By Crystal Gustafson, RN
The one thing that most people can agree on about a hospital is that virtually nobody really wants to be there; patients would rather be at home and healthy.
This leads to stress, anxiety, pain, and fear in the hospital setting and unfortunately are all common emotions experienced not only by patients and families, but healthcare workers as well.
Below are seven tips that I’ve found work well with dealing with particularly anxious patients and family members both as a travel nurse and a charge nurse.
When dealing with anxious patients, the most important skill to learn is to listen. Most patients just want to know that you are listening to their concerns. People come into their room all day long talking at them and rarely ask them how they’re feeling. Take two minutes, preferably at the beginning of your shift, to sit down and talk with your patient. Ask open-ended questions like “how are you feeling?” or “is there anything that I can do to make you feel more comfortable?”
The majority of patients with anxiety are not frequent fliers — they don’t know the hospital routine like some of your other patients. Most people’s fear of the hospital comes from being in an unfamiliar environment and not knowing what to expect. To help minimize anxiety, let your patient know everything that you are doing and why you are doing it.
Also, before you enter the patient’s room, make sure you’re prepared. Bring with you any new medication hand-outs and be able to explain the rationale behind administering all of them. Prepare your patients on what to expect with any procedures that will occur that day or the next. If you can’t answer all of their questions, then find someone for them who can.
Do not tell someone who is anxious to relax. IT DOESN’T WORK. Instead, ask them what you can do to help them relax.
Some patients will be able to tell you what they need. If they cannot tell you, then help them with some relaxation techniques. Give specific directions like “breathe in through your nose and out through your mouth.” Take some vital signs to make sure the patient isn’t anxious for a medical reason. Dim the lights. Ask family members to step out for a moment to let the patient rest. Also, consider offering the services of the chaplain, a cup of tea, or a warm blanket.
Let the patient and/or family members know that you will be checking in with them or “rounding” on them every hour to make sure everything is okay. Explain the plan of care including medication schedule, repositioning, or procedural preparations for the day/night. Introduce the on-coming nurse during report and reassure the patient that they’ll be in good hands.
Make efforts to lighten the mood and be personable. Ask patients about their lives — how many kids/grandkids do they have, where are they from, how they met their spouse, etc. This helps do two things: one, it gives patients something to focus on besides their current situation and anxiety, and two, it’ll make them more comfortable with you, which also lessens stress.
If in report you get a particularly anxious patient or family member, then prepare yourself to “practice your patience.” Use this as an opportunity to train yourself to remain calm in stressful situations.
Also, know how negative emotional responses like anxiety or fear are activated in your body. Maybe it’s a knot in your stomach, a fast heart rate, or tense muscles. Recognize these feelings and take a few deep breaths before heading into your next task.
Be aware of your own biases or assumptions. We all have conscious and unconscious beliefs about how people should or should not behave in certain situations. But, the truth is that unless you’ve actually been in that situation yourself, you shouldn’t judge how someone else should feel or act. Do your best to put yourself in their shoes.
Patients have every right to be anxious — being in the hospital is scary. But, learning how to manage stress in yourself and others is a unique skill that you’ll carry with you throughout your life, not just on shift.
Crystal Gustafson is a Critical Care Registered Nurse who spent time as a travel nurse in various states including Arizona, Texas, Florida and California. She has recently accepted a system wide float pool position with Exempla Healthcare System in her hometown of Denver, Colorado and also has a blog about prevention and education in healthcare. You can learn more about Crystal on her blog.