REASSURANCE

We talk of “the doctor (or nurse) as a drug”. Reassurance is an important part of controlling symptoms. It is based on a trusting relationship. (Trust mainly depends on whether the patient likes you, and that is significantly correlated to whether you spend some time talking with the patient about non-medical issues.) (see Trust)

A common fear is that any new symptom means that the cancer is spreading, or that the situation is worsening. It is very important to explore fears behind symptoms. An important question is, “Have you known anybody else with cancer?”

It is very important to pin-point the worry before giving reassurance. It is useless to reassure a patient that he won’t get pain, when his real terror is of suffocating to death.

«  Never just say “don’t worry”. This implies there is something to worry about without giving the patient the chance to discuss it.

Examination is usually an essential part of reassuring someone about a physical problem, to demonstrate that you are in full possession of the facts prior to starting to reassure. The final step in reassurance is explanation. Even when the situation is as bad as it can be, explanation still reduces uncertainty and thus raises morale. (see Explanation)

People sometimes feel embarrassed at having to complain about all their discomforts and physical problems. It is sometimes helpful to reframe this situation by explaining that telling you about symptoms is not “complaining”, but is, in fact, helping you to do your job efficiently.

«  False reassurance is a distancing tactic, and destroys trust. It is important to be honest. (“We can’t completely cure that liver of yours, I’m afraid.”) It is also important to be optimistic – which is where expertise in symptom control comes in. (“I’m sure we can help you.”)

The author and publisher have taken precautions to ensure that the information in this book is error-free. However, readers must be guided by their own personal and professional standards of good practice in evaluating and applying recommendations made herein. The contents of this book represent the views and experience of the author, and not necessarily those of the publisher.