1-15. DEGREE OF CONCERN
Of course, closeness of family members and the ability to deal with illness within
the family varies. Most are appropriately concerned. Extremes in either direction
(under-concern and over-concern) can have a destructive effect on the well being of the
patient. For example, if the family is denying the severity of the illness, the patient may
wonder about his ability to view things realistically or he may not feel the need to accept
proper treatment. If, on the other hand, the family is drastically overly concerned, the
patient may begin to think the medical personnel are hiding something from him. If the
family, patient, and medical staff respond in different ways, additional anxiety, fear, or
guilt may result.
1-16. DEGREE OF HOPE
The degree of hope among family members also affects the patient's degree of
hope. Time spent by the health care provider with family members helping to develop
trust and understanding generally leads to a greater degree of confidence and
hopefulness. Medical and nursing personnel can provide support by allowing family
members to openly express their needs and feelings. Active listening can help to
assure them that their anxious behavior or fear is understood and accepted. (See
"Active Listening," paragraph 2-4.)
1-17. BEDSIDE MANNER
a. Explanations of treatments, procedures, and equipment help to calm anxiety
and guilt. Remember that if family members are especially nervous, explanations may
have to be repeated or simplified. Keep them informed as things progress or change.
Explain why unexpected tests have been ordered and what they will involve. Do not
take it personally if they feel more secure asking for a second or third opinion.
b. Encourage family participation in the patient's care. If they are doing a good
job, let them know. Health care professionals must also take special care to provide the
same courtesies (smiles, greetings, calling by name, demonstration of concern, etc.) to
the family that they would to the patient. (See "Developing a Therapeutic Bedside
Manner," paragraph 1-10.)
c. In hospitals, there are many rules and regulations (visiting hours, number of
visitors, age of visitors, food and beverage restrictions, etc.) that were set up for
particular reasons, which may not be readily apparent. If you need to enforce these
with the family, explain why. Generally, people are reasonable when they understand
that there is a real need for the enforcement of a rule.
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