Develop your communication cycle to include an explanation of how the communication cycle may be used to communicate difficult, complex and sensitive issues. (M1)
The communication cycle is a set of 6 stages that have to all be completed to ensure effective communication between people. Communication is a natural process and is easy for someone that has speech, hearing and eyesight. It is slightly more complex for those that have not got all 3 main communication skills but there are ways around them such as Braille and Sign Language.
In certain situations the communication cycle can have extra stages added in to it or taken away. This is because some circumstances have to be carefully thought over and you must watch and listen to everything that is happening while trying to communicate effectively or that you have not listened to what has been said completely and judged to soon.
Your name is Sarah. You work in a children’s hospice where a 2 year old girl is living on end-of-life care.
Overnight, her health has dramatically deteriorated meaning she is on life support machines that are breathing for her. You tell her single parent father Paul that she may never wake up from her coma and that he has to make a choice for her:
Paul: I can’t believe this has happened to my beautiful little girl, this is too soon. Are you sure there’s no chance of her waking up?
Sarah: There is always a chance that she could come around but it is very rare and could lead to further damage to her health.
I’m so sorry for having to put you in this situation sir, but we really need an answer for the sake of your daughter’s health and wellbeing.
Paul: If you really cared for my daughter’s health and wellbeing I would not have to make the decision whether to keep her alive in pain or kill my own daughter!
Sarah: Please calm down sir, it was not my choice for this to happen and I assure you that we did everything we could to prevent this, but we really need an answer from you.
Paul: Are saying that it would be in her best interests to put her to rest now?
Sarah: From a medical point of view, yes, because she is in pain, but I cannot make this decision for you sir.
Paul: I just don’t know if I can cope without her, she’s my life.
Sarah: I can’t stress enough for how sorry I am for you; we do have bereavement support for anyone that wishes to use it after they lose somebody for as long as you need.
Paul: Ok, if it’s best for her, I don’t want my little girl to be in pain, I would never keep her alive for myself if I knew she was hurting.
Sarah: No, of course not. I will go and get the papers and let the Doctor know. You can stay with her.
Paul: Thank you.
Paul is in disbelief at first, unable to come to terms with the situation, in denial asking whether she will ever wake up. Sarah knows what he wants to hear but cannot lie to him, so she tells him there is a very slim chance. She thinks about what she will say next, as she can tell he will get angered from her response whatever she says. When she says about the patients health and well being he tries to pass the blame to the doctors, but he knows it was not their fault. This is when he starts to fear for himself, not thinking he will be able to live with his own decision. Sarah cleverly offers a bereavement plan to him, saying that it can give him all the support he will need, which quickly brings him back to earth. He then agrees to switch of his daughters life support machines to rid her of her pain. (Moyo, F. 2008)
The communication cycle has had a number of extra stages added to it in this conversation between the father and hospice worker.
In some situations, people will only here what they want to hear. Such as if a doctor was telling their patient that they have found a lump, the patient may immediately switch off, normally presuming the worst, so in this case, cancer. The patient would be going through any past experiences or stories that she had heard about the affects of cancer, while the doctor could be saying that it is benign so will not cause any harm because they caught it early, and with a very small surgery it can be removed. This communication barrier looks like:
Someone in a difficult, complex or sensitive situation may probe questions to help them understand and get more information. Questions that could be asked could consist of ‘what are the disadvantages to this?’, ‘Could you explain that again please?’ and ‘what exactly are you going to do to me?’ (Changing Minds)
Reflective listening also helps people feel more relaxed because you are taking an interest into what they are saying. There are many different techniques to reflective listening, some easier than others. An easy method to use is repeating certain words that they have said, for example, the person says ‘I can’t do this anymore, its making me depressed.’ You could then reply with ‘what’s making you depressed?’ This shows you have been listening to them and that you are interested in them. (Skills for Life Improvement Programme)
Another method of reflective listening can help if the person is finding it hard to express their feelings, by verifying the meaning to what they have said can help you get an understanding into what they are telling you. An example of this would be if the person was telling you about a difficult situation and keep stuttering their words, you could help them by rephrasing what they said. (Skills for Life Improvement Programme)
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