Depending on the emergency and treatment circumstance, it can often be helpful to have patients’ family members present to answer questions about a patient’s background or medical history, but it can also be overwhelming and add even more stress for the providers and patients involved.
To mitigate any added stressors that many come with having patients’ family members present during airway emergencies and treatment and to ensure patients’ needs are tended to as safely and effectively as possible, and with minimal distractions, first responders must familiarize themselves with different methods of communicating with family members to alleviate their anxiety and stress and address any difficult questions or reactions they express along the way.
Introducing yourself and establishing open communication
Each time you begin treating a new patient during an airway emergency, it’s critical that you introduce yourself to everyone present — not just the patient, but their family members as well. This will help with establishing comfort and trust early on and make it clear to patients’ family members that you value their feelings and concerns and are committed to providing the best care to their loved one.
Early on, responders should make sure to identify everyone present and find out what their relationship is to the patient and communicate to the patient and family members what they can expect during treatment, including who will be helping them and who they can ask for help or clarification along the way.
Proactively discussing expectations helps build trust among everyone involved and creates room to address any initial concerns or fears before they become a problem.
Identifying signs of agitation
There are several tell-tale signs to look for that will indicate whether a family member is agitated or not, such as raising their voice, making demands, speaking aggressively or inappropriately and not maintaining or respecting personal space.
When a responder senses agitation from a family member, it’s important that they follow their gut instinct and address it immediately through clear verbal communication, as the agitation will only continue to build the longer the person waits for acknowledgement and a response to their concerns.
Confirming for the family member what you are observing, and that you notice their agitation, and asking how you can help will go a long way in making them feel validated and heard.
Family members are often upset when they don’t understand the circumstances of their loved one’s airway symptoms or emergency, the severity of their condition, or what to expect during each stage of treatment. While a simple conversation can sometimes alleviate their concerns, you often won’t have all the answers to their questions and may need to direct them to a contact or resource, such as a health advocate or specific health department or specialist, who can provide them with more information.
There are several de-escalation techniques that first responders are taught to implement when working with anxious or agitated patients, and these same techniques can also be applied when navigating difficult interactions with patients’ family members.
The techniques include:
- Approaching the person in a calm, confident and non-threatening manner
- Being empathetic, non-judgmental and respectful
- Trying to identify the person’s unmet needs and explore their fears/concerns
- Emphasizing your desire to help and asking what they want and what they’re worried about
- Using short, clear statements that don’t include medical jargon (the person may become more agitated if they don’t understand what you’re saying to them)
Even after you have followed all the above steps, you may still find yourself in a situation with a patient’s family member that feels uncomfortable, aggressive or even unsafe. No matter what, your safety and the safety of your patient is of utmost priority during any airway emergency or treatment scenario. Be sure to reach out to a trusted fellow responder if you’re feeling unsafe or unsure of how to navigate an interaction with a patient’s family member.
Read The Joint Commission’s Quick Safety chapter on de-escalation to learn more tips for interacting with patients’ families during airway emergencies.