Nursing the patient who is anxious

Anxiety is the most universal of all human emotions. It is an energy that cannot be observed directly and must therefore be inferred from behaviour. Most people when faced with a new and unfamiliar situation will experience some degree of anxiety. Normal anxiety is proportional to the threat a person is faced with and can provide arousal that is appropriate to the situation. Mild levels of anxiety can be beneficial, acting as a motivating force, which enhances productivity and performance. Severe anxiety can have an inhibiting effect and move a person away from his optimal level of performance towards behaviours which are non-coping and maladaptive (Graves and Thompson 1 ). The manifestations of anxiety are both physical and psychological (see Figure 1.1) and prepare the individual for fight or flight. While under normal circumstances changes in the functioning of the autonomic system heighten a person’s capacity to deal with threats, severe anxiety can severely inhibit a person’s level of functioning in so much that the ability to perceive accurately and without distortion is narrowed. In panic, the most extreme manifestation of anxiety, there is a total lack of focus and the person may thrash about purposelessly, his attention being unfocused and unchannelled in such a way that his safety may be threatened.