Communication for First Aiders
Harry Decker
Communication for First Aiders
“Communication is the key to success.” I hate that phrase, I think it sounds really clichéd, but as much as is pains me to, I agree entirely with the message it is trying to get across – it is especially relevant to first aid and healthcare staff of all grades.
Communication can be verbal or non-verbal, and is certainly the most important skill we possess. Effective communication allows you to form a bond with your patient – as event first aiders we are often only in contact with our patient for ten to twenty minutes at a time, sometimes less, so first impressions, and the way in which we behave around our patients is key. If you are able to put your patient at ease, they will have more confidence in you, making your job easier.
If time allows, shake your patient’s hand, introduce yourself, and make eye contact. This will immediately put them at ease. If your patient is a child, involve them in your initial contact as well as the parents, bring yourself down to their eye level – you will appear less intimidating, and the patient will feel more at ease.
Don’t stand behind your patient to talk to them – if they are unable to move, for example they are on a trolley bed, move in front of them to talk where possible. This is just polite; it stops your patient from having to lean round to see you and reply. Another thing I try to avoid doing where possible is talking “over” your patient – this is where you talk as though your patient is not there, when they are in earshot. Where practical, involve your patient in the conversation about their treatment. Obviously this is not always suitable – it may panic them more, for example if you are concerned about the lack of sensation from the waist down on a patient with a ?spinal, do not blurt it out across them to your fellow first aider.
Very importantly, always inform your patient of what you are doing, even if they are unconscious (hearing is the last sense you lose). You do not have to go into great depths explaining, unless the patient asks you to, but for any treatment or test, a good way of gaining their consent is informing them of what you are about to do – “I’m just going to put this peg on your finger, it isn’t going to hurt, but it will just give me a little bit more information about what might be the matter, is that okay with you?” By informing your patient of what you are doing, it gives them the opportunity to refuse, or ask more questions before allowing you to perform the procedure, and prevents them from panicking, possibly making their condition worse.
Tailor your speech, and body language to the patient. You are not going to be using the same tone of voice, or the same type of language to a five year old, as you are a thirty-five year old, and again it will be different to how you speak to a confused seventy-five year old. Never patronise your patient, or appear condescending. It is important however, to take control of some situations, by being firm, yet sympathetic – this is different from being patronising. Being patronising is assuming your patient is stupid, and is not the right attitude to have.
Communication is also one of our biggest treatment tools. If you win the confidence of the casualty, you will be able to effectively communicate with them. At first aid level, the only intervention we can offer to a patient hyperventilating due to a panic attack is firm reassurance. This involves both verbal and non-verbal communication. The verbal part is telling them that the only person that can stop the hyperventilating is them, and by reassuring them any pins and needles, cramps etc are perfectly normal, and the non verbal part involves coming down to their eye level, making eye contact, and placing a reassuring hand on their shoulder (if they allow you to). This has worked, without fail, for every hyperventilating panic attack patient I have ever dealt with.
The way in which your casualty communicates with you is just as important, although it is worth noting the way they respond to you is often based upon how you communicate with them. The body language of your casualty can sometimes give you a good idea as to what is wrong, for example, a patient who withdraws from your touch when you press on an area whilst performing an examination is normally experiencing pain in the area, or the way they hold their arm, neck etc is indicative of where the pain is. It also important you give the impression you can be trusted, and are competent when taking a history – the patient is more likely to disclose all the information to a first aider who appears interested and concerned in them, and who is making the effort to come down to their eye level, than a first aider who is standing there with his hands in his pockets, looking elsewhere.
I don’t claim to be an expert in communication – I’m not. I have never really received any formal training in how to communicate with my patients above and beyond what is covered on any course. The ideas I suggest in my article are based on experience – both my own, and others experiences. It is true the real learning happens outside the classroom. You can teach a first aider how to use all their kit, how to perform a primary survey, how to lift a carry chair, but communication, and putting these skills into practise are all things you learn out in the field – quite literally sometimes in event first aid, a cold, wet, muddy field.
I’m always interested in hearing new tips and tricks, so if you have any you would like to share, my email address is harry.decker@firstaidcentral.co.uk
Harry Decker
First Aid Central
www.firstaidcentral.co.uk
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