Balm Reader Training Outline
AGENDA:
· Introduction
· Ethics and Confidentiality
· HIPPA
· Patient interaction
· Health and Sanitation
· Reading Tips
· Reading Exercises
· Post-Test
The Balm Reader
Promoting health through literature
Mission Statement:
To work with local health care facilities in promoting patient health through bibliotherapy- The use of selected reading materials as therapeutic adjuvants in medicine and in psychiatry.
Bibliotherapy: The use of selected reading materials as therapeutic adjuvants in medicine and in psychiatry.
To provide pre-health students the opportunity to interact and gain experience with patient care
To promote public health as a whole
Background: Originated in 2012 as a Creative Inquiry project at Clemson University
Student-led project; works selected for the Balm Reader based on recommendations from students, English faculty, librarians, health care workers and patients
Ethics and Confidentiality
Informed Consent: Script
Informed consent is the process by which a fully informed patient can participate in choices about her health care. It originates from the legal and ethical right the patient has to direct what happens to her body and from the ethical duty of the care taker to involve the patient in her health care. Before you arrive at the health organization where you will be reading, you will receive a script that will direct your interaction with the patient. Since we do not have an Informed Consent Letter that patients will be required to sign, it is imperative that you follow the script as closely as possible in order to ensure that the patient is fully informed before you begin reading. If the patient does not wish to participate in our program, or if he or she asks to stop at any point, it is imperative that you respect his or her decision and act accordingly. ONE THING TO CONSIDER: If someone is unresponsive, then you will not be able to go through the script with them. You may encounter a situation like this in a hospice facility, for example. If this is the case, please speak to a staff member or care taker about the patient beforehand in order to select the best reading. Even though someone is not responsive, it does not mean that they are unable to hear.
TAKE SOME TIME TO REVIEW THE SCRIPT.
Respect and Humanity
Health Services is a helping profession. In this role, you need to treat the patients with utmost respect. They are not just “a service project” or “volunteer hours,” they are human beings and they deserve to be valued and treated with kindness and dignity.
Privacy and Confidentiality
When you are reading to individuals in health and care facilities, it is possible that you may acquire identifying information about that person and his or her health condition. You must protect the patient by keeping that information confidential and private. You may not share any information about the patients, even with friends. If you have a concern about one of the patients, you may direct your questions toward staff members of the health facility.
HIPAA
As someone who will be providing services in health and care facilities, you are required to abide by HIPAA regulations. If you do not, you could receive civil and criminal penalties. The organizations that you will be working with expect their health volunteers to be trained in HIPAA.
Health Insurance Portability and Accountability Act
· US Department of Health and Human Services
· Federal Law since 1996
· Regulates security and privacy of protected health information
o Privacy: an individual’s rights to control access and disclosure of their protected or individually identifiable health care information (IIHI)
o Security: an organization’s responsibility to control the means by which such information remains confidential
· Protected Health Information (PHI)
o Individually Identifiable Health Information (IIHI)
o Electronic, paper, oral
o Created or received by a health care provider, public health authority, employer, school or university
o Applies to health information of living and deceased
· Individually Identifiable Health Information (IIHI) is any information that is:
o Created or received by a health care provider, health plan, employer, or health care clearinghouse; and
o Relates to the physical or mental health or condition of an individual, the provision of health care to an individual, or the payment for the provision of health care to an individual, and
o Identifies or may be used to identify an individual.
o EX: name, address, etc.
· Any information that you collect about the patient must be safeguarded and submitted to the Balm Reader Secretary in a protected manner.
· You are required to keep confidential any information that the patient discloses to you that you are not instructed to collect.
· GO OVER THE DATA COLLECTION FORM.
Health and Sanitation
· When you are reading to people, you are responsible for helping protect their health and welfare.
· Maintain a high state of cleanliness and sanitation.
· If you are sick, DO NOT attend reading sessions.
· If you cannot find another Balm Reader to take your place, notify the health organization and the Balm Reader Student Organizational Leadership that you will not be able to keep the appointment.
Handwashing
· Video
· Important things to remember:
o Washing your hands properly is an easy way to help prevent the spread of germs
o The immune systems of the individuals who you are reading to may already be weakened; therefore, it is imperative that you follow hand washing guidelines strictly
o Wash hands thoroughly before and after the reading session
o Use plenty of soap and water
o Wash for at least 20 seconds
o Wash back of hands, palms, in between fingers, around nails and under jewelry
· Additional Notes:
o Wash hands in front of patient if possible.
o You may want to bring your own alcohol-based hand sanitizer
Patient Interaction
· Relationship
o This is the most important part of the interaction. Everything, even the reading, comes after this. Our job is to promote healing through literature, but that can’t happen without having a strong positive relationship between readers and patients.
· Cultural Competence
o The people who you read to may be from a different background, age, social class, race, ethnicity, gender, sexual orientation, etc. You have to assess these differences when you arrive and use cultural competency skills to bridge any gaps in communication. For example, if you are working with an elderly individual, do not walk in and say “What’s up?”
· Duration
o You may be assigned a reading duration by the Balm Reader Coordinator or by the organization. If you do not have an assigned duration, you can feel it out for yourself. Reading sessions typically last 30 minutes. Gauge this based on the patient’s energy and level of interaction.
· Reading Selection
o Use the script to help guide the reading selection process. It will be helpful to look over the selections in the Balm Reader beforehand to familiarize yourself with the works so that you can assist the patient in selecting an appropriate reading. You can use questions such as “Do you like poems, short stories, novels, etc.?” and “Would you like for me to read something comforting, entertaining, etc.?” Keep time in mind. Choose readings that are appropriate for the length of time that you have together. For example, if you have 30 minutes to read to a patient, you could read a short story and some short poems or read a long novel excerpt.
