What do you say instead of "You'll be fine/okay"?

DragonClaw

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I went for my clinicals and the was a young adult women who was a bit dinged up in a MVC. She was bleeding from the head, medic wanted to put 2IVs in, only could get one, self extricated from a totaled car, etc.

I kept wanting to tell her she'd be fine, but I can't actually know that and we're not supposed to say that, right? I didn't know what to say.

She wasn't dying as far as we knew, but she was still not the best. I just wasn't sure what the fallback is when the normal reaction is "You'll be fine".

(Also, is it normal on clinicals for a student to basically do nothing?)
 

mgr22

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I don't know if I ever told a patient they'd be fine. To me, it sounds patronizing, superficial and insincere. And even someone who is "fine" doesn't necessarily stay that way.

There are plenty of things you can say to your patients without trying to predict the future.
 

DragonClaw

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I don't know if I ever told a patient they'd be fine. To me, it sounds patronizing, superficial and insincere. And even someone who is "fine" doesn't necessarily stay that way.

There are plenty of things you can say to your patients without trying to predict the future.
It's an attempt at reassurance, but I agree it sounds patronizing and superficial. I guess it's trying to get them to not freak out. Like if you've ever had siblings and rough houses and then someone got hurt and you tell them "You're fine, you're not hurt don't tell mom"

I dunno.
 

VentMonkey

Ajaw
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“I’ll/ we’ll do my/ our best.”...”You’re in great hands.”...”We will (are) doing everything that we can.”

The latter is usually enough to reassure family members during a resuscitation.

Also, it helps if you exude confidence and experience. Neither of which you seem to possess yet.

Seriously, get the job then figure out the rest as you go a long. GL.
 

Peak

ED/Prehospital Registered Nurse
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Even though it may feel good to tell someone it's going to be okay that often isn't the right thing to do. It isn't uncommon that I tell patients or their family that I'm worried that they are very sick or aren't doing well. It's hard but sometimes you have to be very genuine and honest if you really want to take care of your patient and their family.

If I have a patient who isn't well but also doesn't seem to be have a disease requiring surgery or hospitalization then I'll say something along the lines of 'I think that you'll probably be okay, but I wouldn't want to be wrong and miss something so let's get you to the hospital/do some tests (imaging, labs, whatever). I'm going to ... (start an IV, give appropriate pain management, tell them about labs you are going to run) and then I'll update the care team when we get to the hospital/leave the room so that we can make a good plan to take care of you. What questions can I answer for you right now?'

If a patient is more critical I'll say something along the lines of 'I'm worried that you could be really sick, but I want to do a couple of things quickly so that we try to get you doing better. I'll try to explain things as we go along but please let me know if you have questions as I do things... (continue with rest of spiel).

If a patient is actually really sick I never offer false reassurance. I hesitate to say things like 'we are doing everything we can' because it can seem both fatalistic and for some people I think can make it seem like if we do enough things we can save them. Rather I typically actually describe in manner appropriate for the situation and the audience's knowledge level what is happening and how we are trying to fix it. For example I would say that 'your husband/father's cancer had spread and caused a tear a hole in his bowel, that the contents have cause a very large infection and that has kept his body from being able to support his blood pressure. We are giving him fluids and medications to support his blood pressure, and antibiotics to try to fight the infection; as well as pain medications to keep him more comfortable. At this point we are going to talk to the intensive care unit doctors as well as the surgery team to try to figure out what the best plan for him is. I'll keep you updated as we develop that plan but what questions can I answer for you.' This of course is a more ED example but can be modified based on whatever environment I'm in on a given day. Families may ask more detailed medical questions, but at least initially I try to avoid most medical jargon as while we may be comforted by using it most families quickly get lost and stop listening.

The same goes when we have patients coding or facing the end of life, most families are going to be grasping as whatever hope they can find, especially if it is a kid or the patients condition was very sudden. These conversations are never easy, especially if you don't have the experience or knowledge to approach that conversation in a real but supportive manner. Offering false hope or promises never helps them, especially if we need the patients family to help make good decisions regarding stopping resuscitation efforts or withdrawing care.

Fortunately in EMS you can probably get away with saying very little until you get to the hospital, and there will typically be a veteran medic, police officer, or other responder who does have more experience with those conversations.

Of course the patient condition will vary and of course there is no script that will always fit perfectly or work well for every person, the more you get comfortable talking to patients the more natural it becomes.
 

RocketMedic

Earl of the Wheeled Chair
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Definitely don’t say they’ll be fine when you’re going to hospice lol.
 

Bullets

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“We are going to take great care of you”.
Yup, and then at the hospital I always introduce the nurse to the patient with "This is John, he'll be your nurse and they're going to take great care of you"
 

DesertMedic66

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“Yo dawg, I got you fam”
 

DesertMedic66

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Is the emphasis on dawg or fam. Purely educational reasons, of course.
In this situation it should be placed on dawg. Make sure to do a slight pause after saying dawg.
 
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