when the clinician feels overwhelmed:
reframing the approach to caring for the complex patient
Presented by Brenda Lovegrove-Lepisto and Kathleen McGrail
Tuesday, March 2, 2021, from 11:00 am - 1:00 pm EST
Many of us have had the experience of encountering patients whose care is complex - socially, emotionally, psychologically and medically challenging, and likely, many times. It is easy to feel defeated before you even enter the room. Under these circumstances, frustrated and helpless clinicians often blame the patients themselves for poor control and poor outcomes…”if they just took their medications…. if they just tried harder…why should I care if they don’t….”
In this context, how do we, as clinicians, preceptors, and RCC facilitators, sustain compassion ourselves and support learners and colleagues when caring for these complicated patients? How do we help learners and ourselves find the way through these patient encounters fostering and preserving feelings of connection and hope?
As educators our task is three-fold: to develop a framework for understanding the challenge, unpack affective dimensions of the experience, and identify effective responses.
Despite training using our valuable RCC model, we need more. Our work requires emotional muscle, in-the-moment empathic imagination, and mindfulness to discern the best path forward. Appreciating the impact of chronic trauma on the patient, on their health, and on the interaction may serve as guidance for our path forward.
In a relationship-centered teaching setting, patient scenarios like this can become sentinel experiences, moments of new and profound insight, with the potential to transform the care experience from one of feeing hopeless and ineffective to one of understanding, empowerment, and connection. And in the process, our collective and individual reservoirs of compassion and meaning-in-work may be refreshed.
Objectives:
- Reflect on the experience and feelings when encountering a complex, patient
- Describe the chronic trauma spectrum, including adverse childhood experiences
- Identify signs and symptoms of trauma emerging early in the physician-patient dialogue
- Identify an effective approach to such complex patients by applying principles of RCC