CHAPTER 2 Principles and Elements of Interpersonal Communication CHAPTER 2 Setting the Stage Components of the Interpersonal Communication Model Personal Responsibilities in the Communication Model In Search of the Meaning of the Message Importance of Perception in Communication Setting the Stage CHAPTER 2 George Raymond, a 59-year-old man with moderate hypertension, enters your pharmacy holding an unlit cigar. You know George because you attend the same church. He is a high school principal, has a wife who works, and has four children. He has been told to quit smoking and go on a diet. He also has a long history of not taking his medications correctly. He comes to pick up a new prescription—an antibiotic for a urinary tract infection. Although he knows you personally, he is somewhat hesitant as he approaches the prescription area. He looks down at the ground and mumbles, “The doctor called in a new prescription for me, and can I also have a refill of my heart medication?” Components of the Interpersonal Communication Model CHAPTER 2 Components of the Interpersonal Communication Model CHAPTER 2 THE SENDER In the interpersonal communication process, the sender transmits a message to another person. In the example described above, the initial sender of a message was Mr. Raymond: “The doctor called in a new prescription for me, and can I also have a refill of my heart medication?” THE MESSAGE In interpersonal communication, the message is the element that is transmitted from one person to another. Messages can be thoughts, ideas, emotions, information, or other factors and can be transmitted both verbally (by talking) and nonverbally (by using facial expressions, hand gestures, and so on). Components of the Interpersonal Communication Model CHAPTER 2 THE RECEIVER The receiver (you in the above example) receives the message from the sender (Mr. Raymond). As the receiver, you “decode” the message and assign a particular meaning to it, which may or may not be Mr. Raymond’s intended meaning. In receiving and translating the message, you probably considered both the verbal and nonverbal components of the message. FEEDBACK Feedback is the process whereby receivers communicate back to senders their understanding of the senders’ message. In most situations, receivers do not passively absorb messages; they respond to them with their own verbal and nonverbal messages. By using verbal and nonverbal communication, the receiver feeds back information to the sender about how the message was translated. Components of the Interpersonal Communication Model CHAPTER 2 BARRIERS Interpersonal communication is usually affected by a number of interferences or barriers. These barriers affect the accuracy of the communication exchange. Environmental Barriers Personal Barriers Administrative Barriers Time Barriers Components of the Interpersonal Communication Model CHAPTER 2 • Sender. You are responsible for ensuring that the message is transmitted in the clearest form, in terminology understood by the other person, and in an environment conducive to clear transmission. • Receiver. You have the responsibility of listening to what is being transmitted by the sender. To ensure accurate communication, you should provide feedback to the sender by describing what you understood the message to be. Words and Their Context CHAPTER 2 A 9-month-old baby is admitted to the hospital with a severe infection. The pharmacist spoke with the mother upon admission and learned that about 1 week ago her son had developed a minor bacterial infection and received an antibiotic, which she gave him for 4 days until the infection appeared to be cleared up. When asked why she stopped the antibiotic, the mother stated that she was just following the directions on the prescription label: “Take one-half teaspoonful three times a day for infection until all gone.” The mother stated that she gave the medication until the infection was all gone. Unfortunately, the intended message was that the antibiotic should be given until the liquid was all gone (which would have been about 14 days—long enough to treat the bacterial infection). The mother assigned a meaning to the message on the prescription label that was not accurate; and thus, she stopped giving the antibiotic, a super-infection developed, and the baby was hospitalized. Words and Their Context CHAPTER 2 Congruent and Incongruent Messages • A red-faced agitated patron comes into the pharmacy, raises a fist, and loudly proclaims, “I’m not angry, I’m just here to ask about a prescription error.” • A disappointed pharmacist has tried, so far without success, to convince a physician to change an obviously inappropriate medication order. When asked how he is feeling, he meekly replies, “Oh, I’m just fine.” • A patient hands a pharmacist a prescription for