Nursing Times Award Winner

The straw that breaks the camel's back

Waiting areas in hospitals, whether in A & E or general outpatients, can be a daunting experience, especially when they are crowded with people. Stressed staff trying to deal with a variety of patients and relatives, all of whom have a reason to be very anxious, need to demonstrate kindness and compassion to avoid a tense situation becoming explosive. The queues may be long, the chairs may be uncomfortable, the vending machine is broken and the walls have posters on them reminding patients of the zero tolerance policy towards anyone who exhibits any kind of threatening behaviour. These are all physical factors designed to make a difficult situation far worse.

Of course, being rude or threatening anyone is not good. But being impatient, anxious, agitated and angry are emotions that are commonly displayed by anyone who is worried that either they, or a loved one, may be seriously ill. Whilst it may not be good behaviour, it would be wrong to call it inappropriate behaviour given the stressful situation. Yet, that is how many senior nurses describe a patient or relative who behaves in a way deemed to be outside what they feel is a normal code of conduct.

Responding to someone who is anxious about their illness by being equally intolerant of their behaviour rarely helps the situation. On the other hand, empathizing with their situation, apologising for the wait, offering then a drink (if they are allowed one), or offering to phone someone to make them aware of any delays, are all gestures that can instantly diffuse a situation.

Nurses are trained to understand and deal with someone who might be stressed. Showing compassion, combined with a suggestion of how the situation may be eased, is a skill that can make a huge difference to a tense atmosphere in a crowded waiting room. Rising to the bait, on the other hand, generally makes the situation far worse.

Not surprisingly, some of the best examples of customer care come from the most successful companies including Disney, John Lewis and Marks and Spencer. Disney have learned to minimise the distress of a long queue by offering entertainment to customers while they wait. Sometimes they offer refreshements too. They are also very good at keeping people informed about the likely length of their wait.

Kissing it Better often works in outpatient departments by providing pleasant distractions for patients. Wonderful student beauty therpists may offer free hand massages and manicures, small choirs may sing a selection of popular songs. It all helps to pass the time and makes patients feel more relaxed. And, in general, relaxed patients are happier patients.

We know that these activities significantly reduce complaints. Complaints are not pleasant issues to deal with so, staff are also more relaxed when our wonderful volunteers are offering these services. Sometimes, if it is quiet. they can benefit from a quick, relaxing hand massage too.

Understanding the needs of a patient, and reacting accordingly, is what good nursing is all about.

It's a simple idea but, sadly, in the heat of the moment, it can sometimes be forgotten...often with disastrous consequences.


Jill Fraser

Jill Fraser

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