Forming a strong relationship and establishing trust are critical components of patient care. Our patients are literally putting their life in our hands. Many times, this complex, verbal and physical ritual must be performed within three to ten minutes.
The first and most important point to realize is that each patient is unique and special. That sounds sort of hokey but it instills basic respect for the individual. Next, the fact that we occupy our position and the clinical garb that we adorn ourselves with establish credibility and a certain air of authority. However, there is much more that we can do to facilitate and expedite this sacred bond of trust.
1. Look the patient in the eyes and introduce yourself as a Nurse Anesthetist in training or Student Nurse Anesthetist. Let them know that you will be helping them take a nap, monitoring their vital signs, and by their side during the entire anesthetic.
2. Touch the patient. Shake a hand, squeeze their shoulder, or pat their leg. This initiates the caregiver/patient relationship and facilitates the bond.
3. Smile and project warm confidence. Take a note from the Beach Boys and throw out good vibrations.
4. Rapport is a two way street. Share information about yourself as you get to know the patient, e.g. “I had this surgery too”.
5. Seek to understand. Show empathy.
6. Address the family. Look around the room or bedside and say hello. Talk to your pediatric patients and get on their level.
7. Be factual about risks and complications, but keep hope alive. Use age/ education appropriate terminology.
8. Freely provide pertinent clinical facts and answer questions truthfully, but frame the information properly. People will believe what you tell them.
9. Diffuse anxiety and disarm hostile situations. Seek to be the calm in the storm. Use humor when appropriate.
10. Finally, give them what they need. Two milligrams of Versed is a great drug for anxiety, but it may do nothing for someone who takes their TID Xanax and Klonopin with a Harvey Wallbanger chaser. The same goes for narcotics and the guy that’s writhing in pain even after he chewed up his AM OxyContin and put on two Duragesic patches.
I know this seems like a lot to consider and implement in such a short period of time. However, there will be situations where you will have to draw on each and every one of these points, plus all the psycosocial stuff you learned back in nursing school and maybe an episode or two of Dr. Phil. In the end, the best approach may be to find a colleague who is really good at this and study/emulate their techniques.
This is a great article on communication and rapport. Communication gaffes: a root cause of malpractice claims. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1201002
