5 Strategies for Reducing Team Members’ Personal Anxiety Pre-Catheterization

Studies have shown that patients often experience anxiety before catheterization, and treating or reducing that anxiety is an important part of ensuring a safe procedure. Numerous research studies have evaluated potential methods of decreasing the patient’s anxiety with varying levels of success.¹ Regardless of the method, the obvious conclusion is that anxiety is a common, negative event that can be harmful for the patient.

We as staff are all aware of patient anxiety related to the procedure, but what about the technologists and nurses that are part of the cardiac catheterization team?

The truth is that many staff members have anxiety before procedures, and yet that anxiety is rarely addressed, as the needs of the patient are often seen as paramount over the needs of the team. It is important to realize our patients need the team members to be as confident and anxiety-free as possible, which being mentioned, begs the question…Have you given a thought to your personal levels of anxiety?  

The follow-up to that question is: Do you recognize these changes in our ‘flight or fight’ mechanism are in play before, after, and during a procedure? Stress responses are normal, uncontrollable stresses or the feeling of not being in control, where the negative responses have negative effects. 

This article is short, not meant to be flip or overly dramatizing, but a quick self check for those of us who attend to our patients. 

Tips for reducing anxiety

• Learn to breathe

Anxiety is not always nervousness about life, the success of the procedure or the health of the patient. Sometimes it is the result of something more physical, and often due to not breathing properly. Without full, deep breaths, you heartbeat will increase and light-headedness may result. So make sure you are taking healthy breaths.

• Focus on the patient

Another method of reducing anxiety is to not focus on it. Often this is easier said than done, but anxiety attacks tend to increase when you are trying your best not to be anxious. Find a way to focus more on the patient during the procedure. If you are especially nervous, try talking quietly to yourself, rehearsing any tasks you may need to do out loud so that you are focused on your tasks and not your anxiety level.

• Talk with your coworkers

Hiding your anxiety can also be problematic. When you try to hide your anxiety from those around you, you will discover that it actually increases the severity and/or frequency of the symptoms. Most people feel that sharing such a feeling can be embarrassing, but the effects of not sharing it can be far worse. Rather than hide it, tell your coworkers. Let them be supportive and overlook your work so that you feel less pressure on yourself and know that you have a team around you. 

• Exercise

Exercise is another technique that helps to decrease your anxiety. Try to start exercising before or after work. While not everyone has the opportunity to see a therapist or utilize other anxiety reduction techniques, exercise is the one method that’s simply effective and most people can arrange their daily schedules to provide time for some type of exercise. Exercise creates a better mood, improves confidence, and tires out your body in a way that reduces the severity of anxiety symptoms.

• Reduce daily anxiety

Finally, anxiety accumulates in a way that is unlike other types of mental health problems. The more you experience it regularly, the more severe your anxiety feels when you have natural anxiety during a catheterization procedure. If you utilize techniques such as anxiety tests to increase your awareness and help lower your life anxiety outside of your work, it will help to ensure as much calmness as possible, and any natural anxiousness will start to disappear.

Reducing procedural anxiety

It is not uncommon to find that you have some anxiety during the performance of a procedure, regardless of your level of experience. In some ways it might even be beneficial – keeping you on your toes and making sure that you never get too confident with your abilities. When anxiety starts to disrupt your ability to perform your job adequately, however, it becomes a problem. Look for ways to reduce your anxiety, and you will find that your work becomes much easier and less dangerous for the patient.

Being on task and charged up for the patient is not the same as being anxious about your ability, job, or task. Look to see where those lines blur, and seek ways to defuse the stress.

This article received double-blind peer review from members of the Cath Lab Digest editorial board.

Ryan Rivera writes more at https://www.calmclinic.com.

Reference

1. Cooper K, Stollings S. Guided imagery for anxiety. End of Life/Palliative Education Resource Center. Medical College of Wisconsin. Available online at https://www.eperc.mcw.edu/EPERC/FastFactsIndex/ff_211.htm. Accessed April 5, 2012.

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Commentaries to “5 Strategies for Reducing Team Members’ Personal Anxiety Pre-Catheterization”

The cath lab environment can be frightening for both patients and team members new to the field. Those patients with anxiety can be attended to with the loving care you would extend to family members who need some extra attention. Those staff members who demonstrate ‘analysis paralysis’ — that is, failure to act for fear of failure — can be aided by a senior team member and kindly physician taking this person under their wing for personal instruction and confidence building. The article by Rivera reminds us all that knowledge is power: the power to act correctly, carefully, and kindly.

— Morton Kern, MD,
Clinical Editor, Cath Lab Digest, Chief Cardiology, Long Beach Veterans Administration Health Care System, Long Beach, California; Associate Chief Cardiology, Professor of Medicine, University of California Irvine, Orange, California.

I think a lot of us “old-timers” forget what it was like when we first started working in the cath lab. This article reminds us to be a little more forgiving to our “green” co-workers. The breathing and relaxation techniques will help in some situations. But, ultimately, the ability to relax comes from the knowledge you get from watching each physician and gaining their trust that you are there to help, and that they don’t have to worry about what you may be doing. You need to be a “sponge” and learn. Read cath lab journals, watch your peers, go to the seminars, read online articles, etc. Knowledge is power and it doesn’t take that long before you start getting the confidence to look like you know what you are doing, and people will actually start coming to you for the answers!

— Cary Lunsford, RCIS, FSICP, Presbyterian Intercommunity Hospital, Whittier, California

For our teaching hospital, the attitude and capabilities of the attending physician set the mood for all of the staff and trainees. Before the procedure, helping everyone relax by talking with the team and the patient, with limited joking where appropriate, makes for a comfortable and enjoyable procedure for everyone.

When the proverbial material hits the fan, I have found that keeping a calm and competent demeanor helps everyone focus on the task at hand. Speaking directly and clearly can help communicate the seriousness of the situation, but anything beyond this will raise tensions and anxiety.

— Arnold Seto, MD, MPA,
University of California-Irvine and Long Beach VA Medical Center,
Orange, California