Empathy vs. Boundaries & Self-Care

[scpm]

Hi! I'm reaching out for advice/opinions on some situations related to a clinical volunteering role.

I've been volunteering at this setting for about a year now. Without getting specific, the patients I see are facing very serious, disabling health issues. It can be a pretty stressful, emotionally intense environment. I've developed close relationships with several patients, as well as their families.

Heres the bit I need some guidance on: Sometimes I feel like I get too emotionally invested and it can be hard to leave my shift when patients I'm visiting with keep wanting me to stay longer / do more for them. Last week when I was with a patient, I left while they still seemed upset and I've been feeling so so guilty about it. They had several issues they wanted me to bring up with their nurses, and then wait with them until a staff member came to their room. Usually, if I can, I stay and help with communication between patients and staff where it's beneficial.

I brought up everything they asked with the nurses, but it can take a while for someone to actually come into the room unless it's something really urgent. I had been there for a long time, and my own blood sugar was low since I hadn't eaten for a while, I was a little dizzy, and I was starting to feel drained. Although I let them know the nurses would be in to see them soon and said a warm "Goodbye see you next week", they were still stressed and seemed worried that I wasn't staying longer.

I feel like if I knew how to establish clearer boundaries, I would be able to do this role more effectively. I want to be able to comfort and support patients in really vulnerable situations, but I also know that keeping a certain emotional distance & taking care of yourself is important for health care professionals as well.

I also feel really guilty & selfish when I call out of a shift. One night I was really nauseous from a medication side effect and got no sleep at all. I woke up really anxious / still feeling mentally foggy from not sleeping. I called out of my shift but felt bad about it. I knew it would be hard to handle any potentially stressful situations when I felt gross myself, but I also kept asking myself if I could have just powered through and gone in.

Obviously, as a future physician I know I couldn't just call out when I felt a little off but even as a volunteer it makes me question how good I am at keeping my own boundaries/health in check.

Has anyone else dealt with boundary setting in really emotionally difficult clinical situations? How do you all balance empathy to patients without getting swept up in their pain yourself?

Any thoughts/advice is appreciated!!

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[KnightDoc]

Hi! I'm reaching out for advice/opinions on some situations related to a clinical volunteering role.

I've been volunteering at this setting for about a year now. Without getting specific, the patients I see are facing very serious, disabling health issues. It can be a pretty stressful, emotionally intense environment. I've developed close relationships with several patients, as well as their families.

Heres the bit I need some guidance on: Sometimes I feel like I get too emotionally invested and it can be hard to leave my shift when patients I'm visiting with keep wanting me to stay longer / do more for them. Last week when I was with a patient, I left while they still seemed upset and I've been feeling so so guilty about it. They had several issues they wanted me to bring up with their nurses, and then wait with them until a staff member came to their room. Usually, if I can, I stay and help with communication between patients and staff where it's beneficial.

I brought up everything they asked with the nurses, but it can take a while for someone to actually come into the room unless it's something really urgent. I had been there for a long time, and my own blood sugar was low since I hadn't eaten for a while, I was a little dizzy, and I was starting to feel drained. Although I let them know the nurses would be in to see them soon and said a warm "Goodbye see you next week", they were still stressed and seemed worried that I wasn't staying longer.

I feel like if I knew how to establish clearer boundaries, I would be able to do this role more effectively. I want to be able to comfort and support patients in really vulnerable situations, but I also know that keeping a certain emotional distance & taking care of yourself is important for health care professionals as well.

I also feel really guilty & selfish when I call out of a shift. One night I was really nauseous from a medication side effect and got no sleep at all. I woke up really anxious / still feeling mentally foggy from not sleeping. I called out of my shift but felt bad about it. I knew it would be hard to handle any potentially stressful situations when I felt gross myself, but I also kept asking myself if I could have just powered through and gone in.

Obviously, as a future physician I know I couldn't just call out when I felt a little off but even as a volunteer it makes me question how good I am at keeping my own boundaries/health in check.

Has anyone else dealt with boundary setting in really emotionally difficult clinical situations? How do you all balance empathy to patients without getting swept up in their pain yourself?

Any thoughts/advice is appreciated!!