a tranquilizer, then bursts into tears. The pharmacist asks if anything is the matter, and the patient responds, “No, I’m okay, it’s nothing at all.” Using Feedback to Check the Meaning of the Message CHAPTER 2 A patient being seen in an anticoagulation clinic mentioned to the pharmacist that he had developed several bruises on his hands and legs. The pharmacist immediately checked the patient’s computer records and found a recent INR value of 6, which was well above his targeted 2–3 range. The pharmacist asked whether the patient had changed his diet, lifestyle, or drug regimen. The patient said no, but that he was given another medication during his last clinic visit. The pharmacist then went back to the profile and noticed that the patient had been receiving 4 mg daily Coumadin for some time, but his dose was reduced to 3 mg during the last visit to adjust his INR. The pharmacist suspected what the issue might be and asked the patient, “Did you stop taking the 4 mg tablet?” The patient replied, “No, nobody told me to, so I have been following instructions and taking both tablets!!” Thus, he was taking 7 mg per day rather than the intended 3 mg. Using Feedback to Check the Meaning of the Message CHAPTER 2 Statements or Questions That Elicit Feedback • “I want to be sure I have explained things clearly. Please summarize the most important things to remember about this medicine.” • “How do you intend to take the medication?” • “Please show me how you are going to use this nasal inhaler.” • “It is important that I understand that you know how to take this medication. Now when you get home, how are you going to take this medication?” • “Describe in your own words how you are going to take this medication.” Using Feedback to Check the Meaning of the Message CHAPTER 2 Advice Pharmacists Should Follow When Communicating with People of Different Backgrounds • Learn as much as you can about the patient’s background. Most communication problems arise when there is a lack of knowledge about the other person’s reasons for a particular communication style. • View diversity as an opportunity. With a little patience and the right attitude, you will be amazed at the opportunities that crop up to help one another. • Do not condescend. Patronizing behavior is not appreciated and is recognized as such in any culture. • Talk about your differences. Misunderstandings will often take root when people from differing backgrounds do not talk to one another. Be willing to talk openly and with a constructive attitude. Summary CHAPTER 2 The interpersonal communication model reveals that you must recognize that interpersonal communication is more than merely speaking to others, offering a printed prescription label, or affixing an auxiliary label to a prescription. You must make sure that the messages you transmit to others are received accurately. There is no guarantee that the meaning of your message will be translated as intended. You need to make sure that you enhance your listening skills so that you can become a better receiver of messages as well. Review Cases CHAPTER 2 Review Case 1 A patient, Ms. Reynolds, enters a pharmacy, having just come from her physician’s office. Ms. Reynolds: My doctor just gave me a prescription for methotrexate and did not tell me anything about it! What’s it used for? Pharmacist: I am busy right now to go into detail, but it is used to treat various conditions, including cancer and rheumatoid arthritis. Ms. Reynolds: What?!! Oh my goodness!! I can’t believe this. My doctor must think I have cancer and is waiting to tell me. 1. How could the pharmacist have handled this situation differently to check for misperceptions? 2. What would you have said to the patient? 3. Would you call anyone else about this? If so, who? Review Cases CHAPTER 2 Review Case 2 You are a pharmacist in a pharmacy located in a medical building. Cynthia Jackson, a 22-year-old college student, enters your pharmacy. Cynthia has no prescription insurance and is on a limited budget. She has been dealing with chronic sinusitis and finally realized that she needed to see an ear, nose, and throat specialist. Cynthia visited Dr. Sampson, who practices in your building. You know Dr. Sampson to be a good physician, but one who lacks interpersonal skills at times. He prescribed an expensive antibiotic that would cost Cynthia $75. After you tell her the price, Cynthia states, “Dr. Sampson didn’t help me very much. He spends 5 minutes with me and then prescribes this expensive antibiotic and nothing else! And how do you get off charging me so much for just an antibiotic?” 1. What feelings do you sense coming from Cynthia? 2. How does Cynthia’s perception of Dr. Sampson influence her behavior? 3. How would you respond to Cynthia? 4. What kind of recommendations would you give her?