Know ways to combat implicit bias Recognize that we all have implicit bias that can negatively impact our clinical interactions and outcomes Accept responsibility to ID and understand your own implicit biases Appropriate interactions with patients who have disabilities. Be able to identify people first language Emphasize abilities, not limitations Emphasize the need for accessibility, not disability Avoid language the implies stereotypes Do not use offensive language Do not portray people with disabilities as inspirational only because of their disability Do not use language the suggests a lack of something Know different communication styles/preferences for various cultures (per lecture slides) Tone, Volume, and Speed • • • • • • Loud and expressive speech • African American, Caribbean, Latino, an Arab cultures. Softer tones of voice, less expressive speech • Some American Indian cultures, Alaskan native, and Latin American indigenous Direct eye contact • While speaking and listening is valued by white Americans Direct eye contact • Rude in some Asian cultures Pauses and silence • Often considered uncomfortable for people with dominant U.S. cultural norms • Some American Indian cultures value silences and pauses to process information and collect thoughts. Usually cultures that value high verbal expressiveness also appreciate facial expressiveness • • • • • • • • • Neutral face • Some American Indian and Asian cultures Western European, white Americans are comfortable with expressing emotions such as feeling sad East Asian cultures • Strong emotions may be considered inappropriate East Asian cultures • Tend to have low self-disclosure especially related to mental illness, SUD • Trust and rapport can facilitate disclosure Latin American, Asian cultures • Negative or embarrassing things should be stated subtlety Dominant US norm More direct than other cultures Formality (warmth, respect, formality) Many Latinx, African American, and white Americans like a warm and personal style East Asian cultures- more formal Know acceptable practice for working with an interpreter-- from assigned readings. Allow extra time (twice) Eliminate distractions Document the name of the interpreter* Introduce yourself to the patient/family/friends, do not direct intro to the interpreter Use first person language Face and speck directly to the patient, not the interpreter Use sentence by sentence* Use “teach back” to ensure patient understands Patient may waive their right to an interpreter, this should be properly documented Know law on “families of choice”- from assigned readings. Nursing communication techniques for patients with hearing or vision loss. VISION LOSS: Introduce/identify yourself and anyone with you to the person with vision loss If the person uses glasses, ensure that they are readily available Touch the person's arm lightly when you speak so that he or she knows to whom you are speaking before you begin Face the person and speak directly to him or her Use a normal tone of voice Explain when you are leaving the environment When offering directions, be as specific When assisting, allow the person to take your arm Never pet or otherwise distract a canine companion or service animal without permission HEARING: • • • • • • • • • • • • • • Ask the person how he or she prefers to communicate Eliminate or minimize background noise and distractions If the person uses an assistive hearing device (hearing aid), ensure that it is readily available to the person If you are speaking through a sign language interpreter, pause occasionally to allow the interpreter time to translate completely and accurately Talk directly to the person who is assisted by a sign interpreter, not to the interpreter Visual (wave) or tactile signals (light touch) can be used to get the person's attention. Speak without exaggerating your words Do not raise your voice, unless you are specifically requested to do so. If the person lip reads (speech reads), face the person and keep your hands and other objects away from your mouth. Maintain eye contact. Do not turn away or walk around while talking. Anticipate that only 30% of lip reading (speech reading) will be understood The avg Deaf ASL user reads at </= 6th grade level, lower health literacy If you do not understand something that is said, ask the person to repeat it or to write it down. Do not pretend to understand if you do not Nursing communication techniques for patients with intellectual or mental health disabilities. INTELLECTUAL: • • • • • • • • • • • • • • Treat adults as adults. Adjust your method of communication as necessary depending on the individual's responses to you. Use simple, direct sentences or supplementary visual forms of communication, such as gestures, diagrams, or demonstrations as needed Use concrete, specific language. Be prepared to repeat the same information more than once in different ways. When asking questions, phrase them without suggesting desired or preferred responses He or she may also benefit from watching a task demonstrated. Do not pretend to understand if you do not. Ask the person to repeat what was said. Be patient, flexible, and supportive. Do not assume that the person will be able to read well; some may not read at all. Avoid giving too many directions at one time Eliminate distractions and minimize background noise if possible. Avoid sensory overload MENTAL HEALTH: • • • • Speak directly to the person, using clear, simple communication. Treat persons who are adults as adults. • Do not patronize, condescend, or threaten when communicating with the person. Do not make decisions for the person or assume that you know the person's preferences. Offer to shake hands when introduced. Use the same good manners in interacting with a person who has a psychiatric/mental health disability that you would with anyone else Encouraging people with IDD to have similar roles as their peers who do not have IDD through policy and practice Abuse - what is the nursing role? Routine screening Realize an increased risk of abuse Recognize signs of abuse- physical and behavioral Report- KY state law requires reporting of child abuse, neglect and dependency and the abuse, neglect or financial exploitation of adults with disabilities Report to the Cabinet for Health and Family Services .They will then perform an investigation Know the 7 types of Elder Abuse -readings. physical abuse, neglect, emotional abuse, financial abuse, sexual abuse, self-neglect, and abandonment.