Your life (and emotional well-being) in their hands: working with your healthcare team.
One of the issues I encounter most frequently in clinical health psychology is about difficult conversations with the healthcare team involved in treating my patient's physical health condition. The most common challenges are feeling frightened in healthcare settings and being unsupported or unheard during treatment and consultations.
Let us think about being frightened first. Firstly, please remember that it is completely normal to feel anxious. Walking into a healthcare setting means that you are about to encounter difficult conversations and/or medical tests or treatments that could have significant consequences and unpleasant side effects. Although it is a normal and understandable reaction, anxiety can mean that you do not get the best out of important conversations and find it difficult to comply with treatment. If you have the time and capacity to plan, here are some things that might help:
Take someone you trust with you and let them know how they can help support you: do you want them to stay in the background or take an active part in the discussion? Would it help if they take notes, and make sure you have the answers to the questions you wanted to ask?
Practice a few quick relaxation skills before you go and remember to use the ones that work for you. Breathing exercises and grounding techniques are often a good starting point. I will add a tip sheet with some of these soon.
If you might be waiting around (almost guaranteed!) take a simple distraction with you. When you are anxious, a book can be a challenge, but magazines, newspapers or puzzles might help, have a podcast on your phone and some earphones if you are in an area where you can use your phone.
If you take someone, do they know what it looks like when you get anxious or distressed and what would you like them to do? (Ask for a break, hold your hand, and ask your healthcare professional to slow down, remind you to breathe).
If you take someone it can be useful to let them know that there might be bits of the conversation you want to do in private. Let them know that it is not about them. It is about your needs which are the most important in these situations. (Quote me if you need to! "A qualified psychologist I trust said…….")
This can be tricky but be careful who you take with you: family and loved ones are certainly well-meaning but if they are likely to be distressed on your behalf it might be better to leave them at home or in the waiting room. Again, this is one of those situations where you can choose, quote me, and get your healthcare team to back you up if you need to. I will add another blog about managing distress in other people soon.
Plan questions and what you would like to know: it can help to have a notebook or notes app on your phone make sure you put these in before you go and jot the answers in while there or as soon as you finish.
Remember to get contact details, so you can ask any questions you think of later.
It can be helpful to message your healthcare team in advance and let them know you are nervous. If you know how they can make you more comfortable, most teams will appreciate knowing that. Should they remind you to breathe, take things slowly, offer tissues or ignore tears? All of those are valid.
For inpatient stays, I have often recommended that people print or write a notice for their door or bed area like "If you can see this notice, I am nervous. I would appreciate it if you would take things slowly, make sure I understand what is happening and talk directly to me. If I become distressed, please help by reminding me to breathe or distract me by asking about my dogs."
It is all right to let your healthcare team know that there is information you do not want to know! Unless you directly ask. It can help them understand the situation if you let them know if you do or do not want family or loved ones to know.
Let us talk about engaging with (usually senior) healthcare professionals who might lack what we sometimes call a "bedside manner." A bit of background first: Older medical professional will not have had a huge amount of training or feedback about the way they engage with their patients. Traditional medical and especially surgical, training has always focussed on technical skills and knowledge rather than people skills. Fortunately, those people skills are becoming more important in training and feedback, but the world does not change overnight. It can sometimes be helpful to remember that it is unusual to find great people skills and the ability to cut into someone with the skill and accuracy in the same human package.
If you had a choice going into surgery, would you choose someone competent but brusque or a warm human being who wasn't as skilled? You can check a healthcare professional's technical reputation through objective review sites like the Private Healthcare Information Network.
It might be possible to choose the professional you have anxiety-provoking conversations with: Can you get important test results from a conversation with your GP, if you know them well rather than the surgeon who you find abrupt? Alternatively, can you get emotional support from the nursing team, family, or friends before and after appointments, treatment, or surgery? It is a cliché because there is a lot of truth in it (and because nurses often get more training in communication skills!) that nurses can be easier to talk to. Here are a few tips for those difficult conversations:
Explain that you are nervous and how they can help (see the tips above – slow down? Remind you to breathe? Check you have understood them?)
Ask to take a break in the conversation or during treatment if you are not coping well.
Ask one of the team to have the silliest conversation they can manage during treatment to distract you if appropriate.
Plan a treat for after your appointment or inpatient stay.
Appoint a family member or friend you trust to be your advocate and stay connected with them.
Let the healthcare professional you are finding difficult know that you are struggling with the conversation and ask them to try being a little more sympathetic or bring someone else in to support both of you.
If you need to end the conversation, you absolutely can. Make sure you agree to follow up or hand over to another professional to avoid delays in urgent decisions or treatment.
Engaging with a healthcare team in the face of significant illness or injury is not easy. Hopefully, some of my tips here are useful.
Good luck! If you need further support, you can reach out to Oak Tree Psychology at https://oaktreepsychology.com/. You can also find us on social media for updates, resources, and support