August 25, 2017
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Nonye Aghanya, NP, RN & Rachel ChinQuee MSN, RN
As nurses we may not realize that our patients view us as their source of truth. On one hand it is extremely empowering, in other ways it is complex and hard to navigate.
I wanted to write a post to help nurses address some complicated scenarios to support the nurses to look competent/compassionate.
In order to help me in the writing of this post, I sought the help of Nurse Practitioner Nonye Aghanya, who is the author of “Simple Tips to developing A productive Clinician-Patient Relationship”.
Many of us excel in ensuring our patients leave our care better than they were before, but we stumble when it comes to those tough or awkward questions patients tend to ask. We all go through this and here are a few tips on how you can combat these popular patient questions:
What are my test results?
Patients and their family members usually aren’t aware that there are boundaries on our scopes of practice. Even though we would love the whole world to be educated on what a Nurses do, that more than likely will not happen any time soon.
Depending on the position a nurse holds, they may not be able to provide a patient with their test results. Many patients find this to be annoying, mainly because their physicians are so hard to reach and they want to know the impact of their results on their lives!
I strongly empathize with patients and nurses on this issue. While patients want to know, nurses aren’t allowed to tell nor can we control when the doctor will show up.
Despite the fact that we are not in control, I cringe when I hear nurses brush patients off telling them that they cant tell them their results and the doctor will have to let them know.
Here is how you can answer the classic question of “What are my test results?”
As a nurse your response should reduce the patients anxiety by showing them that you care and you are advocating for them.
A sample response would be:“Dr. Smith will give you the results, he/she normally comes to this unit between 8-10am unless they have an emergency for another patient, I will make sure he/she checks your results and that they come to speak with you”.
Answering their question in a positive way rather than acting like its not your job helps to reduce the patient feeling anxious. After all, the test results are for their body and their lives that will be impacted by these results, wouldn’t you be annoyed if it appeared to be a secret?
A Patient Starts Crying:
This was always tough for me as a patient tech and bedside nurse. I never knew what to do when patients were crying because every one deals with sadness in different ways. Many of us work in areas that patients are there because they’re sick, that is not news flash to many of us but considering the impact of that illness on a patient’s entire life may not always be at the forefront of our minds.
When some one starts crying the best thing I have found to do is to ask the person if you can do anything for them. Take these examples and do what you are most confortable with:
Can I give you a hug?
Do you want me to pray with you?
Do you want me to explain what the doctor said?
Do you need some time alone?
Can I get you anything?
When patients realize that there is a genuine concern from the nurse, they become open to discussing the impact of their illness. We should maintain a positive outlook and give physical, emotional, and spiritual encouragement to our patients.
What Decision Should I Make:
So many times in my career patients or family members listen to what options in care their doctors give them, and the second the doctor is gone, they are asking me what decision they should make. I was always frozen when I got this question because I don’t want to give some one terrible advice that changes their life!
After a few years I learned how to manage these questions so that I didn’t come off like a jerk Nurse who was too busy to care or a decision maker in their lives. I would ask a few questions to support the patient into making their own decision.
Here is how I did it:
1. How do you feel about each of your options?
2. Which decision is most comfortable for you and your family?
3. Do you have any family members or friends who you can discuss this with?
4. Are there any resources I can get you to help you make a decision?
5. Do you want to think of a list of questions and come back and see the doctor before you decide?
Taking this route lets a patient know that you do care even though you can’t tell them which decision is best to make. It is ok to give them facts or statistics, but also be honest about side effects. Be general about the information that you give and always end it with if that works for you and your family.
I worked as a Hepatitis C coordinator and many patients would ask me if they should under-go curative medication regime and if it was “worth it”. This high dollar medication was often not covered by insurance at 100% and had life altering side effects with no guarantee of curing the virus. In this role I went through supporting most patients on how they could make the best decision for them selves while also being supported.
As nurses we are with our patients more than any other discipline, and ultimately our patients look to us as their guiding light in the confusing healthcare environment. While we are limited as to how we can respond or what we can do for our patients, we must always remember that we are advocates for our patients.
If you want more help on learning how to communicate with patients pick up Nonye’s book “Simple Tips to Developing A productive Clinician-Patient Relationship”.
Much Love,
Rachel
www.nursealot.com