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'I can't help but wonder whether patients are being honest with themselves'

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Nursing Times blogger Clare Aubrey considers how fear of their condition affects different patients and what they do to cope

I’ve always felt quite privileged when patients decide to share their feelings with me, especially when they look to me for some support, no matter how limited my training has been so far.

However, my current placement on the coronary care unit has really opened my eyes to the fear that patients can feel and the reality of how scary it must be to suffer from something as serious as a heart attack. I’ve heard “why has this happened to me?” and “what can I do? I don’t want this to happen again” many times, but what I really want to talk about is the patients who don’t ask and those who seem a little too relaxed about the whole thing.

I can’t help but wonder if I’m getting the whole picture?

Most of the patients I see are men and while they sit comfortably in their beds, chatting with the rest of the ward, talking football and rubbishing the food, I can’t help but wonder whether all of them are being honest with themselves and with us. Our patients have sometimes put their needs to one side saying, “I didn’t want to disturb the nurses - they looked busy”, “I don’t want to be a fuss” and my favourite regarding pain, “it’s nothing I can’t handle”.

Personally, I find this worrying as I know that it is difficult to help a patient when you don’t know there’s a problem. For this reason on my placement, I’m paying particular attention to all the non-verbal signs that are available to me.

The North Derbyshire Health Psychology Service has listed helplessness, sadness and a shame at being exposed as vulnerable as some of the psychological repercussions following myocardial infarction. I think it’s sometimes hard to identify these, particularly with patients who put on a brave face in a ward with others. I suppose the best we can do for our patients is to observe them for signs of this behaviour and, most importantly, be ready to help if they do feel the need to unload their feelings.

I’m enjoying my time as a student because I feel able to devote time to observing patients closely, monitoring their mood changes and being available to offer support when they need it but I am concerned that when I qualify I will become busier, possibly to the detriment to these patients who perhaps more subtlety let me know how they feel. My consolation is that the more I practise reading the signs now, the more able I will feel as a qualified nurse to support those who need my help, no matter how strong they may pretend to be.

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Readers' comments (1)

  • Hmm, perhaps there is an element of denial in a lot of people.

    But remember also that men (since you mention them specifically) do not always conform to the feminine ideology of wanting to talk and share their feelings that seems to be the pervading dichotomy in this society. Men are different.
    Masculinity is different. This is not always taught or understood in a predominantly feminine profession.

    They may very well understand there condition completely, they may just wish to deal with it in their own way, personally, quietly, without any fuss or certainly without showing any outward signs of emotion or weakness. That 'brave face' is the norm for a lot of men, and is how they best deal with things. Often forcing them to talk about their feelings will be counterproductive.

    Not every man is like this of course, but a lot of men, especially of a certain generation are.

    And this has to be respected too.

    The trick is to let them open up to you in their own time, if they want to at all. If they don't, fine, as long as they know you are there if they choose to do so. Give them all the information they need, and let them know you are there if you need them.

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