“…the strong do what they can and the weak suffer what they must.” Thucydides, History of the Peloponnesian War
Advice for all medical staff when confronted with a patient who has a needle phobia. (Written by a psychotherapist who has a deep-seated needle phobia.)
- Smile and look sympathetic. Don’t look annoyed or judgemental. Having a face that says, “You stupid fool! Why are you being so awkward and complicating my day!” doesn’t put the patient at ease or keep the retreating veins near the surface. Go on, show a bit of compassion for someone in genuine fear.
- Understand that the fear is genuine. Patients don’t wake up and say: “I know what I’ll do today. I’ll pretend to have a fear just to be awkward.” The look of terror isn’t good acting. In many cases, there may be sound reasons behind the fear relating to previous traumas.
- Make sure you don’t make things even worse. In some cases the phobia has been made stronger by numerous unhappy repeated experiences. Work to make sure that this occasion challenges the awful experience rather than reinforces it.
- Know that the patient knows it is irrational. Don’t be patronising. Saying: “It probably won’t hurt,” or “We need to get blood to find out what is wrong with you,” isn’t telling patients something they don’t already know.
- Understand the power of the feeling for the patient. The patient sees threat, and the amygdala is firing off strong, primitive fight, flight, or freeze responses. It is automatic. If the patient could easily control it (s)he would have done so by now.
- The patients are probably acutely embarrassed by the situation. They too wish it would go away, perhaps more so than you. In many cases they may have made real efforts and spent significant money (e.g counselling, psychotherapy, cognitive behaviour therapy, EMDR, hypnotherapy, neuro-linguistic programming) to attempt to solve the problem themselves.
- Don’t look terrified in a way which says: “I learned how to do it one way. But if you vary that, I might fail.” Such looks destroy confidence and increase fear.
- Realise it isn’t about you or your skill. Patients being honest with you about difficulty or requesting you respect some wishes of theirs (not there but there), isn’t an affront to your competence. It doesn’t mean that you have to Rambo in just to prove how great you are. Listen to them and work with them to find a solution.
- Don’t spend too long preparing equipment or tapping for veins. Surprisingly, waving syringes in the air or repeatedly touching sensitive areas doesn’t help. It is not unknown for patients to faint if the starting process takes a long time.
* Be warm, compassionate, and understanding.
* Be confident.
* Do as much preparation as possible before entering the room.
* Respect the patient’s wishes, if possible. Give them as much control in the process as you can.
* Be as quick as possible, and if possible, even quicker.