Person/s seeking assistance
Most people feel apprehensive when entering a new environment for the first time. New environments typically stimulate unsure and hesitant behaviours. If the new environment holds unknown procedures and perhaps pain, there might even be feelings of fear and anger (Garcia Barreiro et al 2004). Investing time to familiarise people with a new
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environment can avoid any negative emotions related to the novelty of the environment and the unknown procedures associated with the environment (Purtilo
& Haddad 2007). In such situations it is helpful to imagine what the personal reaction of the health professional might be in a similar situation.
Knowing where to find toilets and other necessary facilities is reassuring, however, understanding what to expect during a procedure or intervention, or as a result of a particular need, is equally important.
Assisting the Person/s to become familiar with the environment – the facilities, people and procedures – is essential to ensure positive responses and out-comes (see Ch 3).
Health professional
There are times when health professionals may find themselves in unfamiliar environments when assist-ing a Person/s. Some of these environments may feel cosy and relaxing, while others seem daunting, smelly or cluttered. (A visit to the home of a Person/s who lives adjacent to a fertiliser factory does test the ability of the health professional to successfully com-plete their task in such an environment.) When visit-ing a Person/s in their home or takvisit-ing them to an unfamiliar environment as part of the intervention, it is important for health professionals to take the necessary measures to minimise their anxiety related to the novelty of the environment (e.g. outline every expectation and indicate the level of assistance avail-able). In such circumstances it is imperative that the health professional continues to respond with respect and empathy.
ROOMS
Furniture placement and physical comfort
Various factors require consideration when choosing the type of furniture and how to place the furniture within a room. Placement of furniture can encourage or discourage interaction. Chairs side-by-side facing the same direction do not encourage communica-tion, nor do they demonstrate interest and care. A desk between the people communicat-ing is not only a physical barrier, it is also an emotional barrier. Such a desk communicates a desire to keep others distant. It is important to avoid using furniture as a physical barrier when aiming at family/Person-centred practice. Arranging the chairs around a desk, a comfortable distance apart, so they face each other or are adjacent to each other promotes communication that is more personal. This configuration facilitates eye contact, which is valued in most Western cultures, although not in some other cultures. It is important to ensure that all communicating individuals are physically comfortable before the
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Have you ever sought assistance from a service about which you knew very little?•
How did you feel initially?•
What made you feel more comfortable?A person waking from a ten-day coma asks to ‘get up’ to go to the toilet. A helpful nurse returns a few minutes later with a commode chair on wheels. This is a standard procedure where the person transfers onto the commode chair and the nurse wheels the person and commode to the toilet cubicle. This is appropriate for someone who is weak from lack of sustenance and exercise. Upon seeing the commode chair the person bursts into tears and states I don’t want to go that much! in your health profession that might illicit a similar reaction?
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commencement of the interaction. If a table is required for placement of written material, a round table allows a clear view for everyone seated at the table.
Waiting rooms
Waiting rooms are often crowded and noisy. Regard-less of the busy nature of the room or the size of the room, there are basic principles that make a waiting room pleasant for those waiting. The colour of the room (paint and furniture), the texture and type of furniture, the lighting and ventilation create either a warm, welcoming atmosphere or a cold, clinical feeling. The first encourages a feeling of comfort, relaxation and safety, while the other feels impersonal and unfriendly. The first encourages people to linger, while the other encourages people to leave as quickly as possible (Northouse & Northouse 1992). The more impersonal the waiting room, the greater the likelihood of expressions of frustration and hostility (Purtilo & Haddad 2007). Such behaviour can result from personal factors or having to wait too long, but may also result from the impersonal or clinical nature of the environment.
The feeling of comfort gained from sitting or lying on particular types of furniture varies from person to person according to size, height, physical condition, age and gender. Equipping waiting rooms with varying types of chairs and mattresses can assist to overcome these personal variations. Ventilation and
natural light can contribute to the ambience of any room. However, sometimes these are not possible. In such cases it is important to consider the colour and type of furniture to create an inviting and comfortable environment.
Treatment rooms and rooms with beds
The same principles outlined for creation of an appropriate waiting room atmosphere also apply to treatment areas. However, it is important to consider additional environmen-tal factors when in such areas. Many treatment areas do not naturally facilitate confidential and private communication. It is important for health professionals working in such environments to consider individual needs for privacy.
The need for privacy may vary according to personality type and the emotional state of the individual at any given time. Consistent consideration of these needs will promote personal disclosure when required and the development of rapport. It is important to consider the difference between visual privacy and auditory privacy.
Drawing curtains around a treatment bed or a bed in a ward does not guarantee privacy. A private room will facilitate personal communication, while a public space will keep the communication at a superficial level in order to protect confidentiality.
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Consider the effect of your physical comfort on your ability to concentrate, understand and remember specific details. Can you concentrate regardless of your comfort?•
Decide on the best way to establish whether a Person/s is physically comfortable. Remember the Person/s is feeling vulnerable so they may not tell you directly they are physically uncomfortable. How will you know they are comfortable or uncomfortable?What might you do to make them physically comfortable if you establish they are uncomfortable?
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For each member of the group, list the colours and textures that create a feeling of comfort and emotional warmth. Have these changed with•
Consider the variations in personal age?taste.
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