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.
Patients may have many fears, some real, many imagined, but first and foremost, they need to understand that they have a choice about how they respond to and deal with fear. The job for nurses is to empower patients to deal with their fears in positive, life-enhancing ways. An expert nurse possesses a well-developed sense of intuition and the ability to pick up on subtle changes, differences and cues that others might miss. The expert nurse understands and anticipates a patient's fears. The expert nurse knows when and how to intervene, and does so with a grace that encourages and empowers the patient.
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 he perceives it.
The expert nurse suspends judgment and acknowledges the patient's fears, without being pulled into the fantasy. Keep in mind that nurses cannot fix people, but can 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 his fear tells him will happen. For example, the patient admits to being afraid of pain. Ask, "What if we could make it less painful?" Then together, the nurse 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.
All patients have fears, but the intervention of an expert nurse can help a patient with fears prevent becoming a fearful patient.