Background

Many of us have or are now working in a high volume, fast paced MR environment. The old saying “time is money”, but what happens when your patient is anxious, in pain, angry or any other of the many obstacles we as Technologist/Radiographers may encounter^1,2? How do you handle a surgeon, resident or nurse that are pushing you to hurry and move their patient ahead of others? I have read many articles on how a physician/radiologist is to diffuse an angry patient³, but I have found little on how the technologist/radiographers resolves the issue and helps the patient. While this may be helpful for an attending it may not help a radiologist as much since normally they have less interaction with our patients than we do. The first line of defense is your receptionist. From that point on it can go up or down depending on the patients first encounter with staff at your facility. First impressions will set the mood for the entire procedure and possibly the whole time your patient is at your institution.

Teaching Points

It’s the start of your shift. Your schedule is booked, the phone is ringing with emergency requests, and the MR scanner is down. You also find you are short staffed. This is how at some point, we have started our day. What to do? You may be stressed before you get started, but how do we contain our anxiety and not project this on our patients? Do you present a calm and professional demeanor? Yes! Do you make the patient feel that they are the most important person and you are absolutely concerned and involved with their care? Yes! Invest in time. Time to listen not just what they are saying but listen to body language. Tense? Pacing? Passive/aggressive? Just to name a few. Look at your own body language. Body language can give you away if you are rushed or feel irritated. Project a calm demeanor. Reassurance/empathy-goes a long way with getting your patient to work with you and you can get the procedure done in a timely manner². Explain the procedure before you take them into the scan room. Reassurance that you are not leaving your patient⁴. TOUCH is an amazing comfort to a patient on the table. I know in a world with a pandemic, touch is not something we want to try but you will be amazed that just a hand on their forearm or their hand as long as you are wearing gloves can change the whole outcome of the study. When patients come into a hospital/clinic they feel they have lost all control. Control is something that I have heard time and time again from my patients. Reassure your patient that in fact they are in control. They can stop the scan at any time. Of course, we don’t want that to happen but you have given that person the feeling of control over their procedure. How we handle each situation will set the mode for your day. One option would have the radiologist on duty prioritize your schedule. Meaning that the add-ons prioritize which one in the event that you have a space goes first. Of course emergency patients take the priority over general. Be flexible. Make sure your patients that are waiting are informed of the situation. Give them the option to wait, get something to eat (if applicable) or reschedule at a time that is convenient for them. Most importantly when doing this is to be KIND and PATIENT. Some patients may have had a bad experience in the past⁵. You can’t please everyone every time but there is no reason you cannot try to diffuse a potential volatile situation. Angry patients are very difficult to calm down. The need to de-escalate the situation is a high priority. Try to remove them from the situation. Take them to a quiet place to talk. Avoid trying to justify the situation. Just give them the facts. Once again LISTEN. With an angry patient do not allow yourself to be in a dangerous situation. Position yourself so that you can leave the area if you need to exit quickly. Let them vent and listen to the frustration that they feel either real or perceived. If necessary, get your lead tech or supervisor involved. We can make a difference every day. This great English expression “at the end of the day” reminds us that when it is all said and done what is important to realize is who is in the center of everything we do. Who is the beneficiary of everything we strive to accomplish? It is those who walk into our department for their healthcare and imaging needs.

Summary

Listen, touch, time, kindness. The patient is a person and not just the next case.

Acknowledgements

Disclaimer: The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Uniformed Services University of the Health Sciences or the Department of Defense of the United States of America.