false reassurance

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Specializes in Emergency, Telemetry, Transplant.

Hi all--

Just wondering if other nursing schools made a point bringing up false reassurace when talking about communication issues, specifically to stay away from it. An example: pt will be having open heart surgery in the morning, is crying and expressing fears about what may happen; the nurse tells them "it will be alright."

The reason I ask, I have heard many nurses I work with say somethign similar to this to pts and it really bothers me when they are dismissive toward their pt's feelings. (and I'm not trying to say that they are not good nurses by saying this--many who have said this are otherwise great nurses)

Thanks in advance, interested to hear what others have to say....

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Specializes in Home health was tops, 2nd was L&D.

What would you really want them to say? I used to listen to my patients fears more than say anything. Of course it might actually be okay.. no one really knows. As a patient I would not want a nurse to be negative, or to try to explain the procedure or make me feel more nervous.

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What's wrong with that? They might really think it will be okay. Having surgery does come with some risks but many do make it through and recover. I don't find this dismissive at all. It's kind and more times than not honest.

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Yes we covered false reassurance as part of therapeutic communication (that false reassurances are untherapeutic).

I think it can be hard to stay away from in practice, especially if you know it WILL very likely be alright and are trying to help a patient feel less anxious.

In my experience as a patient once, I was undergoing a fairly uncomplicated procedure, but was experiencing a lot of anxiety about it. I appreciated that the nurses told me that it was going to be ok, that some of them had had the procedure done themselves and were nervous but that it ended up being no big deal. That would have been very incorrect on a nursing school exam, but I don't think a textbook therapeutic response would have helped me.

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Specializes in ED.

In my program they always stress the need to respond in a way that addresses the patient's needs...so they would tell us to try not to shut the patient down with pat respponses or false reassurance. In that case my professor wold have said. "you seem anxious and afriad about the surgery...do you want to tell me what's on your mind?"

The palliative care nurses I've seen this semester (I am in a 4 week rotation right now on a palliative care unit) have been probably the best communicators I've seen. Really good role models. Sometimes the Pt isn't upset at what you think they are upset about! It's always good to ask! Also these RNs really seem to know when it's best to keep talking or asking questions and when it's best to just be a quiet listener or hand-holder.

It's always so individual - I know people who love reassurance - that's all they want to hear - and I know people who hate reassurance - it actually makes them angry and distrustful...so we have to just tune in to the individual Pt!

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If the procedure was truly risky, it is doubtful that the doctor would be performing it (except in extreme circumstances). To act calm and provide reassurance is neither dismissive nor unprofessional. On the other hand, giving the patient possible reason for anxiety would not improve their outcome, and possibly overstep the nurse's role in giving medical advice.

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Specializes in Home health was tops, 2nd was L&D.

I feel this is one of those things nursing schools feel they need to teach nurses not to do but when in the real world.. nurses as people do them because it helps many people.

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You are absolutely right!

"It will be Ok" is dismissive of the patients fears/concerns.

This is the time to sit at their bedside.. look in their eyes.. and say "tell me what you are afraid of ".

That is what our patients need.

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Specializes in Emergency, Telemetry, Transplant.

For all the people who think it is OK to say "it will be all right:"

You say to a close friend.."my spouse just got laid off, my daughter just applied to college, I'm not sure she will get in, but I don't know how we would pay for it even if she did get in, and my sisten has cancer..." The friend they says "oh, I'm sure it will turn out okay."

Well, it may be the easy way out to provide that false reassurance (I've done it myself), and it feels 'natural,' but that does not mean it is the right thing to do and I feel that it is not very helfpul to our patients' feelings...

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Specializes in Emergency, Telemetry, Transplant.
no one really knows.

Which is exactly why you don't want to tell them "It will be alright"

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Specializes in Med/Surg, Ortho, ASC.

Originally Posted by nlmoore viewpost.gif

"no one really knows"

Which is exactly why you don't want to tell them "It will be alright"

I understand your point and agree. But truly, what is the proper thing to say, if a response is expected?

"No one really knows?"

I too try very hard to be a therapeutic listener while keeping my responses to a minimum. However, sometimes the patient really looks to you for an answer and it is difficult to find something to say without using pat phrases.

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Specializes in Home health was tops, 2nd was L&D.

So again I ask what do you suggest a nurse actually say to her patient?????

I suspect few have much time to sit and hold their hand for very long. Should they say" gosh I do not know what to say to you..it might not be okay" Do you really think patients in general are so dumb as they expect the nurse to really know how it will turn out?

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