Encourage patient to identify source of fear; try to assess patient's understanding of situation. Patient's perceptions may be erroneously based.- Explain all treatments and procedures, answering any questions patient might have. Present information at patient's level of understanding or acceptance to reduce patient's anxiety and enhance cooperation.
- Don't dismiss fear or blithely reassure patient that “everything will be alright.” Refusing to acknowledge fear or giving false reassurance impairs coping.
- Provide patient with accurate information about patient's condition and scheduled procedures and treatments. Accurate information dispels misconceptions that can fuel fear.
Orient patient to surroundings. Make any adaptations to compensate for sensory deficits. This enhances patient's ability to orient to time, place, person, and events.- Assign same nurse to care for patient whenever possible to provide consistency of care, enhance trust, and reduce threat commonly associated with multiple caregivers.
- Spend as much time as possible establishing rapport with patient. Communicate at patient's eye level. Speak in a soft, reassuring voice. Establishing rapport encourages patient to express feelings and provides comfort.
- If patient has no visitors, spend an extra 15 minutes each shift in casual conversation; encourage other staff members to stop for brief visits to help patient cope with separation.
- Remain with patient when experiencing a higher than usual level of fear to provide a source of support.
- Help patient maintain daily contact with family:
- Arrange for telephone calls.
- Help write letters.
- Promptly convey messages to patient from family and vice versa.
- Encourage patient to have pictures of loved ones.
- Provide privacy for visits; take patient to day room or other quiet area. These measures help patient reestablish and maintain social relationships.
- Involve patient in planning care and setting goals to renew confidence and give sense of control in a crisis situation.
Instruct patient in relaxation techniques, such as imagery and progressive muscle relaxation, to reduce symptoms of sympathetic stimulation.- Administer antianxiety medications, as ordered, and monitor effectiveness. Drug therapy may be needed to manage high anxiety levels or panic disorders.
- Answer questions and help patient understand care to reduce anxiety and correct misconceptions.
- When feasible and where policies permit, relax visiting restrictions to reduce patient's sense of isolation.
- Allow a close family member or friend to participate in care to provide an additional source of support.
- Support family and friends in their efforts to understand patient's fear and to respond accordingly to help them understand that patient's emotions are appropriate in context of situation.
Suggested NIC Interventions
Active Listening; Anxiety Reduction; Cognitive Restructuring; Counseling; Coping Enhancement; Decision-Making Support; Security Enhancement; Presence; Support Group |