AS A DIRECT care nurse in a busy procedure center of a small community hospital, I appreciate all that technology does to help patients. At the same time, I'm mindful of the human aspect of providing care. I often recall what a professor once told me: "You can teach anyone to use a machine. But to really communicate with a patient requires a real human, with compassion, active listening, and empathy." My experience with one memorable patient brought home this insight.
Sedation concerns
Mr. D arrived for his procedure right on time. He told me he'd complied with all preprocedure instructions. I explained what he could expect before, during, and after his procedure. Mr. D was cooperative and verbalized understanding.
I then asked Mr. D if he had any questions. Although we'd reviewed the plans for sedation and analgesia, he still had some concerns. He said that it was the falling asleep part he was worried about.
Typically when patients express those thoughts, they're worried about not waking up or about dying. But not this time. Mr. D said the reason for his concern was related to the life he used to lead: a life addicted to drugs. He worried that the drugs would trigger his addiction.
This was a pivotal point in our conversation, and I embraced it because it gave me the opportunity to listen, empathize, and support Mr. D.
Working together
The disease of addiction isn't fully understood, and healthcare professionals are often confused about how to help those affected by it. To help Mr. D with his fears and anxiety, I wanted him to know that I accepted and respected him.
"Are you in recovery?" I asked. He said yes. I congratulated him, and he smiled. I put my hand on his arm and gave him a minute to feel whatever he was feeling. I asked him how long he'd been in recovery. Fifteen years, he told me. He said he attended a local Narcotics Anonymous (NA) group, which literally saved his life.
We then returned to his concern that the medications administered during his procedure might trigger his addiction. I advised him to share his addiction fears with all healthcare providers and encouraged Mr. D to continue going to his NA group in case he needed some extra support following his procedure.
"We talked about a lot of things today, more than I was expecting," Mr. D said as we ended the conversation. "Thank you." I thanked him for sharing, and told him that knowing about his addiction would help me take better care of him.
Acceptance and respect
Patients in recovery face constant challenges to stay clean. Entering the healthcare environment is a potential high-risk situation. If you anticipate your patient will be discharged with pain medications, ask about any addiction concerns. Document and notify the healthcare provider of these concerns.
You can help your patients with a history of addiction by planning their care in support of their recovery. Let them know that you accept and respect them at all stages of addiction and recovery. Taking the time to listen and empathize with Mr. D helped me understand-and deal with-his fears, and it let Mr. D feel confident that the procedure wouldn't derail his recovery.