Essay On Rapport Building

The Role of Rapport Building for Paramedics

Effective communication plays a very large and important role in the field of paramedic practice. Not only is communication vital for the outcome of the patient, but it is also important in providing treatment which is satisfactory to the patient themselves (Curtis, Ramsden, & Lord, 2011). This essay will aim to accurately define and describe the skill of rapport building, as well as provide a look into the importance of rapport building in providing quality treatment and positive patient outcome in the context of paramedic practice. It will also provide a reflection on the author's attempt at rapport building during an interview with an experienced paramedic, in order to identify how well they performed in this skill, and where any alterations may prove to be useful in effective communication in

their future as a paramedic.
Definition and Description of Rapport Building
Rapport building often takes place at the beginning of an interaction. However, it can also be something which is strengthened throughout the course of the entire interaction. It is the use of verbal and nonverbal communication skills, and empathy, to form a peaceful and trusting relationship with the person one is trying to communicate with (Kieckhaefer, Vallano, & Compo, 2013). A main aim of rapport building, especially in a clinical setting, is to try and have the person one is communicating with disclose pertinent information which will meet the goals of the interaction (Duggan & Parrott, 2006). For example, a paramedic will try and build a rapport with their patient with the intention that this will make the patient more comfortable with them. Therefore, they will be more likely to disclose a higher volume of accurate information about their ailment, as well as their history, for paramedics to form not only an accurate diagnosis, but to also provide them with sufficient information to give to staff upon their arrival at hospital (J. Dunn, personal communication, April 8, 2015).
According to Duggan and Parrot (2006), an important element to rapport building is the appropriate use of body language at the correct times. Gregory and Mursell (2010) also advise that a vital aspect of rapport building in the context of paramedic practice lies in the introduction that the paramedic provides to the patient, such as shaking the patient’s hand, using their name, and having a generally open and warm demeanour.
Verbal encouragers, such as saying “Ah”, and “Yeah” whilst the patient is talking can also build rapport as they show the patient that their words are being heard and they are being encouraged to continue (Hazelwood & Shakespeare-Finch, 2010).
An interview with paramedic Jessica Dunn revealed that non-verbal communication skills in particular play a significant role in keeping the interaction with patients smooth, and allowing rapport to be continuously strengthened throughout the time a paramedic spends with their patient (personal communication, April 8, 2015). Dunn also specified that the use of body language helps maintain the rapport, such as refraining from crossing one’s arms when addressing a patient, as well as being sure to maintain eye contact. If a patient is sitting down, it is also important to get down onto their level in order to achieve effective eye contact.
Rapport building can also be strengthened through empathy. Empathy is considered an important skill for a paramedic to have. It is the ability to see a situation from the point of view of another. For example, in a paramedic practice context, this would be the paramedic’s ability to see how a situation may be coming across to their patient and how it could be affecting them personally, rather than the paramedic just considering the situation from their own outsider’s viewpoint (Gregory, Ward, & Sanders, 2010). Through the use of empathy, a paramedic can make an attempt to relay to the patient that they perhaps have some kind of an understanding of what they are going through at that point in time, thus gaining the patient’s trust, making them feel more at ease around the paramedics, and therefore strengthening the rapport.
The Importance of Rapport Building
Rapport building is an important factor in almost all interactions between a health care provider and a patient. Lang (2012) states that the initial contact between a patient and a health care provider is absolutely crucial in determining how a patient will interact with their health care provider throughout their treatment. Whilst Lang’s writings are based off findings presented to them from patients undergoing treatment whilst in hospital, it can be assumed that the statement surely remains true when put into the context of a paramedic’s interaction with their patients. This is because paramedics are often called to patients whilst they are in their homes, and whilst they are quite vulnerable. Patients have to be able to trust paramedics, who are complete strangers to them, to come into their private living space whilst they are in a vulnerable state, and start asking questions which can often be very personal in nature. Considering that rapport building is the act of gaining someone’s trust during an interaction, it is easy to identify just how important rapport building is for paramedics whilst treating patients.
Health care professionals who have built a strong rapport with their patients tend to have better success with having their patients disclose important information (Duggan & Parrott, 2006). Having a patient disclose all important information to paramedics is a vital aspect of patient care. Paramedics build a possible diagnosis and treatment plan based off not only obvious symptoms they can observe, but also from other information a patient discloses to them which can reveal hidden signs and symptoms pointing towards a different diagnosis than what was initially considered by paramedics.
Potential Consequences of Ineffective Rapport Building
As rapport building is such a crucial element when it comes to treating a patient, there can be quite significant repercussions should rapport building fail. If a patient does not trust the paramedic treating them, then they can be prone to potentially closing off and not disclosing all relevant information the paramedic may require to efficiently treat them. Furthermore, a lack of necessary information provided to a paramedic can affect the patient’s treatment after they leave the care of paramedics.
As Dunn commented, if paramedics have not established much of a rapport with their patient, thus potentially not having acquired adequate information from them, then the content of their handover is going to be quite minimal. This means hospital staff will potentially lack important information about the patient, and cause them difficulties in their ongoing treatment for that patient (personal communication, April 8, 2015). Dunn also indicated that mentally ill patients can prove to occasionally react negatively if a paramedic does not build a good rapport, as they often are not happy with the paramedic’s presence in the first place. This is a time where good rapport building, whilst it may be more difficult than usual, is crucial to effective patient care, as well as, at times, the safety of the paramedic and others. If the paramedic makes a communicative error, it could upset the patient to such a degree that they may become violent towards them and bystanders.
Whilst paramedics may be tempted to address people using ‘darling’ or ‘sweetie’ to assist in rapport building, this may cause issues. The patient may take these terms the wrong way (Gregory & Mursell, 2010), which could cause a breakdown of any rapport the paramedic had built up, and may lead to the patient shutting off and ceasing their co-operation.
Reflection
During my interview with Jessica Dunn, many of these rapport building skills were displayed. I incorporated the use of verbal encouragers throughout my interaction with Ms Dunn, maintained eye contact, kept my body language relaxed and attentive, and I kept my demeanour open and engaged by smiling at appropriate times and nodding along to her words. At the beginning of the interview, I also made sure to thank her for taking the time to help me with the video, as well as to let her know what my aims were, so as to be sure that we were both on the same page.
Ahead of the interview, I knew that rapport building was potentially going to be a challenge.

As I have a tendency to be quite shy, I often have difficulty with meeting and communicating with new people. I found this was especially evident during my clinical placement as a student paramedic at another university. When dealing with patients, there were often long, slightly awkward silences as continuing a conversation away from clinical questioning was quite difficult for me. Upon looking back at the interview, I’m pleased to see that I displayed quite a number of rapport building techniques throughout my conversation, and this has given me hope that my skills are perhaps improving as I mature.
I feel that the interview has given me a deeper understanding of the importance of communication in my future career, specifically rapport building. I’ve also gained an understanding of how to build an effective rapport with patients. Remembering things such as verbal encouragers and being sure to remain as close to eye-level as possible with my patients are really going to make all the difference in my future career.

Conclusion
From the information provided by research and an experienced paramedic, it is clear that communication plays a vital role in paramedic practice. Perhaps one of the most crucial communicative skills a paramedic can utilise is that of rapport building. The ability to build a solid rapport with a patient leads to a higher disclosure of information by the patient to assist in their treatment, as well maintaining order and peace during potentially stressful circumstances. The interview and research has provided the author with guidance on how to improve their own rapport building skills in their future as a paramedic, and an appreciation for the skill.