As a nurse, you are on the frontlines of healthcare, spending more time your patients and their caregivers than any other care team member. As a result, nurses help patients deal with a variety of emotions.
Emotional distress occurs “when someone is overwhelmed by their emotions and thoughts.” At some point in your career, you will work with a patient or caregiver experiencing emotional distress. Perhaps it is after a diagnosis, recurrence, bad news or the reality of changes with a chronic illness. Increasing your awareness and focusing on communication skills will help you offer support for depression, anxiety, loss/grief and even spiritual distress.
Patients who receive a negative health diagnosis — cancer, for example — may experience depression, which may be undetected or undertreated since it can be seen as a natural reaction. The tricky part for nurses is determining whether the symptoms — fatigue, appetite changes, psychological changes — are from their health condition, its treatment or from depression unrelated to their physical condition. Start by asking your patient these two simple questions:
- Do you have little interest or pleasure in doing things?
- Have you been feeling down, depressed or hopeless in the past two weeks?
Work with your multidisciplinary team and the patient’s caregivers to monitor emotional changes that may indicate depression.
Nurse.com says, “Anxiety can be the basis of most conflicts in healthcare settings.” This is natural as most patients are unfamiliar with the healthcare system and can experience stress related to uncertainty. They may have questions like, “Am I going to be okay?” and, “Did I do something to cause this to happen to me?” or even, “How am I going to pay for this?”
Try these three tips to help reduce your patients’ anxiety:
- Take time to listen to their concerns.
- Aim to connect with your patients or their caregivers on a personal level so they feel that they are being heard and have an ally in their corner.
- Remain calm. As their nurse, if you seem upset, they may feel that they have a reason to be anxious too.
Communication plays a significant role in the patient experience and anxiety level. Remember that communication is more than just words, so watch non-verbal behavior, both yours and theirs.
Loss and Grief
A “loss” is not always the loss of life but can include loss due to health changes. Patients and caregivers may experience grief over a variety of losses:
|Physical||· Loss of health
· Scarring or disfigurement
· Loss of mobility, strength or endurance
|Psychosocial||· Self-esteem over changed physical appearance
· Loss of independence
· Isolation or loss of identify
· Weakness because of illness
|Financial||· Loss of income, savings, even loss of home
· Loss of vacation time, work status or promotion
|Spiritual||· Loss of faith, dream, goals
· Loss of hope for the future
Part of your role as a nurse is to help patients understand that they are experiencing grief and coach them through their feelings. Reach out to other care team members, social workers or spiritual leaders.
Both religious and nonreligious people can have a strong sense of spirituality and experience spiritual distress at different points throughout an illness. Some patients prefer that care team members ask about their spiritual or religious beliefs to enable the incorporation of these beliefs into the medical decisions and the plan of care.
Be aware of local support services, both at the care facility and in the community. Some healthcare facilities may have a spiritual guide, chaplain or other religious leader on staff who is specially trained to deal with spiritual distress. Others have specially trained spiritual nurses who wear a special pin or sticker on their badge so patients know they can feel comfortable requesting prayers or asking spiritual or religious questions.
Sometimes it can be difficult to assess how well someone is coping with distressing news, as each person processes emotions differently. Look for signs and symptoms of depression, anxiety or spiritual distress. Remember to ask open-ended questions that require a descriptive answer, such as “What are you feeling?” instead of the more common question, “How are you feeling?” where the answer is often “fine” or “okay.” Listen without judging or trying to “fix” everything. Most of all, slow down and give them your full attention without any distractions, so they can see that you truly care.
Learn more about the UL Lafayette online RN to BSN program.