Helping Patients With Anxiety and Depression

This article was originally published in the Q4 2023 issue of Med-Surg Nurse Life Magazine.

According to the National Alliance on Mental Illness (NAMI), 22.8% of U.S. adults experienced mental illness in 2021. This means that with 57.8 million people, or 1 in 5 adults, you are guaranteed to encounter patients who are experiencing symptoms of depression and anxiety. Besides coming to your clinic or hospital with preexisting mental illness, the experience of medical treatment alone is enough to make anyone feel distress.

As a medical-surgical nurse, there is so much you can do to make it a little easier to deal with the uneasiness that inevitably comes along with being ill and the experience of being a patient. In your role in medical-surgical nursing, you will be working with patients who are very ill and/or having invasive procedures. These patients will benefit so much from a few simple strategies you can use to support their mental health:

Be Transparent and Make Sure Patients Are Aware of What to Expect
Because the field of medicine can be confusing and complicated, it may help to take on the role of a translator. Doctors often assume that patients know what they are talking about when they deliver a diagnosis or discuss a treatment plan, but that is not the reality. By carefully explaining the diagnosis and how the doctor plans to treat it, you will decrease their anxiety. Patients need to know which symptoms might be problematic and when to reach out to their doctor. They also need to understand what symptoms concerned the doctor and how they arrived at the diagnosis. This health education is so important so patients can understand what is happening in their bodies.

When it comes to procedures, patients need to know exactly what will happen and why the doctor has chosen to move forward with this treatment. Tell them what to expect, even if you have to say that it might be painful. For example, it might be easier to tell a patient that they might get a brief stick from an IV. You don’t want the patient to be surprised by a very painful procedure, as it could impact the trust they have in you throughout the rest of their time under your care.

Teach Your Patients Relaxation Techniques
There are so many anxiety management techniques you can use to help your patients deal with medical procedures. When anxious, your patient’s heart rate and blood pressure may increase, which has negative consequences. Patients get nervous because they worry about experiencing pain with a procedure or even that they might not survive surgery, as being put under anesthesia for surgical reasons causes many people anxiety.

Teaching your patients deep breathing techniques is the first step to reducing anxiety. Speak softly and gently, telling the patient to breathe in and out. Continue to reassure your patients by telling them that they will be OK. You may also try telling them to count backwards from 100 or repeat a certain word over and over again.

Some nurses may also use aromatherapy, putting lavender scents in the patient’s hospital room or rubbing it on their arms. Patients sometimes respond positively to this technique.

Finally, for patients who are experiencing increases in their heart rate, you may want to turn the monitor around so they can’t see the numbers going up.

Listen to Your Patients
One of the best ways to manage depression and anxiety is simply to listen to your patients. Ask them what they are most worried about and provide reassurance. For example, if a patient is anxious about an upcoming surgery, talk to them about the procedure and how they will feel better in the end. When you know exactly what your patients are worried about, you can provide solutions and ease their distress. Even though you have a lot of patients to take care of, treat each patient as if they are your only focus. Sit by their bedside and let them vent about what worries them.

Make Family Members Allies
Patients may do better when their family members are involved in their treatment. They can provide you with important information about the patient’s mental state. For example, is a patient’s depression a new symptom that is caused by the illness experience? By providing the doctor with this knowledge, you are adding important information to the overall treatment plan. It is so helpful when family members are by the bedside providing support to the patient, making them substantially less anxious and depressed. Just having their friends and family members there to chat reduces the vulnerability to symptoms of mental health. Family members can also act as advocates to ensure the patient communicates properly with the treatment team and gets the medical care they need.

Dealing With Depression
You should always screen for symptoms of depression. For example, what does the patient’s affect look like? Are they tearful? Do they look sad? Frequently ask them how they are feeling to make sure that they are not depressed. Don’t be afraid to ask them if they are thinking about harming themselves or suicide. It might feel uncomfortable to ask some of these questions, but patients on medical-surgical floors are often dealing with illnesses that bring on depression. By asking about it directly, you may be saving a life.

Consider Medications for Anxiety
If all else fails, there are medications that might take the edge off for patients who are struggling with anxiety. Some of them (like benzodiazepines) can be addictive, so you must take caution, but they are good when other techniques like talking and breathing don’t work. Work with the treatment provider to consider pharmacological options that might work.