Bedside Manners and Coping with Fear and Anxiety

Gregory wasn’t feeling very well. Then one day he had trouble breathing and his wife, Emily, took him to the Emergency Department. He was questioned, tested, and prodded by doctors, nurses, and technicians–all to diagnose and treat his condition.  In the meantime, Gregory and Emily started to feel anxious and fearful because no one could give them a clear idea of his condition. Gregory was admitted to the hospital where more tests, procedures, and medications were administered.  Various diagnoses were proposed and explored. As time went on, some of Gregory’s symptoms decreased in severity but others emerged. Gregory and Emily believed that everyone was diligent in their efforts to treat him, but that didn’t alleviate their fear of the unknown as to what was causing Gregory’s symptoms and what his prognosis might be.

Most of us know and accept that diagnosing and treating medical illnesses can be a complex and challenging endeavor. There can be many approaches that may be administered on a medically approved trial-and-error basis (e.g., medications and their dosages, respiratory therapy). Generally, we trust our treating health professionals to be competent in their knowledge and experience. Yet, patients and their family can still feel anxious and frightened about their situation when even the “experts” aren’t sure what is happening.

Medical professionals are aware of how overwhelming medical conditions can be to patients and their families. Initially the diagnosis may be uncertain and the treatment may not be immediately effective. Moreover, patients and families may not fully understand their medical condition and prognosis. Without clear information from the medical professionals, their worry and distress are likely to increase as time passes.  Consequently, it’s imperative that they be provided with information as soon as possible to what will be done to obtain a more certain diagnosis and treatment plan.  Being in a prolonged state of “limbo” is highly taxing on individuals who are already stressed from the medical illness.

How can medical professionals deal with these increasing emotional reactions when they themselves may have few definitive answers? Some suggestions include informing the patient and family as to

  • how often patients experience the symptoms they are having
  • how difficult it is at this early stage to render a final diagnosis
  • how long it may take to establish a stable status
  • some possible tests and procedures they plan to conduct and why

This is especially effective if the information is followed with reassuring words (e.g., “This is common.” “We will not stop until we know what’s going on.”). In addition, the patient and family should be encouraged to ask questions.

Being in a state of “unknowing” may be okay for some patients and family members; however, medical professionals have an ethical and legal obligation to provide patients with informed consent. That is, to be told in a way the patient can understand

  • their medical diagnosis/condition
  • the reasons for the tests, procedures, and treatment, as well as the risks and benefits, and the likelihood of these to occur
  • alternate methods of treatment, and their risks and benefits
  • the consequences of their condition, if treated or untreated

Unfortunately, not all medical professionals have a soothing bedside manner. Their interaction style and communication skills may not be conducive to the patient feeling comforted and supported. For instance, the medical professional may be abrupt or distant, or prone to use technical terminology. This is not what anxious and frightened patients and families should experience. Being ill is stressful enough. Not knowing what is going on and having a treating professional whose behavior may be “oft-putting” is simply another potential stressor impacting the patient’s emotional and physical health. Therefore, if patients and families do not feel comfortable with or respected by these professionals, they may consider informing the professional of this or seeking care from other professionals. Regardless, the need to be properly informed about one’s condition is an essential right.

Education can be a powerful tool in easing anxiety and fear. The primary source of the education should be the treating medical professionals. However, there are additional sources where more detailed information is available. The ease of using the Internet and exploring the various medical information (e.g., WebMD. Medline Plus) and professional association (e.g., American Heart Association, American Cancer Society) websites can be very helpful. Other information sources are brochures and instructional videos provided by hospitals, clinics, and doctors’ offices.  Some medical insurance companies also have nursing professionals available by phone or email to answer medical questions.

Knowledge is power. It is also a way to attenuate the fear of the unknown. If we are educated about our condition, then we are in a better position to gain confidence about our ability to help ourselves. Such self-efficacy along with the support of others can improve not only our emotional symptoms, but our physical ones as well.

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