Nonverbal Communication

Communication skills

Second year
Lec.5 &6

Nonverbal Communication

Words are not the only way by which pharmacists communicate. Interpersonal communication involves both verbal and nonverbal expression. Words normally express ideas, whereas nonverbal expressions convey attitudes and emotions.
You are constantly providing messages to those around you by your dress, facial expression, body movements, and other aspects of your appearance and behavior. Nonverbal expressions include kinesics, proxemics, and elements of the physical environment in which communication takes place.
Nonverbal communication involves a complete mix of behaviors, psychological responses, and environmental interactions through which we consciously or unconsciously relate to another person.
Nonverbal communications are unique for three reasons.
they mirror innermost thoughts and feelings..
, nonverbal communication is difficult, if not impossible, to fake during an interpersonal interaction.
your nonverbal communication must be consistent with your verbal communication or people will be suspicious of the intended meaning of your message.
When analyzing nonverbal communication ,avoid focusing on just one cue. Look at all the nonverbal cues that you are receiving and use verbal communication to fully understand the meaning of the nonverbal behavior.

Elements of Nonverbal Communication

Important nonverbal elements discussed here include
1. kinesics (body movement),
2. proxemics (distance between persons trying to communicate),
3. the physical environment, and
4. potential distracting elements of nonverbal communication


Kinesics(body movement)
The manner in which you use your arms, legs, hands, head, face, and torso may have a dramatic impact on the messages that you send. In general, individuals from various societies use different body movements to communicate certain messages.
The key is to be aware of your tendency to close off communication through your body movements. For example, if during a consultation you suddenly have the impression that the patient is no longer interested in speaking with you, examine your body position to see whether it appears to be defensive.
To improve communication kinesics, consider the suggestions in the key components of kinesics:

1.eye contact (consistent, but not a stare)

2. Relaxed posture

3Appropriate comfortable gestures

4 Frontal appearance (shoulders square to other person)

. Slight lean toward the other person

6 Erect body position (head up, shoulders back)

Proxemics

The distance between two interacting persons plays an important role in nonverbal communication. Proxemics, the structure and use of space, is a powerful nonverbal tool. The ideal space is about 0.5-1 meter.

Patients usually indicate nonverbally whether they feel comfortable with the distance . The type of instructions that you need to give to the patient will also affect the distance. For sensitive issues, such as explaining the use of a rectal or vaginal medication, you may need to enter the patients private zone, especially if others are around.
Ideally, the pharmacy setting should provide various levels of privacy so that both the sender and the receiver of messages feel comfortable.

Environmental nonverbal factors

A number of environmental factors play important roles in communicating nonverbal messages to patients.
For example,
the colors used in the pharmacys decor,
the lighting, and
the uses of space .
the use of the prescription counter is an important environmental factor.
In addition, the presence of a private consulting area may indicate to your patients that you are interested in counseling them in a private manner.
The general appearance within the pharmacy setting conveys nonverbal messages to patients. Dirt, clutter, and general untidiness carry negative nonverbal messages. These messages influence patient perceptions about your professional role and your level of interest in serving your patients.
In addition, the physical characteristics of pharmacy employees also send nonverbal messages to patients.

Distracting Nonverbal Communication

One of the most distracting nonverbal elements is lack of eye contact.
Unfortunately, many pharmacists unconsciously do not look at patients when talking to them. Their tendency is to look at the prescription, the prescription container, the computer screen, or other objects while talking. This behavior may indicate to patients that you are not totally confident about what you are saying or that you really do not care about speaking with them.
Not looking at the patient also limits your ability to assess whether the patient understands the information. In other words, lack of eye contact limits your ability to receive feedback from the patient about the messages that you are giving.
Another potentially distracting nonverbal element is facial expression. An inadvertent facial expression may send a message that you did not intend to transmit.
Another potential distraction to communication may be your tone of voice. People interpret the message not only by the words you use, but also by the tone of voice you use. For example, a comment in a sarcastic or threatening tone of voice will produce a different effect than the same phrase spoken with an empathic tone.
An inappropriate tone of voice may create an entirely different meaning from the one intended.

Detecting Nonverbal Cues in Others

Assessing the meaning behind the nonverbal messages of others is difficult, because we tend to interpret nonverbal cues based on our own personal backgrounds and experiences. We filter these
messages based on our personal orientation and experiences. The meaning of the nonverbal messages that we receive may or may not be the meanings intended by the sender


Dealing with Sensitive Issues
Some elderly and physically ill persons may have limited or impaired sense capabilities that will influence how they communicate nonverbally. The following example illustrates this point.

Case study 3.1

During his first externship experience in a community pharmacy, a pharmacy student (Ali) was assigned the task of receiving new prescriptions from patients. He wanted to help the patients and was looking forward to the opportunity of talking with them about their problems. One day, Mr. Ahemad approached the prescription
counter to have his prescription for levodop a refilled. Ali, who did not realize that Mr. Ahemad had Parkinsons disease, noticed that his hands were shaking and commented, I see you are a bit nervous today, Mr. Ahemad. Whats the matter?Ali observed a nonverbal message (rapid hand movement) from Mr. Ahemad and assigned a wrong (and embarrassing) meaning to it. Ali should not have jumped to the conclusion based on just one nonverbal cue but should have noticed that Mr. Ahemads head was also moving and that he walked with a shuffled gait characteristic of Parkinsons disease.

This example illustrates that we need to adjust our communication in accordance with the messages that nonverbal cues are sending us.

It is interesting to note that a found that embarrassment was the most common reason why consumers did not approach their health care provider. A wide variety of embarrassing issues could exist within practice, including incontinence, sexual dysfunction, depression, menopause, hemorrhoids, contraception, and
breast or prostate cancer.
As a pharmacist, you should be prepared to recognize situations that may be sensitive areas for patients. You should be comfortable discussing such matters in a nonthreatening way and in a nonverbal environment that conveys confidentiality and privacy. Here are some tips and tactics to help with sensitive situations.

1. Watch your patients. Before engaging in a conversation, watch their behavior to get a clue about their feelings. They may appear to be embarrassed before they reach the prescription counter.
2. Discuss sensitive issues with clarity and avoid potentially frightening scenarios. For example, you may bring up the subject of incontinence by saying,
Miss Smith, we have many women who get their prescriptions from us
here for bladder control problems. While this problem is potentially embarrassing, there are several effective means to deal with it. Would you like to step away to another area and we can discuss it?
3. Be cognizant of the potential for non adherence. Many patients with sensitive issues do not follow their medical regimens as directed. Check medication refill rates and observe patient behavior when they are describing how they take their medications. If you suspect non adherence to medication regimens,. For example, you could ask How do you feel about taking this medication? This gives you an opportunity to watch and listen to both verbal and nonverbal messages.