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The Pharmacy Technician
FOUNDATIONS AND PRACTICES
Chapter 3
Communication and
Customer Care
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 3.1
The communication process.
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Sender and Receiver
• The sender
– Initiates communication
– Makes a statement or asks a question
• The receiver
– The individual to whom the sender is
transmitting a message
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Message and Channel
• The message
– The information provided by a sender
• The channel
– The mode or "medium" in which a message is
delivered
– May be written, spoken, or nonverbal (body
language)
– The channel may affect how the message is
interpreted
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Feedback
• Reverses the communication process
• The initial receiver becomes the sender
•
and vice versa
In effective communication, the process
continues to reverse back and forth
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Context
• Refers to the situation, or environment, in
•
•
which the message is delivered
Multiple contexts may be involved in one
communication scenario
Like the channel, context affects how the
message is interpreted
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 3.2
Verbal communication.
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Verbal Communication
• Auditory: that which is spoken or said
• Includes:
–
–
–
–
–
tone of voice
inflection
pitch (volume level)
pronunciation (diction)
word choice
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Tone of Voice
•
"The insurance company denied the
prescription."
– Use a sympathetic, caring tone of voice
– Use a monotone, impersonal tone of voice
– Use a condescending, aggravated tone of
voice
• One statement, three different messages
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Inflection
• Exaggerated pronunciation of a specific
word or phrase
– "The insurance company denied the
prescription."
– "The insurance company denied the
prescription."
– "The insurance company denied the
prescription."
• One statement, three different messages
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Pitch
• The volume at which a person speaks
• Too soft signifies weakness or uncertainty
• Too loud signifies aggression or hostility
• Important factor in dealing with geriatric
patients
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Hints for Effective Face-to-face
Communication
• Smile; be a pleasant individual to
•
•
communicate with
Speak clearly and at an appropriate
volume
Use professional and appropriate tones of
voice, inflections, word choices, and
diction
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Hints for Effective Face-to-face
Communication (cont.)
• Use active listening techniques when
•
•
•
someone speaks to you
Acknowledge the speaker by nodding your
head
Do not interrupt while someone is
speaking
Ask questions to ensure that you both
completely understand the conversation
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Hints for Effective Telephone-based
Communication
• Use a pleasant and professional tone of
•
•
voice
If answering a phone call, state your name
and place of business, and ask how you
can help the caller
If making a phone call, explain your need
or objective
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Hints for Effective Written
Communication
• Slow down and think about the message
•
•
•
you are writing
Ensure that your handwriting is legible
Use correct grammar
Rewrite a message if you have hurriedly
taken notes
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Nonverbal Communication Overview
• The most underestimated type of
•
•
communication
Research indicates that up to 80 percent
of communication is nonverbal
Most individuals are unaware of their
nonverbal cues and messages
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Examples of Nonverbal Communication
• Facial expressions—communicate
•
•
•
emotions such as happiness, anger, or
surprise
Gestures—can communicate thoughts,
requests, or strong emotions
Eye contact—communicates interest or
disinterest in the dialogue
Posture—communicates confidence and
energy level
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Examples of Nonverbal Communication
(cont.)
• Personal space—communicates level of
•
•
comfort and trust with an individual; may
also be a cultural norm
Body movement—can communicate
disinterest, agitation, or desire to close the
communication as soon as possible
Silence—can deliver either positive or
negative feedback, depending on the
context of the communication
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 3.4
Language barriers.
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Language
• Caused when patient or co-worker is
•
unable to speak or understand English
Affects one out of every five people in the
United States
– 21 million people in the United States speak
English less than adequately
– 46 million people in the United States do not
speak English as their primary language
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Overcoming Language Barriers
• Speak the native language, if possible
– Use a guidebook of common phrases
– Take a community college language course
• Offer to use a translator
• Provide written instructions in the patient’s
•
native language
Computer systems in most pharmacies
can print prescription labels and drug
monographs in almost any language
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 3.5
A hearing-impaired person will often wear a hearing aid.
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Hearing Impairments
• Deafness—little or no residual hearing
•
•
capability; the person is unable to hear
Hard of hearing—partially unable to hear
and typically requires hearing aid(s)
Unilateral hearing loss—hears normally in
one ear, but has trouble hearing out of the
other ear
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Tips for Working With Patients Who
Have Hearing Impairments
• Look directly at them when speaking
• Speak louder
• Reduce background noise
• Learn sign language
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Illiteracy
• 40–44 million American adults have
•
difficulty using the reading, writing, and
computational skills considered necessary
for everyday life
Individuals who lack sufficient reading and
writing skills feel embarrassed and are
hesitant to reveal their struggle to others
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Illiteracy (cont.)
• Patients who are illiterate are at significant
risk of improper medication administration,
and thus may experience serious adverse
effects
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Tips for Working With Patients Who Are
Illiterate
• Always have the pharmacist provide
•
•
counseling for new prescriptions
Always ask patients if they have any
questions
Watch for indicators of low-level literacy
skills
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Be Prepared!
