Expert nursing tips: How to deal with a fearful patient

I was a fearful patient. I can recall the experience clearly. I was three-years-old and about to have my tonsils removed. When they came to take me to the operating room, I tried to hide behind a screen in the corner of the room. No amount of coaxing by my mother could persude me to come out.

We have many fears, some real, many imagined, but first and foremost, we need to understand we have a choice about how we respond to and deal with fear. Our job as nurses is to empower our patients to deal with their fears in positive, life-enhancing ways.

Fear is defined as expectation with alarm; fear takes a premise with impending doom and amplifies it, sometimes to the point that physical symptoms appear. As a nurse, your first impulse might be to dismiss the fear because of its fantasy element or unrealistic expecation. However, this approach can diminish the patient's credibility and self-esteem. Your first step as an expert nurse should be to encourage the patient to express fears. With a child, that may involve art therapy, having the child draw a picture of what the fear looks like, or how they perceive it.

The expert nurse suspends judgment and acknowledges the patient's fears, without being pulled into the fantasy. Keep in mind that our job as nurses is sometimes not to fix people, but to equip them to fix themselves. Acknowledge the patient's fears and right to have them by saying something like, "I can understand why you are afraid."

Reassure the patient that he can control his response to fear. Try a "what-if" exercise. Ask the patient what their fear tells them will happen. For example, the patient admits to being afraid of pain. Ask, "What if we could make it less painful?" Then together, you can explore ways to make the patient more comfortable which should automatically lessen the fear.

Fear usually exists in the future. If you can ground the patient in the present, you can lessen the hold of the future. Using the example of fear of pain, you might ask what the patient has done in the past to lessen pain, and create a plan for the future pain he fears. Often, discussing fears brings enough light to the situation to lessen their hold on the patient. When he knows you care and empathize, fear may lose its power over his responses and empower him to deal with it.

The definition of an expert nurse includes a well-developed nursing intuition and the ability to pick up on subtle changes, differences and cues that others might miss. The expert nurse understands and anticipates patient's fears. The expert nurse knows when and how to intervene, and does so with a grace that encourages and empowers the patient. All patients have fears, but the intervention of an expert nurse can help a patient with fears prevent becoming a fearful patient.

Learn more about this author, Joyce Good Henderson.
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