I think you really need to speak to someone at the clinic about this, hopefully your supervisor or maybe the person in charge. You have identified a serious issue -- if you don't address it, soon, you will absolutely burn out. You will also have a difficult time as a physician if you can't be empathetic and caring while establishing boundaries.

 

[Moko]

Many patients would love to have additional time with their nurses, techs, doctors, therapists etc. The hard realities though is that time is a limited resource (any minute spent with one patient is a minute not spent with someone else), and that ultimately we need to take care of ourselves first if we are to help others. If you are not feeling well yourself, you should not be toughing it out especially as a volunteer as you may inadvertently expose patients to whatever you have (this becomes less true later on as your role becomes progressively more essential). Compassion and empathy are good traits to have, but can be detrimental in excess. Give patients realistic expectations ("yes I can stay for another few minutes, though I need to go soon to take care of something else / make sure other patients are doing okay"). Don't feel guilty about prioritizing yourself in these situations.

 

[scpm]

@Moko @KnightDoc Thank you so much for your responses! I will consider scheduling a meeting with my volunteer coordinator and asking for his opinion.

If anyone else has similar experiences / wants to keep the discussion going here or in PM feel free!

Thank you again!

 

[Select All That Apply]

@scpm Your job as a volunteer is to be there for the patients as a point of contact and to listen to their concerns. In your post you discussed about establishing clearer boundaries, but what are you establishing boundaries between? Yourself and the patient? It seems like you don't understand that your role is to let them know that someone is listening. Whenever you interact with patients they will have tons of expectations and there will be social considerations that will spill over on top of that. If you are feeling overwhelmed by making promises to convey that you can get a nurse to address them, then you need to orient them to use their call button in order to call for a staff member. There are systems in place that patients need to use because the resources are there, patients often will not use them and choose to take matters into their own hands which can result in more drastic situations like a fall in which the hospital becomes liable.

As far as your personal medical health is concerned, I think that if you are being candid where you are having these events where you know your "blood sugar was low" and getting "nauseous" from medications then you may be due for a visit to your PCP in order to see if you could be diabetic or need to reconsider whatever medications were making you nauseous in the first place. If I were a volunteer coordinator I wouldn't understand how to address these issues aside from either reducing your hours as a volunteer or moving you to another unit where there are less sick people. Maybe in a best case scenario the volunteer coordinator could go to the unit manager and have all the nurses reprimanded to spend more time with their more verbal/HCHAP$ responsive patients instead of wasting time on treating higher acuity/more lethargic patients.

 

[AMCASTuesdays]

OP its really comforting to know other folks struggle with this. This was a big part of my PS actually - learning how to become more effective in clinical spaces by setting boundaries. As I'm sure a lot of people on here can echo, when you're empathetic you want to do absolutely everything you can and it's easy to forget yourself in that. But as @Moko said, ultimately you're less effective if you consistently overextend yourself. Its something i'm still working on, but its helped to see the boundaries I have to set as being best for the people I'm working for and with. I really feel for you based on how you're describing that this has effected you and I'm glad that you can identify that this is a something you want to address for the better. It's way better to do that now than in about 10 years.

 

[Cornfed101]

OP its really comforting to know other folks struggle with this. This was a big part of my PS actually - learning how to become more effective in clinical spaces by setting boundaries. As I'm sure a lot of people on here can echo, when you're empathetic you want to do absolutely everything you can and it's easy to forget yourself in that. But as @Moko said, ultimately you're less effective if you consistently overextend yourself. Its something i'm still working on, but its helped to see the boundaries I have to set as being best for the people I'm working for and with. I really feel for you based on how you're describing that this has effected you and I'm glad that you can identify that this is a something you want to address for the better. It's way better to do that now than in about 10 years.

Some of us have the opposite problem. I am too good at setting boundaries and, while I have compassion for people, sometimes I am too disconnected... We all have things to work on!

