Anesthesia in the News
  • Lead the Dialogue to Patient Empowerment

    One recently published study performed in Sweden examined how nurse anesthetists (NAs) can most effectively empower wary patients and calm their fears through talk and touch.

    ‘The courage to surrender’

    Researchers at the School of Health Sciences at Jönköping University, Jönköping, Sweden, used the term “empowered” to refer to how patients may feel when they are assisted in overcoming feelings of helplessness prior to undergoing anesthesia. Referring to an earlier paper on the subject, study authors wrote, “the basic driving force of empowerment is the patient’s desire or the courage to surrender to the inevitable that anesthesia involves (Liebenhagen & Forsberg, 2013).”

    Twelve NAs participated in the interview-based study: 7 men and 5 women, aged between 29 and 63 years (mean 52 years). The study consisted of 15- to 20-minute interviews in which the anesthesia provider subjects were first asked, “Would you like to describe your perioperative meeting with the patient?” Other questions included, “Can you tell me more?” and “How do you mean?”

    The perioperative period was defined as “pre-, intra- and postoperative care in connection with examinations and operative procedures with or without anesthesia.”

    The essential nine

    The researchers used as their model a guide developed by Gibson in 1991 that proposed nine roles for nurses in patient care: Helper, Supporter, Counselor, Educator, Resource Consultant, Resource Mobilizer, Facilitator, Enabler, and Advocate.

    Many of the NAs discussed coupling verbal reassurance with physical touch to help their patients. “[I] try to talk to the patient while holding their hand or touching their arm,” said one. Another said, “I can stroke the patient on the cheek and say: I am sitting here right next to you. I see and hear you at all time[s].”

    Another technique was explaining exactly what would happen in the perioperative process: “We’re talking about anesthesia and what’s going to happen — explaining which drugs are being administered and how the drugs work. Then you show the respiratory mask and the patient can try to breathe in it. Often you have to repeat yourself,” noted one NA.

    Competence spurs confidence

    Another element to empowerment was instilling confidence in the patient. One NA study participant noted, “In the conversation with the patient, you demonstrate that you are competent. The patient becomes more confident when they learn that you know what you are doing and that you have done this many times before.”

    It is in this perioperative dialogue that the patient experiences a trustful atmosphere in which the patient and the NA can meet. In building a relationship with patients, the researchers claim, NAs empower patients, reassuring them that they have both self-determination and dignity.

    Read the full study, Abelsson A, Falk P, Sundberg B, Nygårdh, A. Empowerment in the perioperative dialog. Nursing Open. 2020; 8: 96-103 at https://doi.org/10.1002/nop2.607