• Pharmacy technicians must deal with
•
•
patients who speak little or no English
The pharmacist must counsel patients on
their prescriptions
However, technicians are the frontline
employees who communicate with
patients directly
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Bilingual Benefits
• A great need for pharmacy professionals
who speak other languages fluently
–
–
–
–
Spanish
Vietnamese
Chinese
French
• Increased marketability and earning
potential
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Defense Mechanisms
• Unconscious behaviors or reactions
•
•
prompted by anxiety
Tend to distort, transform, or otherwise
misrepresent reality
Nine primary defense mechanisms
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Types of Defense Mechanisms, Part 1
• Denial—avoid problem by denying its
existence
– "I don’t have to take this medicine because
I’m not really sick"
• Displacement—transfer of negative
emotions to someone or something else
completely unrelated
– Irrational anger at pharmacy technician due
to bad day at work
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Types of Defense Mechanisms, Part 1
(cont.)
• Intellectualization—deal with conflict/stress
by making generalizations
– "How long does it take to put 30 tablets into a
bottle?"
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Types of Defense Mechanisms, Part 2
• Projection—occurs when thoughts or
impulses are attributed to another person
– Prejudiced patient complains that pharmacist
of another race treats him with disrespect
• Rationalization—apparently logical
explanation offered for inappropriate
actions
– "If one tablet is good, then two tablets are
even better."
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Types of Defense Mechanisms, Part 2
(cont.)
• Reaction formation—goes to the opposite
extreme or overcompensates for
unacceptable impulses
– Patient confronted for requesting an
unnecessary number of prescription drugs
stops taking any medications at all
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Types of Defense Mechanisms, Part 3
• Regression—loss of development already
attained; return to a lower level of behavior
– Adult suddenly becomes "incapable" of taking
tablets and requires all medication in liquid
form
• Repression—exclusion of painful thoughts
or memories
– Patient immediately changes the subject
when asked about death of spouse
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Types of Defense Mechanisms, Part 3
(cont.)
• Sublimation—redirects unacceptable
impulses or emotions into socially
acceptable outlet or channel
– Patient diagnosed with debilitating disease
begins to work excessive hours
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Conflict Resolution
• Get assistance from pharmacist or
•
•
pharmacy manager (best solution)
Transform problems into creative
opportunities
Develop communication tools to build
rapport
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Conflict Resolution (cont.)
• Apply strategies to attack the problem, not
•
•
the person
Identify personal issues that may cloud the
picture
Evaluate problem in broader context
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Universal Keys to Eliminating
Communication Barriers
• Understand the communication process
– Sender → Message → Channel → Receiver
→ Context → Feedback
• Recognize that numerous barriers to
communication exist
– Language → Hearing Impairment → Illiteracy
→ Defense Mechanisms
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Universal Keys to Eliminating
Communication Barriers (cont.)
• Know strategies for overcoming
communication barriers
– Be prepared but be flexible; no single
strategy will work in all situations
• Be willing to recognize and address
communication barriers as they arise
– Most important factor
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Patient Rights
• Right patient
– Prescription must be labeled, dispensed to,
and billed to the right customer
• Right medication
– Prescribed medication must be accurately
interpreted and dispensed
• Right strength
– Dosage prescribed must be accurately
interpreted, labeled, and dispensed
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Patient Rights (cont.)
• Right route
– Intended dosage form, or route of
administration, must be used
• Right time
– Proper directions for administration must be
correctly interpreted, labeled, and explained
to the patient
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Greeting Customers
• The pharmacy technician is usually the
•
•
•
first and last person to speak with a patient
As much as 75 percent (or more) of the
communication at the pharmacy will be
with the pharmacy technician
Most patients who come to the pharmacy
are sick or otherwise unwell
It is important to greet customers in a
timely, caring, and positive manner
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Tips on Greeting Customers
• Smile
• Speak and act sincerely
• Look at your customer attentively
• Introduce yourself and ask for your
customer’s name
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Protecting Confidentiality
• Confidentiality in pharmacy practice is
•
•
required by law
Every piece of data or information
pertaining to a patient is considered
confidential
Personally identifiable information must be
kept safe and secure from nonessential
personnel
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Protecting Confidentiality (cont.)
• Patient profile and medication history must
•
be kept private and used for pharmacyrelated issues only
Information regarding medical conditions
must not be released to anyone without
patient permission
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 3.6
A pharmacist consults with a patient.
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Pharmacist Consultation
• Provision of advice, instructions, or other
clinical information falls outside the scope
of practice for pharmacy technicians
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Pharmacist Consultation (cont.)
• Activities that require a pharmacist
consultation include any:
– New prescription that a patient has not
previously taken
– New prescription or refill that has any
changes from a previous dispensing
– Prescription or refill that flags a drug
utilization review (DUR)
– Request by a customer or patient to speak
with the pharmacist
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Respecting Cultural Differences
• Understand that the United States is a
•
•
"melting pot" of many cultural and ethnic
groups
Physical boundaries, greetings,
salutations, attire, and even medical
beliefs may be different from group to
group
Be attentive to customers and respect
their preferences
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 3.7
The age of a patient is a special consideration in pharmaceutical care.
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Age
• Generally becomes a factor with patients
•
•
at extremities of age—pediatrics and
geriatrics
When providing care for pediatric patients
(under age 12), communicate with the
parent or guardian
When providing care for geriatric patients
(the elderly), communication may be with
patient or a designated caregiver
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.