Takeaway
As an interventional specialist, compassion and connecting with patients are prioritized in my care. Acknowledging concerns, providing reassurance, and verbalizing each step of the procedure helps to build trust and alleviate patient anxiety.
Lifelong Learning in Clinical Excellence | June 3, 2024 | 3 min read
By Stephanie Van, MD, Johns Hopkins Medicine
“Is this going to hurt?”
Mary’s voice shook slightly as she asked a question that I hear all the time. I’d prepared her extensively for today’s procedure during our last visit: going over the indications, risks, and benefits, and the step-by-step anatomy of the procedure using a life-sized spine model. Despite this advanced preparation, we agreed she’d still benefit from premedication with Valium to help keep her relaxed throughout the procedure. She was decidedly NOT a needle person.
As an interventional pain management specialist, I regularly work with people who are physically uncomfortable and emotionally exhausted. So, after I reassured her that she was prepared for each step of this procedure, I told Mary what I tell so many of my patients: “You know I don’t like to cause more pain than what you’re already experiencing.” She cracked a small smile, and the tension in her shoulders eased.
Mary grew up in the 1960s and loved oldies music, so I had a Motown Hits playlist queued up. The Temptations serenaded her as she entered the procedure suite and was introduced to the nursing staff. As she settled herself onto the procedure table, I encouraged her to pretend she was at a weird spa where yes, there were warm blankets, but instead of essential oils, we had cold Chloraprep soap to clean the skin. This well-disguised form of guided imagery usually gets a chuckle from patients and helps dissipate feelings of anxiety. I offered Mary the choice between a traditional spherical stress ball or one shaped like a brain. She opted for the more interesting shape, grateful for a fidget toy that could provide some tactile distraction throughout the procedure. “Alright Mary, I’ll be talking with my team and giving them directions, and you get to just lay there and relax. I’ll talk you through every step of the way, so you know what’s going on.”
As an interventional specialist, most of my job involves educating patients about their options and providing reassurance that they are in control of their care plan. With proper guidance, patients don’t have to feel like things are being done to them; instead, they can feel more like they are enlisting specialists to do things for them.
Here are some strategies to cultivate more empathy:
1. Center the patient experience.
To minimize anxiety or fear, help patients fully appreciate the variety of options they have to choose from aside from interventional procedures. Make sure they understand why you’re recommending a certain approach, what the potential risks and benefits of the procedure are, and what you can do to improve their experience.
2. Take a step-by-step approach.
Verbalizing every step of a procedure ensures patients understand the entire process, which is often happening outside their field of vision. This helps manage expectations—patients know when the pinch and burn of lidocaine is coming, they know they will feel pressure after that, and they know if something feels too sharp, they can ask for more numbing medication.
3. Consider scheduling more time.
The reality is that time is money. An interventional specialist who does 30 procedures in a day makes more profit for their institution than one who does only 15. But no one likes to feel rushed or dismissed. Make sure you have enough time to answer all patient questions before the procedure.
To continue the conversation, please check out the author’s YouTube channel: This Ability Clinic, which features accessible and inclusive healthcare education.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.