COMMUNCATION SKILLS

FOR THE PHELEBOTOMIST

Communication is such an important characteristic for health care professionals, that time
must be spent on understanding its importance. Phlebotomy like many professions in the
health care industry is people oriented. The client’s perception of the health care facility and
the expected quality of care revolves around the interaction they have with every member
of the health care team including the phlebotomist. The phlebotomist who lacks the ability
to communicate may also be at risk for litigation.

Definition: - a process by which information is exchanged between individuals through a

common system of symbols, signs, or behaviour (Merriam- Webster)

Communication Process

Figure 1.
Figure 2.

The goal of communication is to convey information—and the understanding of that

information—from one person or group to another person or group. This communication
process is divided into three basic components:

A sender or messenger transmits a message through a channel to the receiver. 

The sender first develops an idea, which is composed into a message and then transmitted
to the other party, who interprets the message and receives meaning. Developing a
message is known as encoding. Interpreting the message is referred to as decoding.

The channel is the medium through which the sender transmits the message. The three
main communication channels are auditory, visual, and kinesthetic. The visual channel
involves sight, which in turn allows for visual observation and perception. The auditory
channel consists of spoken words and other verbal cues. The kinesthetic channel refers to
physical sensations mediated by touch. Many people are aware of having a dominant
channel—one that they subconsciously rely upon more than the others to send and receive
messages— which influences the ways in which each individual communicates
The other important feature as seen in figure 1 is the feedback. Communication is rarely
one‐way only. When a person receives a message, there is a response. Otherwise, the
sender can't know whether the other parties properly interpreted the message or how they
reacted to it. This is termed the communication feedback loop.

Effective communication occurs when the intended message of the sender and the
interpreted message of the receiver are one and the same. Types of Communication

Verbal Communication –

The most common form of communication is by the spoken word. In the era of messaging
via Whatsapp or using email, people still prefer personal meetings or phone calls (or face to
face skype calls) because they are effective and much more convenient in conveying the
message.

Clear attention must be given to what is said to patients/clients. The phlebotomists ensure
that what is said is

 clear
 accurate
 honest
 appropriate (to the person’s age, language/culture and level of understanding)
 use of clichés must be avoided
 awareness of non-verbal cues is necessary

At all times the phlebotomist must be:

 Courteous and respectful: clients should be addressed as they wish to be addressed.

Some may prefer to be called by their first names, while others might want a more
formal address. Generally, ‘pet’ names – ‘love’, ‘dear’, ‘doll’ – shouldn’t be used.
 Encouraging: phlebotomists should try to prompt clients to communicate with them
by saying encouraging things to them – ‘yes, do go on’, ‘can you tell me a bit more
about that?’

Tone of voice is also important.

Patients feel they’re holding you back from other duties, if your tone of voice is irritated or
impatient. Things can get very busy in the health care setting, and the phlebotomist might
feel as if are being rushed. Always try not to let your irritation, tiredness etc. seep into your
voice, try to stay calm and focused on the patient in front of you.

 Active Listening

Listening is vital to good communication and is especially important for you as a health care
worker. Effective communication requires that the listener participate by focusing on what
is being said and giving appropriate feedback. This is active listening. The ordinary person
can absorb 500 to 600 words per minute, and the average speaking rate is about 150 words
per minute. The phlebotomist must focus on paying attention to what the person is saying
to interpret what is being said. And the best way to do this is to remain quiet but encourage
the patient/client to speak with gentle head nodding and, when appropriate, positive words
(‘yes’, ‘do continue’) and simple questions (‘and how did that make you feel?’). As you
listen, try to identify key words that might sum up how the person is feeling, words like:

 frightened, or scared
 lonely
 fed up, or ‘a bit down’
 pain, or discomfort
 worried.

