudge.

Ask questions. Make sure you have enough information.

•

Acknowledge that you understand. Nod your head and say, • “I understand.”

•

Summarize—re ect—what you heard. Take into account both the words and the nonverbal language. If the patient is quiet but has a frown, a  ushed face, and a clenched jaw, you can say that you are observing anger. Repeat back the verbal message, using your own words.

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

TELEPHONE TECHNIQUES

Communicating on the telephone can be more dif cult than communicating in person. We have to depend on fewer means for transmitting our message. Our customer cannot see our smiling face or our correct posture. We must rely on other factors to indicate our patient-conscious attitude.

Communicating on the Telephone

1. Answer each call by the third ring. If the phone is allowed to ring

longer, the patient may already be irritated by the time you do answer.

2. Make your greeting brief, and use a pleasant tone of voice. State

the name of your employer and your name. Example: “Sunny Oaks Medical Center Laboratory. This is Jackie. How may I help you?”

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