Dealing with tricky patients

[Jman400]

I'm a trauma surgeon and I've finished my fellowship recently. I work at a busy emergency hospital in a major metro, so I regularly see gunshot wounds, car crashes etc. Now for my patients and their families, it's probably the worst thing to ever happen to them and emotions are always running high, which I can perfectly understand.

However, in the past few days, I've had some experiences which I am not sure how to handle. In one case, I finished a 6-hour long surgery at night and was taking a small 15 min break eating some food in the cafeteria and talking to my colleagues. Then the mother of the patient came and basically screamed: "Why aren't you saving my son, how can you just sit here etc etc".

Now I understand that it's probably the worst thing to ever happen to her, but at the same time, I can't be expected to be running round in a full frenzy every single day. For me, its just another day at work. This has happened a few times now in just the past week, although not as dramatic as the one I described.

I explain that I'm trying my best etc. and other doctors are also caring for the patients but is there any way to stop this happening in the first place and how do the rest of you deal with this?

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[dpmd]

I'm a trauma surgeon and I've finished my fellowship recently. I work at a busy emergency hospital in a major metro, so I regularly see gunshot wounds, car crashes etc. Now for my patients and their families, it's probably the worst thing to ever happen to them and emotions are always running high, which I can perfectly understand.

However, in the past few days, I've had some experiences which I am not sure how to handle. In one case, I finished a 6-hour long surgery at night and was taking a small 15 min break eating some food in the cafeteria and talking to my colleagues. Then the mother of the patient came and basically screamed: "Why aren't you saving my son, how can you just sit here etc etc".

Now I understand that it's probably the worst thing to ever happen to her, but at the same time, I can't be expected to be running round in a full frenzy every single day. For me, its just another day at work. This has happened a few times now in just the past week, although not as dramatic as the one I described.

I explain that I'm trying my best etc. and other doctors are also caring for the patients but is there any way to stop this happening in the first place and how do the rest of you deal with this?

I just tried to never be where they could see me. Not worth the hassle. Harder if you don't have a separate room in the cafeteria or somewhere else to sit once you get your food. That plus not taking it personally when they do go off on you is all you can do.

 

[LucidSplash]

I never eat in the cafeteria for this reason. Unless someone has trained in the way we do, they don’t understand the length of our workday or the long surgeries without taking a break to pee or get something to eat or decompress. I don’t see this as their fault, it’s just the way it is, and trying to explain this to someone during, as you say, the worst day of their life, is non-productive for everyone.

So I eat in the docs/surgeons lounge if there is one, or my office, or wherever I can have a few minutes to myself. The cafeteria isn’t that place.

 

[deleted50541]

Now I understand that it's probably the worst thing to ever happen to her, but at the same time, I can't be expected to be running round in a full frenzy every single day. For me, its just another day at work.

That's the disconnect, isn't it. You're tired and hungry, it's been a long day/night, and this is your job. And it intersects with someone's life coming to a complete stop and facing a tragedy for them and their family. You do your best to comfort them and keep them informed of the situation. But you can't control people's emotions and how they're processing the unfolding events.

Conflicts with patients and their families will continue to happen throughout your career, especially in trauma where emotions often run hot. Think about the situations you encountered and how you might have handled them differently. If things really escalate, I've found it helpful to get patient advocacy or another colleague who's familiar with the case involved. On one or two occasions, I've even involved risk management.

Ultimately, you can't completely stop these types of situations from ever happening. All you can do is control your own emotions, do the best job you can, and be mindful of the situation at hand. And avoid the cafeteria if you can...

 

[akwho]

Our trauma hospital has a separate cafeteria for employees. It's weird to me that there wouldn't be a separate area for employees to eat at your hospital given the typical trauma clientele. It seems like a safety issue for the employees if they are available to verbally assault by bereaved family members when trying to eat for 15 minutes during a 24hr shift.

 

[Jman400]

Thanks for the replies everyone, I understand there isn't really anything that can be done and I'll just have to learn to deal with this.

Unfortunately, my hospital is unusual in that the employee cafeteria is adjacent to the normal one, with nothing stopping someone from simply walking over to the employee side.

 

[HighPriest]

But a fake mustache. The curly kind. Tell the patient they must be mistaken, you’re good twin is probably the one caring for their family member, and they should thank their stars they didn’t get the evil one.

This works on two levels because they’ll leave you alone and also be very happy to see you the next time.

 

[Dr G Oogle]

That sucks. Sorry that happened. The masks actually help with this. But what everyone has said about avoiding families by eating elsewhere is right. I’ll even take a 5 minute detour to avoid going into the OR suite through the patient waiting area and if I walk into the cafeteria and I see a family member I’ll bee line straight to a different food dispensary, nothing good comes out of interacting with families outside of clinical interaction

 

[TypeADissection]

I can't remember which book it was from, maybe House of God? Where he talks about the FAR/FAM - Family Avoidance Route/Maneuver. It's funny because I read this the summer between MS1-MS2 and thought, "Wow. That's stone cold. I would never do that." Fast forward to residency/fellowship and if I'm walking with a med student and I see difficult or even long-winded families, it goes like this:

Me: OK so we're gonna go ahead and cut across the snack room, throw our mask up, and head down the stairs, then head back up stairs to checkup on this next patient.
Med student with curious look on face: But isn't the patient at the end of this hallway?
Me: Trust me. This gets us a few more steps and saves us about 10-15 minutes of needless chatter.
Med student now with epiphany: I have so much to learn in the ways of the Jedi.
Me: Yeah that's great Capt. Kirk walk faster.