2.1 Barriers to good communication

Learning Guide 12 from the OU’s K101 course (Open University, 2015) specifies that ‘Communication between two people often comes naturally. When communication is difficult, it is often because of some kind of barriers of one kind or another … Being aware of barriers, and developing ways of overcoming them are important in helping you to deliver effective care.’ (The Open University, 2015, pp. 108–9)

When communication is difficult, it is often because of some kind of barrier; being aware of barriers, and developing ways of overcoming them, are important in helping you to deliver effective care.

There are a number of communication barriers, presented in the K101 Learning Guide above (Open University, 2015), which you should consider when working as a healthcare assistant

• Physical barriers: ‘sometimes the way a building is designed makes it difficult to communicate. Noise, lack of privacy and busy environments where there are a lot of interruptions are barriers to communication.’ Consider also the way desks and chairs are positioned, as this can cause a barrier to communication; and it is also important to remember that dimly lit areas might make it more difficult for hearing-impaired patients to understand you’
• Attitude: ‘Some people are apprehensive about being able to communicate with professionals. This may be because of the technical language some professionals use. But it may also be related to the idea that professionals are busy: they may not have time or be interested in hearing what you have to say. Sometimes incorrect assumptions are made about communicating with people who have a disability. [This] can mean conversations are directed mainly at their carers. It is likewise important that staff have a positive attitude towards patients and don’t become defensive if a patient complains.’
• Emotions: ‘Communicating clearly can be a problem if we are feeling emotions such as distress or anger. Fear can prevent someone from making an initial approach for help. People may be so overwhelmed by their emotions that they struggle to interact with other people.’
• Cultural and language barriers: these ‘can be obvious if we are dealing with someone who does not speak or understand the same language that we do, but there may also be other hidden cultural differences about the way we use language. Language examples might include causing confusion when terms such as ‘passing water’ or ‘breaking wind’ are directly translated word-for-word because the meaning does not translate well.’ Cultural norms may mean, for instance, that many Japanese people have difficulty saying no, or that women may feel inhibited discussing personal matters with male medical staff.
• Illness, disability or pain: ‘Some people may have a disability and/or a sensory impairment, such as a sight, hearing or speech impairment, which makes communication [harder].’
• Memory loss or a learning disability: 'This [might make] it difficult for a person to understand information’, particularly that which is being communicated to them.

Other points to remember:

• Body language: it is important to consider how you are standing or sitting when communicating, as crossing your arms whilst speaking and listening, or looking at your mobile phone, will pose a barrier.
• Time: always try to make time for listening and communicating even though you may be very busy.
• Confidentiality: when communicating information that is sensitive or personal, it is important to find a private place and ensure you will not be interrupted.

Figure 3 The way you communicate with your body language is important

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The photo shows a male healthcare worker holding a packet of orange tablets in his left hand and pointing firmly with his right index finger at his patient. The patient sitting next to him is not making eye contact

Figure 3 The way you communicate with your body language is important

Occasional disagreement may arise between workers from different agencies or between the person receiving care and support and those providing them, and this can lead to conflict. This can be compounded by different personalities and temperaments, differences in beliefs and values, or strong feelings and emotions. Conflict in teams that is not resolved can affect the quality of care, so must be managed quickly and effectively.