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Anaesthetists urged to talk positively to patients


Anaesthetists urged to talk more positively to patients

A fear of needles is extremely common and anaesthetists could do more to help calm their anxious patients, says Australian anaesthetist and hypnosis expert Allan Cyna.

Dr Cyna says about 20 percent of the population has needle phobia to some degree, with about one percent severely debilitated by the condition, so much so they avoid hospitals and medical treatment even if they need it.

While there are certain communication techniques to help such patients feel relaxed and comfortable, Dr Cyna says some anaesthetists may be unaware of them.

Dr Cyna and his colleague Marion Andrew, also an anaesthetist and hypnosis expert, will talk about communicating with patients at the upcoming Australian Society of Anaesthetists and the New Zealand Society of Anaesthetists combined scientific congress being held at the Wellington Convention Centre from October 11-14.

Dr Cyna says effective communication is becoming increasingly recognised as an important and essential part of clinical anaesthetic practice.

In many ways he says anaesthetists are extremely good communicators - they must obtain patient history and make an assessment very quickly, often in an emergency situation.

However, Dr Cyna says the use of negative language is a common problem.

“People tend to warn patients of pain thinking they’re being helpful. For example, if they’re putting a drip in they’ll say ‘this is going to sting’ rather than saying ‘I’m going to put in this drip so we can give you fluids and get you more comfortable’.”

Dr Cyna believes many anaesthetists could find learning the art of what he describes as positive language structure, to be particularly therapeutic for those with needle phobia, children presenting for anaesthesia and women in labour.

He says women in labour having an epidural for pain relief might be asked to “try not to move”.

“Unfortunately when we use the word ‘try’ we’re setting patients up to fail. The word ‘not’ isn’t heard by the subconscious, so the only thing patients take on board is ‘to move’.

“People have a limited state of conscious awareness when they are under extreme stress and it prevents them from consciously listening to what is being said,” says Dr Cyna.

“So by asking someone ‘not to move’ you’re likely to elicit the subconscious response of moving, thus suggesting to the patient the opposite to what is intended.”

Dr Cyna says a more positive approach might be: “In a few moments you will find that you can sit perfectly still and we’ll talk you through how we’re going to put the epidural in as safely and comfortably as possible for you”.

This type of positive communication also benefits needle phobics.

As for children, Dr Cyna says encouraging them to use their imagination can work wonders.

“I remember a five year old patient who came in for a drip every month and needed anaesthetic every time. The boy learned to switch his arm off to sensation and movement by visualising a wire going down his arm that was attached to an imaginary switch that he could turn on and off when he wanted. By using this hypnosis technique he was able to manage having a drip inserted without a general anaesthetic.

“These communication techniques elicit changes in perception, mood and behaviour and help patients co-operate with their anaesthetic care. In this way patients find that they are able to relax and feel a sense of control in extremely stressful circumstances,” he says.

Other topics to be covered at October’s scientific congress include medical emergencies mid-air, dealing with risky patients and magic with an ethical twist.


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