· Unplanned Circumstances
o When working with people, there are always unplanned circumstances that could arise. Examples would be: the patient denying to be read to, the patient falling asleep during the reading, the patient asking you to stop reading during the middle of your session, the patient being confrontational toward you or the patient’s family arriving. In cases like these, it is important to use your best judgment on how to handle each of these situations. In accordance with Balm Reader policies, if a patient asks you to stop reading at any time, you must honor his or her wishes. If the family of the patient arrives, this may also be an appropriate time to stop the reading, unless they ask you to stay. If the patient falls asleep during the reading session, you may feel free to continue the reading anyway, especially if you are halfway through the session or more. Use your discretion. If a patient is being confrontational toward you, retain your composure and continue to act in a polite, professional and patient manner. If you feel uncomfortable, you have the option to ask the patient if they would like to terminate the session or seek help from a staff member.
· Don’t take things personally
o Continuing on from the last bullet point, you must learn not to take things personally. Many people in health and care facilities are in pain and may not always be in a gracious mood. Keep this in mind during your interactions.
· Volume and Positioning
o Before you get into the reading, make sure that the patient can hear you by asking “Can you hear me well enough?” Adjust your volume according to his or her response. Position your self toward the client so that you are facing them and so they can see you, but do not sit on the patient’s bed. This should enhance your communication and it will be helpful for those who need to lip read in order to understand. (DEMONSTRATE APPROPRIATE POSITIONING).
· Environment
o During our interactions, the goal is to create a healing environment. We can do this through our words, actions and attitude.
· Attitude
o When you attend a reading session, it is very important that you have a positive and friendly attitude.
· Professionalism
o You are representing The Balm Reader organization and your university when you attend reading sessions. You are expected to act in a professional manner. This means that you will be dressed professionally, arrive promptly and maintain a professional attitude. As Balm Reader representatives, your professionalism and attitude contributes to the relationship between The Balm Reader and the health facility, which is imperative in order for The Balm Reader to continue to offer reading opportunities. Also, do not hesitate to return patient-initiated touch. For example, a comforting gesture such as placing your hand on someone’s shoulder. However, you may not touch a patient for any medical reason. For example, if a patient is hooked up to an oxygen tank and the nose piece falls out, seek the help of a staff member instead of trying to fix it yourself. Be professional and appropriate in your interactions.
· Other Options
o When you go in for a session, it is possible that the patient who you are working with may be more interested in just talking to you than listening to a reading. If you sense that this is the case, than you may use your best judgment to direct the interaction between you and the patient. As we mentioned before, the relationship is the most important component of the interaction, so if the patient just wants to talk, than you may respect that wish, keeping professionalism and confidentiality in mind.
· Logistics:
o A coordinator from The Balm Reader contact you regarding upcoming reading opportunities so that you may sign up for them. The Coordinator will let you know if there is a copy of the Balm Reader at the organization that you will be visiting, or if you will need to pick up a copy to bring with you. The Balm Reader will be categorized by the type of work (poem, short story, novel excerpt, religious text, etc.) and identified as being related to healing, comfort, inspiration or entertainment. (TAKE TIME TO FAMILIARIZE TRAINEES WITH THE BALM READER.) If you complete more than 5 reading sessions per school year, you will be considered as an active member of The Balm Reader Student Organization for that year; however, you do not have to be an active member of the organization to volunteer for reading sessions. Information collected during your reading session on the data collection sheet should be submitted to The Balm Reader Secretary after each reading session via email (you will need to scan it in).
Reading Tips
· Prepare and practice beforehand
· Speak up
· Move Your Mouth: this will not only help you to annunciate well and prevent you from mumbling but will also help patients that are hard of hearing and need to rely on reading lips
· Nonverbal Cues: Use gestures and expressions to give the story emotion
· Relax: take a deep breath before starting and bring a positive and relaxed attitude into the room with you
· Pace Yourself: Don’t rush through the reading
· Speak Slowly and Clearly
· Control Your Breathing: Make sure you aren’t holding your breath so that you don’t have to take big gasps. Breathe during appropriate pauses.
· Use Pauses Appropriately: Pause when there are commas and periods.
· Have Confidence
· Read Expressively: Do not be monotone; add emphasis to certain words to give them meaning
· Practice: Practice cold readings and read often outside of the program. The more you practice reading aloud, the better you’ll be.
· Have Conversations During Your Session: Make the experience interactive. Your purpose is to bring comfort to patients, whether that means reading them a story or engaging them in an interesting conversation.
· Vocally Distinguish Characters: Give the story life and help the listener better understand the dialogue. If the patient’s eyes are closed, use your voice for expression.
Reading Exercises
· Emotional Words
o Confused
o Angry
o Ecstatic
o Depressed
o Surprised
o Stressed
o Betrayed
o Cheerful
o Hopeful
o Horrified
o Terrified
o Excruciating
· Tongue Twisters
· Cold Reading in front of others
Recap
¡ Review procedures
¡ Sign up for Balm Reader Sessions
¡ Review Script and Balm Reader
¡ Arrive promptly
¡ Check in with Staff Contact
¡ Review Balm Reader
¡ Gain a sense of your patient
¡ Use the script to guide interaction
¡ Complete Data Collection Sheet
¡ Submit Data Collection Sheet to the Balm Reader Student Government
Post-Test
¡ Need a 70% or higher to be certified.
¡ Once you complete your post-test, raise your hand and the Facilitator will come grade your post-test.
¡ When you pass your post-test, you will receive a certificate that verifies that you are a certified Balm Reader.
¡ You will receive a follow-up email shortly after certification that will give you information about how to volunteer for reading opportunities.
Congratulations!
o You are now a Balm Reader!
o Please collect your certificate before you leave.