A registered nurse explains to a student what to say and do in order to start a PCA for a painful patient on a long-term therapy and to reassure him about the procedure.
Nurse: Good morning. I’m Maryann, a registered nurse at the hospital. And this is Sarah, a student nurse who is on training, if you don’t mind her being with us?
Patient: No problem.
Nurse: So Sarah, what shall we begin with?
Student: I guess we have at first to make sure we have the right patient by checking the ID band and asking for his name and date of birth.
Nurse: You’re right. And above all, you must start by introducing yourself to the patient and say what nursing tasks you’ll be carrying out.
Student: Let me try again. I’m Sarah, the trainee nurse. I came along because the doctor has asked for a patient controlled analgesia for the pain you’re experiencing. Can you give me your name and date of birth?
Patient: Sure. I’m Robert Johnson ; born on May 20th 1986. But you can call me Bob.
Nurse: Sarah, how would you announce what you’ll be dealing with?
Student: I’ll tell the patient that I’ll start an intravenous, that he’ll feel the needle prick, that it may hurt and that there will be some bleeding until I fix the catheter. Is that right?
Nurse: Not exactly. Being genuine here is making the patient trust you and earning credibility. And announcing all this in an abrupt way might give a negative feeling about you, what you’re up to, and make the patient stressful.
Student: Should I not give information on what I’m doing then?
Nurse: Of course you should, but in a way that helps the patient relax. Ok. Here how it goes. Look at my face. It seems neutral and rather smiley. I put my hand gently on the patient’s shoulder and ask him: “Now Bob, have you ever had an IV before ?”
Patient: Yes, that was a while ago.
Nurse: And do you remember how it felt?
Patient: It was rather uncomfortable.
Nurse: Ok. So I’m going to use a needle that has a plastic piece around it. It’s called a cannula. It will go into your vein. The needle will come out but the plastic will stay in. Once it’s in, you won’t feel any pain. This will help you get IV fluids and medicine more easily.
Patient: Does it hurt?
Nurse: Well it just feels like a pinprick. And it takes only a couple of seconds. So you should not worry about that, Ok?
Patient: Ok.
Nurse: When I put the needle in, there might be a few drops of blood. If you’re sensitive upon seeing blood, just look the other way. And I’m going to use this tourniquet on your arm and feel your veins nicely and gently. It feels pretty tight but it doesn’t hurt at all. So just relax and take it easy. Do you see what I mean, Sarah?
Student: Yes. You have to use a reassuring language and avoid verbal or nonverbal gestures that may be seen or interpreted as negative. And always tell the patient the information that benefits him in a clear and honest way.
VOCABULAIRE
ID band: bracelet d’identification
Nursing tasks: soins infirmiers
Patient controlled analgesia (PCA): analgésie contrôlée par le patient (ACP)
Needle prick: piqûre d’aiguille
Bleeding: saignement
Long-term therapy: traitement de longue durée
Earning credibility: être plus crédible
Common phrases
Introduce yourself and say what nursing tasks you’ll be carrying out.
→ Présentez-vous et expliquez les soins infirmiers que vous allez réaliser.
Announcing what you’re doing in an abrupt way might make the patient stressful.
→ Énoncer de manière brutale les gestes que vous réalisez peut rendre le patient anxieux.
I’ll use a needle that has a plastic piece around it. It’s a cannula.
→ Je vais utiliser une aiguille qui est entourée d’un dispositif en plastique. C’est une canule.
The needle will come out and the plastic will stay in but it won’t hurt.
→ Nous sortirons l’aiguille mais le dispositif en plastique, lui, restera dans la veine, mais ce ne sera pas douloureux.
It hurts a little but the painis not unbearable.
→ C’est légèrement douloureux mais supportable.
It just feels like a pinprick but it won’t take long.
→ Vous sentirez comme une piqûre d’aiguille mais ça sera rapide.
You should not worry about that.
→ Ne vous en inquiétez pas.