Patient Suffering: How We Add To It or Decrease It

Being in the hospital can be one the most stressful and scary times in someone’s life. For many patients, the reasons for being in the hospital are such that they would put any one of us on edge: their health is at stake, and consequentially their independence, their dreams, and ultimately  their very future can be questionable. Even if the diagnosis is not life threatening, juggling the logistics–kids! work! the house! the dog!– of being taken out of your normal routine can be extremely stressful.

One of the easiest ways to frame the conversation on patient experience is by using this visual of four overlapping circles.The circles represent the suffering a patient can experience and how, depending on the interactions of caregivers as well as the processes they are subjected to, we can either add to or decrease the suffering a patient has.

sufferingThe first two circles–working from small to large–represent inherent suffering the patient will go through.  The first circle, “Diagnosis”  represents the inherent suffering a patient will experience simply from the fact that he or she has been diagnosed with a particular disease. For example, if I were diagnosed with breast cancer, I would experience the inherent suffering of that diagnosis: the fear, worry, cost, and upset on my life that it would cause. The second circle, “Treatment” also represents inherent suffering due to the treatment of the diagnosis. In the breast cancer example, it would be the physical pain of the treatments and surgery, the sickness caused from the chemotherapy, and the logistical mess of rearranging life to accommodate the treatment.

Moving outward, the third circle represents the opportunity for caregivers to either add to the inherent suffering a patient is experiencing or to decrease it. It’s the circle of possibility: we can either help to decrease the suffering patients are already going through, or we can increase it depending on how we interact with them.

There are certain behaviors that help decrease the suffering a patient is experiencing rather than increase it:

  • Listening. Taking the time to listen to the concerns as well as the insight patients have of themselves helps bring them deeper into the conversation of their care while validating their value and input.
  • Following through: Anytime we tell a patient to expect something and are unable to follow through on that expectation, trust is lost and their suffering increases. If an expectation can’t be met, letting them know as soon as possible helps alleviate unneeded suffering.
  • Being Empathetic:  Being able to connect in a way that  we understand the emotions of another helps to open our capability to act compassionately toward a stranger.
  • Keeping Them Informed:  Patients are starving for information. Long periods of waiting without any information, even if it’s just checking in to assure them they have not been forgotten, helps reduce their suffering rather than add to it.
  • Asking for Their Priority: This is probably the biggest way to reduce a patient’s suffering. Asking the patient what is most important to them, or what they are most concerned about, can alleviate so much unneeded suffering. Many times, patients are in such a state of unrest that they don’t even realize their unspoken priorities are causing so much stress. By directly asking, we give them the opportunity to voice and have their biggest concerns met.

One of my favorite stories is of a pediatric surgeon. Before taking the child back into surgery, the last thing he tells the patient’s parents is,”As soon as we walk through those doors, your child becomes my child”. It’s a great example of helping to alleviate suffering by showing empathy as well addressing any family member’s greatest concern.

How about you? How do you help alleviate the suffering patients are going through? I’d love to hear your input!



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