July 22, 2007, 5:00 am

When to Say “It’s Okay”

ear

Holy cow!

What the heck is this?

“Hey! I can see your brain from here!”

Is this what they did before tiny otoscopes were invented?

If they tried to irrigate through that thing they’d blow the brain out of the opposite ear!

It looks like a toilet plunger.

A bit of overkill for ear wax….

*****

Remember the literary project that Maria put together at Intueri? #1 Dinosaur at Musings of a Dinosaur jumped in with a great addition! Here is Dinosaur’s take on “A Picture is Worth a Thousand Words“.

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I think I finally figured something out.

Every now and then I sense a feeling of suspicion or wariness from a patient or family member.

The feeling that they are watching me like a hawk.

Like they don’t quite believe what they are being told.

No matter how many times you reassure them that everything is okay, there is an unspoken response of “Oh really?”

And that is the problem right there.

*****

Reassurance.

If a patient is concerned enough to come to an emergency department, they want validation that seeking treatment was the correct thing to do.

They want to know that we empathize with their concerns, that we understand.

If the first thing out of our mouth is something to the effect of “oh, this is nothing”, the patient may believe they are not being taken seriously. They believe there is something to be concerned about and it makes them anxious that we don’t seem to see it.

*****

I know a physician who handles this type of situation naturally, and I’ve learned by watching and listening.

First, acknowledge that the patient’s symptoms present a concern to them and it is understandable why they would seek treatment. Even if it is a non-urgent issue – it is an issue to the patient.

Second, discuss why the patient is concerned (for example, the patient fears they are having a CVA when it is Bell’s Palsy or a heart attack when it is really costochondritis) and explain why the patient does not fit the criteria for that particular problem.

Finally, explain what the diagnosis actually is and what can be done to make the patient feel better, at that point reassuring the patient that everything is okay.

*****

I guess the moral of the story here is not to be so quick to hand out those reassurance platitudes. For some patients it is a sign that their concerns are being trivialized.

It is hard to view every situation from the patient’s perspective, especially in a busy emergency department. For some, the gift of empathy comes easily. Others need to occasionally remind themselves to empathize.

Being able to do so goes a long way in diffusing suspicion and gaining the patient’s trust.

I’ve seen it in action.

5 Comments

  • Jen
    Jen

    July 22, 2007 at 2:37 pm

    Just wanted to say that I love the way you have updated your blog! I think it’s a little easier to navigate (not that there was anything wrong with the old way, just prefer this new setup 🙂


  • BabsRN
    BabsRN

    July 22, 2007 at 2:49 pm

    Yes, Ma’am. I am actually one of those people who doesn’t trust anything but the honest, brutal truth – in a nice tone of voice, of course, but honest and straightforward nonetheless. I can’t respect anything less. And where I live, I’m surrounded by people who think the same way.


  • POPT
    POPT

    July 22, 2007 at 6:04 pm

    I’ve done acute hemodialysis treatments in hospitals with family members writing down everything I said and did. I agree with Babs. The honest, brutal truth told in a nice tone of voice is the way to go. I also see such times as opportunities for education of both staff and patients. I think when we are busy and distracted and have seen the same thing a gazillion times it is too easy to come across as trivializing the patient’s concerns.


  • Tyler
    Tyler

    July 24, 2007 at 6:43 am

    Validating customers’ concerns before solving their problems is important in any business, because if the customers don’t feel like their personal concerns are understood or appreciated, they will have less confidence, trust, and comfort in your ability to take care of them.

    It looks like a lot of the important aspects of good customer service in business are also present — and much more important — in healthcare.


  • jokergirl
    jokergirl

    July 25, 2007 at 5:09 am

    Thank you. This is one of the things that annoys me most about going to the doctor even for routine checkups – the feeling of not being taken seriously. Whether it is a legitimate concern or just curiosity – the attitude of “You haven’t studied medicine so you’re not going to understand this” is something that put me off a lot of doctors and makes me dread finding new ones every time. I don’t mind not knowing things, but I like to be informed.

    😉


About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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