Are We Hearing the Questions that Patients and Their Families Don’t Ask?

“The spoken and unspoken messages we give patients and families are powerful.”

Viewpoint author Juanita Reigle

As a ‘frequent flyer’ of late, accompanying a family member on the long trek through cancer treatment, I’m acutely aware of the ways in which doctors and nurses communicate with us. Some have never mastered the art of interacting with people in stressful conditions. Others have remarkable radar and a special ability to “read between the lines,” identifying concerns that he and I haven’t yet voiced.

In ‘She’s Fine,’ the Viewpoint essay in AJN’s October issue, Juanita Reigle reflects upon how we respond to the questions patients and family members don’t raise. Some are left unasked because people are too overwhelmed to formulate a question. Some people aren’t ready to hear the answers. And sometimes, sadly, families sense that this doctor or nurse really doesn’t want to engage with them.

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2017-10-09T09:48:08-04:00October 9th, 2017|Nursing, patient experience, Patients|0 Comments

Telling the Truth, Keeping a Patient’s Trust

“Am I going to be okay?” Ami gasps. Her breath hitches, her chest rising and falling in spasms. One of my hands holds a mask to her face; the other hand holds hers. Pain has made her strong—my fingers are almost as white as her pale face, radiant with fear.

Illustration by McClain Moore for AJN. Illustration by McClain Moore for AJN.

That’s the start of the Reflections essay in AJN‘s February issue, “Am I Going to Be Okay?” Nurses tell patients ‘it’s going to be okay’ because the words can keep them calm, because no one can tell the future, because it’s comforting to hear ritualized phrases from a caregiver—even when they’re not, strictly speaking, true.

But are there times when more honesty is desirable? The author of this short Reflections essay delves into one such situation where the patient needs, above all, to feel trust for her nurse. […]

Not Compatible With Nursing

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May (2012) issue of AJN.

photo 1-1 Photo by the author

“His family knows this is not a survivable injury, right?”

This question, posed to me in the doorway of my patient’s room by a trauma surgeon I regard as brilliant, caught me off guard.

“No,” I said. “They don’t know that.”

He frowned at me, mumbled something about false hopes, then moved away to continue his rounds.

This wasn’t the only physician who’d expressed a strong opinion regarding my patient’s mortality—a consultant had deemed his injuries “not compatible with life.” But I’d been caring for this man, as a 1:1 assignment because of his high acuity, for every shift for weeks. It seemed obvious to me that my patient’s continued presence in the ICU—and his relative stability on that particular day—directly opposed the dire predictions. The man’s family did not see his situation as hopeless, and neither did I.

And yet days after the surgeon uttered those words, my patient suffered a complication and became so unstable that for hours he teetered between life and death. The resuscitation effort was massive—and no one mentioned survivability. No one behaved like there was even a shred of futility in bringing […]

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