Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

How do you manage your feelings when working with a patient?


Read perspectives from a clinical social worker, psychiatrist, pediatrician, nurse, director of spiritual care, and a cardiologist.

Lifelong Learning in Clinical Excellence | April 6, 2018 | <1 min read


Jane Schindler, LCSW-C, Johns Hopkins University School of Medicine

If I find myself becoming overly emotional or drawn into a particular client situation, I take a breath and reflect on what’s causing this reaction. Is it something from my past causing an emotional reaction?

I honor my emotions, but am cautious to not take on the emotion of my client.

Exercise, spending time with my family and friends, keeping a journal, and participating in spiritual or nature driven activities provides the work/life balance needed to sustain the level of commitment needed for this work.

I allot time each week to meet with a colleague or supervisor to process the cases that are particularly challenging or causing emotional distress.

I remind myself I’m of no help to others if my own emotions interfere with being fully present to those I serve.

Margaret Chisolm, MD, Johns Hopkins University School of Medicine

Feelings can be helpful in the care of patients: providing diagnostic clues or helping to build rapport.

But feelings also have the potential to interfere with clinical care.

Simply being aware of feelings is the important first step, regardless.

What do you think?

Do you want to add to the conversation? Please share!

Michael Crocetti, MD, Johns Hopkins Community Physicians

Managing feelings is a critical step in establishing a meaningful therapeutic relationship. Ineffective management of feelings may lead to patient dissatisfaction and poor patient engagement in the treatment plan.

The most important thing for me is to acknowledge the feelings of the patient or parent.

Directly address feeling statements with such phrases as, “I see that this discussion is very worrisome to you,” or, “I sense that you’re upset by what we’ve been talking about.”

Acknowledging feelings puts the patient at ease and lets them know they’re being heard.

Paula Neira, JD, MSN, Johns Hopkins University School of Medicine

Whether my feelings are positive or negative, I try to keep a few things in mind so that I can stay focused on providing care:

1.) The patient comes first—it’s about them, not me.

2.) I remind myself that I’m a professional, and have a lot of training at deferring my own emotions until a situation resolves.

3.) I set expectations/boundaries about acceptable communications and behavior, and if those are crossed, I’ll address it in real-time with the patient.

4.) I cut the patient the appropriate amount of slack—they may be having a bad day and human beings sometimes do or say stupid things that, on reflection, they regret.

Paula Teague, DMin, MBA, Johns Hopkins University School of Medicine

As I gel in, I take a minute to center myself and set my intention. This gives me a chance to recognize what I’m feeling. Depending on what I’m feeling I have different strategies.

If the feeling is anxiety or fear, I ask myself why. Is it something from my past? Some fear about the future?


If the feeling is frustration, judgment, or dread, I’ll say to myself,

“May you see this person as like you, with the same hopes, dreams, and fears.”

This helps me connect with the other person.


If I feel joy and curiosity, I just give thanks.

Roy Ziegelstein, MD, Johns Hopkins University School of Medicine

I wouldn’t say I manage my feelings as much as I’m aware of my feelings and of the effect they may have on my patient.


On the one hand, patients generally want to interact with another human being, and appreciate a doctor who’s authentic and honest, and who demonstrates empathy.


On the other hand, patients also need someone whose thinking isn’t overly clouded by emotion and who’s able to deal with what they’re feeling as a patient rather than being overcome by feelings of their own