The Power Of Suggestion
One almost universal condition found in illness is
hypersuggestability. Here is the nurse's despair and her hope.
Suggestion may come from without or from within. When from within, we
call it autosuggestion.
Many of the sick are temporarily resting their reasoning faculties and
their judgment. The sick body is causing a feeling of "jangling nerves,"
and the mind, too, is strongly tempted to be sick. So ev
ry harsh sound,
every jolt, almost every sentence spoken in their hearing suggests
immediate nervous reactions. The mind does not wait to weigh them. The
nervous system reacts to them the second the impression is registered.
The whole self is oversensitive, and the very inflection of a voice has
enormous significance. Let the nurse remember that her way of giving a
treatment, her expression, or her very presence becomes a potent
stimulus on the second, one to which the patient's mind responds like a
flash-light when the button is pressed.
The nurse must comprehend the principle of the nervous effect on the
patient of all that is done and said, and realize her tremendous
privilege in making those stimuli wholesome. The nurse who has a
sympathetic insight, with unswerving loyalty to orders, can carry them
out with the average patient, unpleasant though they may be to him, in
such a way that his wholesome emotional response will be called forth, a
response of co-operation, or of faith or of good breeding, or of
"downing" the impulse to indulgence; or a response directed toward
holding the nurse's interest and attention, and so keeping her in the
room; such a response as will gain some privilege, etc.
But there are some patients in whose cases ordinary persuasion,
suggestion or requests fail. They are too nervously or mentally sick to
be moved by logic, or to respond with customary grace to a request which
their reason is not awake to answer. All usual suggestions may fail of
effect. And for these few, in order that health may be at all assured,
even the discipline of force may be necessary. But the nurse must use
this only as a last resort, of course, and in accordance with the
doctor's orders, and then solely as treatment leading toward the ways of
health. Before turning to this final method she should clearly, firmly,
and kindly explain the principle of the discipline if the patient's mind
is at all capable of grasping it. In any case, force should be used only
as the surgeon uses his knife. It hurts, but only to help and to save;
and it is not called upon when other methods can secure the needed
results. But force, thus limited in its application, may prove the only
suggestion which will bring about the action necessary to health on the
part of the patient. Force unwisely and unkindly used proves a damaging
suggestion, causing reactions of fear or anger; or it may lead to
delusions of persecution and to strengthened resistance.
Many suggestions come to the patient from within. Discomfort in the
right side may suggest appendicitis. A slight indigestion, often purely
nervous, may be interpreted as inability to care for certain diet, etc.
The wise nurse will displace as many of these as she can by casual
suggestions on her own part. She will demand of herself that her very
presence be quieting, calming, happy; that her conversation with her
patient shall vibrate with a certain something that gives him courage
and strengthens the desire and the will to health; that her care of him
shall prove confidence-breeding. The patient's attitude, when he is at
all suggestible, is largely in the nurse's hands, and she can make his
illness a calamity by dishonest, fear-breeding, or suspicion-forming
suggestion. After all, the whole question here is one of the normality
of the nurse's own outlook on life and people. The happier, truer, and
more wholesome it is, the more really can she help her patient to both
bodily and mental health. Of one thing let the overzealous nurse beware.
Do not irritate your patient by a patent, blatant, hollow cheerfulness
that any one of any sense knows is assumed for his benefit. Personally I
know of no more aggravating stimulus.
What We Attend To Determines What We Are.--This is one of the first
laws of education. If the child's attention from birth could be
controlled, his future would be absolutely assured. But attention is a
thing of free will and cannot be forced by others. It can be won through
interest or self-directed by will. The child's attention is entirely
determined by interest, interest in the morbid and painful as truly as
in the bright and happy. Punishment interests him tremendously because
it affects him, it interferes with his plan of life, it holds his entire
immediate attention to his injured self. But something more impelling
quickly makes him forget his hurt feelings and he is happy again. The
average sick person is emotionally very much like the child. His will at
the time, as we noted before, is tempted to take a rest, and his
interest is ready to follow bodily feeling unless something more
impelling is offered. The nurse who can direct attention to other
people, to analyzing the sounds of the street, to understanding
something of the new life of a hospital or sick room, to planning a
house, or choosing its furniture or equipping a library, or supplying a
store; to intelligent references to books or current events; or to
redecorating the room--all in his mind; to an appetizing tray, a dainty
flower, a bit of sunshine, a picture, etc., is fixing the patient's
attention on something constructive, helping him to get well by
forgetting to think of himself.
Thus the nurse, knowing the laws of attention, can keep herself alert to
divert and direct her patient's thought to wholesome interests. Knowing
the possibility of thought substitution, she can open up new channels
of thinking. Knowing the power of the will to assist in health bringing
and health keeping, she can sometimes stimulate long-dormant
determination. Let her beware, however, of making the convalescent too
dependent upon help from without, but prick his pride to gradually
increasing doing for himself. Arouse his reasonable ambition, but let
him realize that life must be taken up again a step at a time; and that
he can do it. If limitations must be accepted, try to inspire the
feeling of pride in accomplishing the utmost possible within a
limitation, and an acceptance of the inevitable without bitterness.
Attending to the unhappy, the painful, the boring without looking beyond
makes life unhappy, painful, and a bore. Not that the nurse should
ignore these realities, but she can accept them whole-souledly herself
as not the final things, as merely the rocks that can be used to stand
upon and get a view of the something better for everybody. When they are
thus used by the wholesome mind, facts, the very barest and meanest of
them, can be made useful as stepping-stones to the happier facts beyond
If the nurse can direct or tactfully lead the patient's attention away
from himself and his illness, she has found a big reinforcement to his
treatment. This question is so vital in the care of patients that it
will be discussed at greater length later on.