I've written before on the sadder parts of working in paediatrics, and how I think it's ok to find it upsetting (it's entirely coincidence that I wrote that post exactly one year ago). As I've got more senior and been more directly involved with patient care and decision making, I've found that the harder parts of my job have got, at times, even tougher.
I am quite involved with the medical student paediatric society (hi LUMPS) and as part of this I mentor students who are interested in paediatrics. One of the commonest questions they ask is "how do you cope with the sad bits?" - most commonly they wonder how I deal with deaths and child protection issues. The honest answer is that I'm not sure I do, at least not in any way that I can really express to anyone else. Paediatricians, on the whole, are a pretty nice bunch, so there's always lots of peer support. Even very senior and experience colleagues still get upset by horrible things happening, and the general consensus is that it's ok to be sad when sad things happen. Still, I find myself wondering whether it's "professional" to be upset by things I see at work.
Is it ok to feel sad when you see a child who has had injuries inflicted by their own family? Is it wrong to cry when a baby you've looked after since their birth passes away? Do these emotions, or expressing them, make me a bad doctor? I'm a naturally self-critical person and so tend to feel like anything I do, say or feel is an indicator of how terrible I am, and I guess this is just another example of this. In reality, I suspect being upset about a patient is no bad thing, as long as it doesn't influence how you treat the next one. So cry, take 5 minutes for a cup of tea, go home after your shift and have a glass of wine, do whatever you need to. But when the next patient comes along, they deserve the same care and attention as all the rest.
It's not unprofessional to be sad. But it is unprofessional to let that sadness affect the care you provide to others.
One of the best registrars I know recently cried with the parents of a baby that had become critically ill very suddenly on the neonatal unit when it became clear they weren't going to make it. As long as it doesn't affect your care of the child I think it is more than ok to show how much you also care, we are no robots. I thought more of that reg when she shared that not less , just my thoughts tho :)
ReplyDeleteI taught medical students for almost 20 years and we had many discussions about coping with the sad and upsetting times. I think you are exactly right - you can't help but feel sad and often you can't help but express that. It isn't unprofessional to do that. You just have to find a way to let that feeling be felt, then pick yourself up and go to the next person who needs you. It is also critical to give yourself some time when you can regroup. There is a growing movement of physician retreats, peer coaching and other ways of creating safe spaces for awareness, exploration, and reflection that are worth a look.
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