Recognizing and acknowledging feelings can diffuse a patient’s anxiety.
I precept pediatric residents as part of their three year continuity clinic. A few weeks ago, one of my senior residents and a first-year intern were the admitting team on the pediatric floor at Johns Hopkins. They admitted a child with a chronic neurologic condition with severe delay.
The challenge of being a single parent
The patient’s mother is single and caring for him on her own. The mother does a fabulous job caring for her son and balancing work and other home duties. Over the past few weeks, prior to the hospitalization, the mom was getting some respite care for her son so that she could run errands after work. During this time her son developed a few bed sores and dehydration, which prompted mom to take him to the ED. The child was admitted for wound care and rehydration.
The day after admission, on rounds, the first-year intern and senior resident spoke with the mother. The intern did a great job explaining the medical facts and plan of care. During the discussion, the mother stated how guilty she felt about what had happened. She said she was typically on top of things and didn’t understand why this happened. The young intern stayed on task and didn’t acknowledge the mother’s feelings. Again, the mother said how guilty she felt about all of this and really questioned her ability as a parent.
Acknowledging the patient’s feelings
The senior resident softly interrupted the young resident, placed her hand on the mother’s shoulder, and said, “We’re so sorry that your son needed to be admitted to the hospital. This can be very hard on parents and it’s normal to question what could have been done differently. You’re an awesome mother and sacrifice a great deal to give him a loving home. Everything will be fine and we’ll help you all along the way.” With that the mother showed a sense of relief, her posture relaxed, and she was ready to hear the plan of care.
This is a great example of recognizing and acknowledging feelings to diffuse an anxious situation. The senior resident recognized that the mother wasn’t really hearing the plan because she felt so guilty and anxious. Once the mother’s feelings were acknowledged, she was better equipped to hear and participate in the plan of care for her son.