Below are the episode show notes and transcript. Some episode transcripts have been edited more than others, but they are up in the meantime to help those who would rather read and for searchability on the web. Extensive editing has not been prioritized as I seek to both produce regular content and maintain my own wellness. Enjoy!
Show notes
Walking through hard times, end of life situations with patients and families…
they are part of medicine, and yet these things can change you, especially as you walk through more of these times.
Join me for episode 29, part 2 of 2 of a journey of “Responding to grief and loss, a physician perspective” and consider how you can help your patients and yourself as you respond to death and grief in medicine!
Then get your work done faster with 10 tips from my free PDF guide, Maximize Your Clinical Efficiency! Click to get your guide NOW!
Today’s sponsor: Pattern
If you KNOW you NEED disability insurance but either haven’t taken care of it yet or want to check your current policy against what you might qualify for, check out today’s sponsor, Pattern, at patternlife.com/mededwell
Transcript
You are giving signout after night shift in the intensive care unit. This patient is on maximal support. That one family is discussing goals of care. Another is ready to withdraw, support. Join me for the rest of today’s episode to discuss how in these difficult times you can care both for your patients and yourselves.
Thank you so much for joining me here on another episode of the MedEdWell podcast, we’re already to episode 29. I’m so thankful for you listening, subscribing and sharing these episodes with other physicians, students, and those in medicine. Are you looking to get home sooner and become more efficient in your medical practice? Check out my free guide, maximize your clinical efficiency. You can get your free PDF guide at www.mededwell.com/efficiencyguide. You’ll also get my weekly emails that I’ve been a lot more consistent in sending out, and I’ll tell some stories and invite you to share and to check out the current week’s episode. So I encourage you to check it out. The link is in the show notes
Today, we’re gonna be talking about grief and death and the perspective of the medical to team those, providing the care. So a caveat in a little context, as a general pediatrician in an outpatient clinic, while there are occasional codes, my experience in walking patients and families through these difficult times was primarily in residency and reflecting on my own experience. Going through loss. These things have changed my medical practice, but many view will have had different experiences. Any of you have walked these journeys daily, weekly. So this is not meant to be the perspective, but rather a perspective mine. So feel free to reach out with feedback and input on this really sensitive, but important issue. Caring for our patients and ourselves wellness can be a really complex journey. Now navigating hard situations and emotions. I invite you to join me for the rest of today’s episode to begin this conversation.
Before we dive in, though, let’s hear from today’s sponsor disability insurance is complicated. Doctors. Shouldn’t have to take time to sort through a bunch of insurance quotes to find the best policy don’t stress over insurance shopping. Let pattern find the best coverage for you. The, to affordable price by visiting patternlife.com/mededwell, that’s patternlife.com/mededwell, the link will also be in the show notes. All right now, back to today’s show. I’m so sorry. Is there anything else we can do to help your loved one, be more comfortable, maybe switching off the monitor alarms, giving your family space time for goodbyes, maybe arranging a video call if there’s restrictions or time remaining is a barrier walking patients through these times can be both a burden and a sacred privilege.
Not only do you get to help patients in one of their most vulnerable times, but you can impact others around your patients. Compassionate care shows the value of individual lives. My grandmother had good inpatient hospice care at the end of her life. And I was encouraged knowing that she was well cared for, but walking patients and families through these situations on a regular basis, often with a lot of chaos, these can lead to compassion, fatigue, and burnout. So what things can help you care for others and to care for yourself is you face death in the context of medicine. First, what physicians and other medical professionals need to know to come alongside patients in the moment. This may be having the family present for the code. If they want to be maybe giving bad or even unexpected news in a way that’s sensitive. The group of oncologists in Texas published an article in 2000, that laid out kind of a framework for giving this bad news.
I remember covering it in medical school and their acronym was spikes. I’ll have a link to the article on the show notes (https://doi.org/10.1634/theoncologist.5-4-302) So S was for setting up the interview, having a good location and app it privacy. He was for getting the perception of the patient, what they understood about what was going on, what their prognosis was, what tests were being done and whether that was concerning for cancer or something else I was for obtaining the patient’s invitation. Are you ready for you to share? Maybe they want someone else to be there or to be the one receiving the initial news and than to relay that shortly thereafter, Kay, was forgiving knowledge and information to the patient E was for addressing patient’s emotions with empathy S was for strategy and summary. What comes next? I found this really helpful in my own medical practice, as I conceptualize some of these things, whether it’s bad or unexpected news, additionally, coming alongside others simply you mean saying, I’m so sorry for your loss.
I’m so sorry for this diagnosis. And then sitting quietly with them or just giving them space to process what you’ve just said. And coming back in a few minutes, it’s okay to show emotion yourself either at the time or later, my experiences with miscarriage and loss have helped me be more sensitive. As I see newborn babies, as I review the chart in advanced moms, grata and para status, the GS and PS include how many prior pregnancies and then how many term pregnancies preterm the abortion spontaneous or induced and living children. So these numbers don’t tell the whole story, but in the midst of postpartum depression screening, I often ask now how many children do you have now? Is this your first? Or maybe it’s saying I was reviewing the record. And I saw that you may have had a loss. I know there can be mixed emotions, sometimes bringing a new baby home and missing the one that you aren’t holding.
It may look different in different situations for you or me with different families, that these are some ideas to get you thinking. How can you be sensitive to some of those things of first when facing death, alongside patients and families. These are a few things to keep in mind, but then number two, when you’re in these situations, make sure to engage and process your feelings. You are a real whole person, not a robot. Maybe this looks like debriefing with your team immediately, or soon after it may mean that you take time to reflect done. What happened about this person who is no longer with you, no longer with their family. It’s a lot to process. Even with peaceful deaths though, death is universal in this world. It is not natural. It just feels wrong. And that’s true. It’s traumatic. And it’s okay to say that though, in facing death with patients, first few things are coming alongside patients and their families.
Number two, engage with and process your feelings. Number three, get help. This kind of goes with number two about engaging with your feelings, but it means that you can’t do this all alone. It could be having the chaplain stopping by the floor, not just for the family, but also for the staff, for the team, maybe as needed or particular structured time talking with colleagues. Yes. With appropriate confidentiality, but maybe just sharing that. You’ve had a really hard day and about the patient that you’ve lost. It may mean that you proactively offer help or seek out help when a patient has passed away. Maybe you say to a colleague, Hey, I’ll take the next admission for you. If you just need a moment to sit and process, it can take strength to add, ask for help, but we all process things differently. So your response might differ from mine after losing my boys 19 weeks, when I came back to work, a colleague offered to see my patient, if it was twins or something else that was too difficult for me.
As I came back, I said, I just had to say the, the word bananas and they’d take over for me. This offer showed me a lot of care and I really appreciated it. So what’s your takeaway? What would you like to implement to change? Maybe it is how you come alongside your patient or their family. Maybe it’s engaging with your feelings and getting help to do that. Imagine how this could look. If you put this into practice, what would be different? Would you have less compassion, fatigue, less burnout, less moral injury. Would you be able to maintain MP empathy and your connection to your why in medicine put some of these things into practice and then email me, or message me on Instagram to let me know how it went. Thank you so much for joining me here on episode 29 of the meed well podcast.
I really want you to take the next step in your wellness and implement some of these things. Please subscribe, share, and review the podcast. So more physic students and medical professionals and get the help they need to take the next step in their wellness. I also wanna encourage you to sign up for my email list and get the free guide, maximize your clinical efficiency so that you can get home sooner. Also check out today’s sponsor pattern, disability insurance, to get a quote today. Again, thanks for joining me here for this important discussion. Thanks so much for all you do and have a great day!