Agree with above medical student’s assessment.
The satisfying addendum by attendings to a well written assessment and plan.
I stood there and did my best to explain what we felt was going on, our impression of the possible causes, and our investigations around them, some of which simply could not be done tonight.
The family was not satisfied. “We want answers. Now.” From there came the questions. “Why must it happen later? Why is this test being done? Why will you not take our complaints seriously?”
I reassured everyone that we were checking every avenue, that there was a method and reason behind the tests and explained as plainly and thoroughly as I could. More importantly, I tried to address their concerns up front and with honesty.
Nothing could appease my audience. I could feel the growing dissatisfaction in their tone, the tension that my presence brought to an obviously well meaning and concerned family.
However, standing there, the focus of every pair of eyes in the room, I began to feel the churning of my stomach, the pounding nudge in my chest, and the burning flush of my face. I had become an enemy in the room, an obstacle between the vocal family who wished to be heard and heard by none other but the doctor himself. It was time I excused myself.
I returned quickly to my attending and explained the situation: I had attempted my best to alleviate their anxiety and answer their questions but I had failed. I needed help.
When he arrived, even then the discussion presented challenges. It took a lot of work to come to an agreement and understanding.
The communication channel is open both ways. The solution to defusing a situation like this is always to make people feel that they have been acknowledged, that their concerns have been understood, that they are not an afterthought in this already complicated system of care. Even with that in mind, the discussion can be challenging. It really takes a lot of patience, perseverance, and thick skin to build up the rapport needed in difficult situations.
Perhaps with time and experience, I can find a way to finally manage this myself. For now: please do not shoot the messenger.
Were you ever involved in a confrontation? How did you deal with it?
Invest in building your network. It will pay dividends in the future.
I showed up to the ward, hoping to be productive or at least to lend a helping hand for the day. I managed to round on all of my patients.
But I despite my best efforts, I could not quite hack. Having barely a voice is not conducive to this line of work.
After just two hours of work, I am taking the rest of the day off to sleep and rest. I shall see you guys on the other side.
Tom of the Medical State of Mind