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Posted August 09, 2017

COACHING MINUTE: Communicating About Duration in the ED

By Suz Fisher, RN, BA

As an emergency department (ED) coach, I am frequently asked how to effectively communicate about duration in the ED. What if we communicate a specific wait time, and we’re wrong? Patients and families will get upset.

But before we talk about how to effectively communicate duration in the emergency department, let’s take a minute to discuss why it’s important to do so. We know from experience that ED patients have anxiety, often caused by uncertainty. When will I get to see a doctor? How long will the procedure take? When will my pain go away? When can I go home?

It is common for people to express anxiety and worry as anger for one simple reason – anger is a safer emotion to express than fear.  When we share feelings of anxiety, we make ourselves vulnerable…but when we express anger, that vulnerability isn’t there.  (This is true in our personal lives as well – if you think about the last time you were angry with a loved one and really unpack the reasons for your anger, you will likely find the root was fear, anxiety, or worry.)

It is also important to acknowledge the uncertainty of timing in the ED while also providing patients with as much information as possible.

  • Mrs. Jones, it can be challenging for us to give specific wait times in the Emergency Department.  What I can tell you is:
    • I’d expect Dr. Martinez to be with you in 30-45 minutes. If she’s going to be longer, we’ll keep you updated.
    • People who are being called back to rooms now checked in between 2:00 and 3:00 this afternoon.  While you’re here in the waiting room. I’m your nurse. If you start to feel worse or if you need anything, please come and let me know.

Remember that duration can be about more than just wait times. You may also need to communicate with patients about how long processes and procedures will take in the ED.

  • It will take about an hour for this IV to run in.
  • Toradol works very well for this kind of pain. It often takes 30 to 45 minutes for it to start working, but it keeps working throughout the day.
  • I only need one more signature, then we’re done with all the forms.
  • It’s going to hurt, but only for a few seconds, and then it’ll feel much better.
  • It generally takes about two and a half hours from the time I order the CT until I have the results, so I’d expect to have some answers for you by about 11:00.

Try adopting some of these examples as you communicate with patients on your next shift. You’ll be able to ease some anxiety, help people to better hear your information and instructions, contribute to positive outcomes for them, and have fewer upset patients in your department.

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