When the person has finished speaking, reflect back to him or her what you’ve understood.
For instance, you might say something like this:

‘It sounds from what you’re saying, Mr Smith, that you’ve got some concerns about the test
you’re about to do, especially about whether it will cause you any discomfort. Would you like
me to explain the procedure again”?
Non-verbal Communication –

80% of language is unspoken. The study of non- verbal communication is called Kinesics. It
includes characteristics of body motion and language such as facial expressions, gestures
and eye contact. Body language is most often conveyed unintentionally and tends to be
more reliable than verbal communication. If verbal and non- verbal communication do not
match, called a kinesic slip, people tend to trust what is seen not what is heard. When
interacting with clients think about these four elements of body language

 Body posture (how we stand or sit): we’ll communicate much better when we bring
our face to the same level as the other person and do not tower above them if he or
she is in bed or a chair. We should be relaxed, not fidgety and impatient. And it’s
important that we adopt an ‘open’ stance, showing the person that we want to be
there and are not desperate to rush away and do something else – standing well
back from the person with your arms crossed and flicking your eyes constantly
towards the door isn’t exactly an encouragement to good communication!
 Eye contact: keep good eye contact with the person, but don’t stare – and
remember that for people from some cultures, making eye contact can seem a bit
rude. This emphasises the importance of knowing about the individuals we’re caring
for and learning how to approach them in the right way.
 Facial expression (Occulesics): so much of what we are thinking is given away by the
expressions on our face. We may not even realise we are rolling our eyes, grimacing
or stifling a yawn, none of which will encourage patients to keep talking to us. We
always need to be aware of our facial expressions and control them.
 Touch: touch is a very powerful means of communication. Lightly touching a person’s
hand can convey your concern and affection for them. But as with eye contact, the
touch must be appropriate, and there are important cultural issues around touch
that need to be understood. It’s also important that clients give permission for you
to touch them.

In addition, phlebotomist must observe the patient’s non-verbal cues. This usually reveals
what the patient is feeling, especially when they don’t say it verbally. For example, when the
patient is anxious, non- verbal signs may include tight eyebrows, an intense frown,
narrowed eyes or a downcast mouth.

A subtle but powerful part of non-verbal communication is the use of space. Every individual
is surrounded by what is called their personal space, that they are comfortable in. Proxemics
is the study of an individual’s concept of space. There are four territorial zones that are
usually evident in personal interaction

Territorial Zone Zone Radius

Intimate 1-18 inches
Personal 1 ½ -4ft
Social 4-12ft
Public More than 12 ft

In most cases, HCWs must enter a client’s personal or intimate space. If not handled
appropriately the client may feel threatened or insecure. Before making contact, the
phlebotomist should explain the procedure and allow the client to ask questions. During the
procedure, the phlebotomist should communicate constantly with the client, explaining
what is being done and why.

Note also that the phlebotomist appearance also sends a message.

Written communication –

There are many ways that written communications can be used. The number of ways is
changing and increasing with advancing technology as smartphones and the internet. One
of the most common forms of written communications used to date is Email. But slowly,
written type of communications is becoming more informal with Whatsapp and other online
messaging apps being used regularly. All different forms of written communication can be
formal or informal.

 Formal and official type of communication which can be emails, letterheads, memos,
reports and other such kinds of written material. These are considered as
documentary evidence
  Informal communication is one where there is nothing official about the
communication that is happening. It can be known as Grapevine communication

Barriers to Communication
Verbal

 Basic language barrier such as medical terminology or jargon

 Hearing impairment
 Age
 Tone of voice
 Language limitations
 Gender

Non-verbal

Slouching Crossing arms

Shrugging shoulders Wrinkling forehead

Rolling eyes, wandering eyes Chewing gums

Looking at the ceiling Repeatedly looking at the clock

Rubbing eyes Lining up objects on desk

Blinking excessively Stretching and yawning

Tapping foot, pencils Pointing a finger at someone

Sighing

Telephone Communication
The telephone is a fundamental part of communication, but can be an additional stress,
bringing additional work and uninvited demands. This affects how the phlebotomist
communicates over the phone. To promote good communication, proper telephone
etiquette should be followed. (See handout)

References
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management/communication-and-interpersonal-skills/the-communication-process

Bhasin, H., Anureet, Arun, Dapaah, Samiksha, Pommi, . . . Lashmi. (2018, April 14). Five Types of

Communication - Types of Communication. Retrieved from

https://www.marketing91.com/five-types-of-communication/

MCCALL, R. (2019). PHLEBOTOMY ESSENTIALS. Place of publication not identified: WOLTERS

KLUWER.

Raut, G. (2017, May 05). Non-verbal communication. Retrieved from https://rcni.com/hosted-

content/rcn/first-steps/non-verbal-communication

Raut, G. (2017, May 05). Quality in care. Retrieved from https://rcni.com/hosted-

content/rcn/first-steps/quality-care

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