Today during debriefing, the facilitator made a profound comment. He said, "the healthcare providers with the highest emotional intelligence hold a double-edged sword. They have the highest work satisfaction and are the most likely to have severe/catastrophic burnout. It's the difference between PTSD and PTS growth." This came after my presentation of a really tough situation I've been managing (almost completely on my own) since Monday.
Before we go there, the facilitator is amazing. He is joining the palliative care team in May that I will be joining in August. He is a surgeon from a former life, converted to palliative care, and also has his MDiv. He is an incredibly positive person, and is good at instilling confidence in the people he works with. I almost want him on my mentor team just for the continued confidence boost I would get.
At any rate, I have had a really difficult case that I picked up on Monday. The family requested transitioning to a focus on comfort. The caregiver that had been living with the patient for the last year was concerned that the family was forcing the patient into an earlier death than she would have naturally had. The anxiety levels and lack of sleep led to an incredibly frustrating night and early morning for them on Tuesday, which resulted in me being blamed for the situation because I had not put in enough medication to manage the patient (despite the fact that I am in training, and should have someone to double check my orders as part of education to provide feedback). I felt terrible because I felt like I had let the patient, the family, and the team down by not asking for recommendations on medication management. We got the patient on a PCA which significantly helped her pain and the family's anxiety, along with my staying with them to observe what she was doing that was concerning and provide guidance on what to look for.
This morning, the patient was more alert and comfortable. Her caregiver was in a better place. And then the surgeon came in upset that this had transpired, and didn't understand why the family had been allowed to do this. This got the caregiver riled up again about how things were moving too fast, and the children were forcing her death too early. I was brought into the meeting between the surgeon and the daughters. The daughters explained their position. The surgeon backed down and apologized, and then continued to pour his heart out. He reported his stress over whether the surgery should have even happened. He felt such remorse, and was looking to the grieving family to help him work through his existential crisis about his career as a surgeon. It turned out he had several recent surgeries that had ended similarly.
The facilitator was able to note that for many surgeons, their excellence in their career was intimately tied to their identity. The second was that I was looked on as the expert in communication, and was needed to validate the emotions in the room while delicately moving the focus forward to future care. The facilitator was in awe at the amount of genuine care I had for the patient, her family, and the surgeon. Despite my frustration in the room, I was able to step back afterward and see the situation for what it was. I now have the chance to hopefully reach out and try to support a colleague who is going into a tail spin and looking for someone to provide a parachute. I hope I have the strength to do what needs to be done to acknowledge the surgeons suffering. I hope I can see when I reach a point where I might end up in a tail spin and know how to reach out to my colleagues for that parachute rather than the patients and families who are already in their own grieving process.
