Coping with Patients Who Are Emotional

Broca👸🏻· xinxin

　　

The reason for me to share experiences about I had encountered when patients cried in front of me, how should I be reacting appropriately was during a conversation between me and my preceptor.

　　On an occasion, my preceptor asked me a question which I had not thought of ever since I was posted to Singapore, she asked," Xin, how would you react if a patient cried in front of you?" For a moment, I was stunned and loss of words. For the past one year, I had come across many a time when patients would be emotional and cried during a conversation with me. Out of many incidence, I would like to share 3 of them which had been impactful to motivate me to improve my skills.

　　Encounter #1, there was an elderly male patient who was diagnosed with diabetes mellitus, his left foot condition was in the stage which required to be nursed in an isolation room. After investigations were tested and amputation would be ideal as according to the Medical Team. His son was updated on the disease processes, he agreed on the surgery and pre-operation procedure was proceeded. His son left the ward after saying to his father," Papa, take care." coldly, the patient teared as he was alone, accompanied with nurses in the mist of transfer to the other ward as part of the procedure for pre-operation. At this moment, I felt helpless as I was not able to comfort him through words.

　　Encounter#2, there was an elderly Indian female patient who was admitted for total knee replacement operation which was done on both knees. On the 7th post operation day, patient seemed to be upset and anxious about the recovery process for her right knee. Even though, changing of dressings had been done for both knees on daily basis, the wound on the right knee seemed to be infected while the wound on her left knee recovered well. During the change of dressings, she would be tearful when she expressed her concern on the condition of her right knee, the light dressing would be stained with haemoserous fluid exudation upon exertion and she had to endure the pain each time to ambulate. As much as I would like to comfort her but I could not as I was concern for using inappropriate words.

　　Encounter #3, the third incidence that I would like to share would be an elderly Chinese male patient who was diagnosed with initial phrase of dementia. As he was origin from Fujian Province in China, he came to Singapore during the World War II era to work and stationed since then. Due to certain political procedure, he was not able to return to China. In despair, he expressed his sadness for he missed his family in the homeland back in China very much in tears. Even though I would be able to use the same language to comfort him, I still felt helpless.

　　In order to improve my knowledge on coping with emotions, I searched information online. The information that I had gathered would be as follow:

1) Stay Calm

In the face of an emotional outburst the most important action is to stay calm. Even if the patient or family member is expressing their emotion toward you, you have to keep a cool head. It is difficult to calmly face this sort of emotion and sometimes abuse with calm, reasoned speaking. If you are someone who has a temper of their own, it may be even more difficult to control your own emotions. However, you need to rein in how you are feeling because exploding with your own emotion will only make the situation more volatile.

Staying calm may also mean removing yourself from the situation. If you feel yourself teetering on the edge of losing your cool, step out and get help. Professionalism is paramount in these situations, and you dont want to break those rules. Take some deep breaths if you are unable to get away. Squeeze your hands tightly to help ground yourself in the face of the emotion. Above all, find a way to calm yourself that will keep you professional and able to help the patient or family member through the turmoil of emotions they are feeling.

　2) Use Active Listening Techniques

You may be tempted to ask the person to calm down, but this is the last thing you want to do. In fact, it could make the situation worse since the person is in no shape to calm down. The words may only set them off. Instead, you want to attempt using active listening techniques. This simply means that you stay calm and listen to what the person is saying. One of the primary ways to do this is to help the person name their feeling. For instance, if they are angry, you could say, "It sounds like you are feeling angry. Is that right?" You may get a smart remark, but doing this several times can help the person get in touch with what is bothering them.

Another technique is reflection. You listen to the angry words coming from the patient or caregiver, and reflect back what they say. For instance, if they say, "You are a lousy nurse and this hospital is the worst Ive ever been to," the proper response would be, "So, you are saying that you are unhappy with your stay here. Is that correct?" You should also ask the person to tell you more. Get them talking about what is bothering them. Draw out exactly what set them off so that you know what you can do to help them get over their emotional distress. Using active listening can help diffuse many situations, and can even be used in situations that are not tense. Learning to be an active listener can make your communications with patients much stronger.

　　3) Get Support

Sometimes you cant control the situation on your own. You may need back-up to get the patient or caregiver to calm down. Usually this means that you may have to get your ward supervisor to help with the emotional outburst. Other nurses can help too. In many cases just seeing your face is enough to set a person off. Another nurse can bring calm just because they are a different person with a different way of reacting to the patient. Getting support is a great way to deal with emotional people because it can take the pressure off you.

It is important to remember that it is no failure of your own when you need help from another nurse. Of course, you are doing the best you can, but patients and caregivers are usually not rational. It isnt a reflection of you that the person had an emotional outburst or that you need help to make the situation better. This happens to both new and experienced nurses alike, and that is why nursing is a team profession. When emotions run high, fall back on the team and dont feel ashamed about it.

　　On conclusion, I would be more attentive in coping with patients who would be more emotional and I would learn how to apply the techniques in my nursing care in future.