 

[AMCASTuesdays]

Some of us have the opposite problem. I am too good at setting boundaries and, while I have compassion for people, sometimes I am too disconnected... We all have things to work on!

yeah luckily we all get you spend a couple years figuring all this out lol

 

[Select All That Apply]

Considering that the OP is a junior and will be taking on gap years in a little more than a year with likely an interest in seeking full time employment in healthcare, I think they would benefit more from having a more realistic picture of the role that they are serving as a volunteer. I think it is interesting though that some other members feel like there can be a candid conversation on establishing boundaries from being an emotion melding empathic individual. I have found the idea of empathy v sympathy to be a tactic used by HR to pull you into the office when your confused CIWA patient has called you a bitch and tries in a failed attempt to inflict bodily injury on you to tell you that there could have been some improvement on your end with how you inserted the IV into their arm or how you used a sitter/security to provide medical assistance.

"You didn't anything wrong, but you could have been more empathic to their condition."

Of course, both the HR representative and the volunteer only see the patient when they have recovered enough of their cognition to be civil and use words to discuss their grievances. I'm tired of how we intentionally shelter certain aspects of healthcare from those who would be better served from seeing the whole picture so that they could weigh in on how these matters affect their own philosophy on whether they think their thoughts for the patient are sympathy or empathy.

 

[AMCASTuesdays]

Considering that the OP is a junior and will be taking on gap years in a little more than a year with likely an interest in seeking full time employment in healthcare, I think they would benefit more from having a more realistic picture of the role that they are serving as a volunteer. I think it is interesting though that some other members feel like there can be a candid conversation on establishing boundaries from being an emotion melding empathic individual. I have found the idea of empathy v sympathy to be a tactic used by HR to pull you into the office when your confused CIWA patient has called you a bitch and tries in a failed attempt to inflict bodily injury on you to tell you that there could have been some improvement on your end with how you inserted the IV into their arm or how you used a sitter/security to provide medical assistance.

"You didn't anything wrong, but you could have been more empathic to their condition."

Of course, both the HR representative and the volunteer only see the patient when they have recovered enough of their cognition to be civil and use words to discuss their grievances. I'm tired of how we intentionally shelter certain aspects of healthcare from those who would be better served from seeing the whole picture so that they could weigh in on how these matters affect their own philosophy on whether they think their thoughts for the patient are sympathy or empathy.

Haven't been this confused since CARS

 

[Select All That Apply]

Haven't been this confused since CARS

I'm sorry.

 

[Medic741]

Hi! I'm reaching out for advice/opinions on some situations related to a clinical volunteering role.

I've been volunteering at this setting for about a year now. Without getting specific, the patients I see are facing very serious, disabling health issues. It can be a pretty stressful, emotionally intense environment. I've developed close relationships with several patients, as well as their families.

Heres the bit I need some guidance on: Sometimes I feel like I get too emotionally invested and it can be hard to leave my shift when patients I'm visiting with keep wanting me to stay longer / do more for them. Last week when I was with a patient, I left while they still seemed upset and I've been feeling so so guilty about it. They had several issues they wanted me to bring up with their nurses, and then wait with them until a staff member came to their room. Usually, if I can, I stay and help with communication between patients and staff where it's beneficial.

I brought up everything they asked with the nurses, but it can take a while for someone to actually come into the room unless it's something really urgent. I had been there for a long time, and my own blood sugar was low since I hadn't eaten for a while, I was a little dizzy, and I was starting to feel drained. Although I let them know the nurses would be in to see them soon and said a warm "Goodbye see you next week", they were still stressed and seemed worried that I wasn't staying longer.

I feel like if I knew how to establish clearer boundaries, I would be able to do this role more effectively. I want to be able to comfort and support patients in really vulnerable situations, but I also know that keeping a certain emotional distance & taking care of yourself is important for health care professionals as well.

I also feel really guilty & selfish when I call out of a shift. One night I was really nauseous from a medication side effect and got no sleep at all. I woke up really anxious / still feeling mentally foggy from not sleeping. I called out of my shift but felt bad about it. I knew it would be hard to handle any potentially stressful situations when I felt gross myself, but I also kept asking myself if I could have just powered through and gone in.

Obviously, as a future physician I know I couldn't just call out when I felt a little off but even as a volunteer it makes me question how good I am at keeping my own boundaries/health in check.

Has anyone else dealt with boundary setting in really emotionally difficult clinical situations? How do you all balance empathy to patients without getting swept up in their pain yourself?

Any thoughts/advice is appreciated!!

Read house of god (serious) & remember ‘the patient is the one with the disease’