Communication and Interpersonal Skills
What this domain covers
Communication is a clinical skill. What you say, how you say it, and what you write all affect care, safety, and the resident's sense of dignity.
Therapeutic basics. Face the resident, make eye contact at their level, use a normal tone, and allow time to respond. Use plain words instead of medical jargon. Ask one question at a time and avoid yes/no questions when you need real information. Restate and clarify to check understanding. Never promise things you cannot guarantee, argue with a resident's feelings, or discuss a resident in a public area.
Special situations. For a hearing-impaired resident, reduce background noise, speak clearly at normal volume, and face them so they can read lips; do not shout or exaggerate mouth movements. For a resident with aphasia, be patient, use yes/no questions, gestures, and pictures, and never finish sentences for them. Use a qualified interpreter and speak directly to the resident, not to the interpreter. For a resident who is confused, use short sentences, one step at a time.
Reporting and documenting. Report changes promptly and factually to the nurse. Use objective language: "Mr. Lee cried out when turned and refused breakfast" rather than "Mr. Lee was difficult." SBAR (Situation, Background, Assessment, Recommendation) is a useful structure for handoff. Document only care you personally provided or observed, at the time it happened, and never alter a record or chart for someone else.
Traps. Test items punish judgmental charting, sharing resident information with a coworker who is not involved in care, and failing to report a change because it seemed minor.
Rule of thumb. If you would not want it said about you in a hallway, do not say it about a resident - and if it changed, report it.