What Lies Beneath the Surface? A Case for Self-Reflection By Meg Helgert RN, FNP Have you ever been in this situation? You walk into a patient’s room and several family members are there. The air is thick with feelings and emotion and everyone wants to talk. The daughter starts telling you about how badly her mother’s doctor treated her while in the office earlier in the day. The patient complains about the food, the husband “hates hospitals” and the complaints go on, nothing seems right. So you listen and nod, offer some thoughts and leave the room only to feel “bad” for some reason -- you can’t quite put your finger on the feeling. One second later, a co-worker asks you if you’ll cover her/his patients for lunch, and you say you will despite a tone and body language that reflect irritation. She in turn goes to lunch and complains that the food workers are day dreaming and not taking her order, and she gives a snarky remark to the check-out person, who in turn yells at the clean-up person for not cleaning the tables fast enough. We are all affected by internal thoughts and feelings, our own and others -- even when the surface behavior we are dealing with doesn't acknowledge this side of life. Paying attention to how we are feeling each moment takes some practice, but it can make us more effective, for the good of both others and ourselves. Similarly, watching for the emotional tone in our patients and co-workers can guide the way we respond to them, and this will usually lead to a better outcome for everyone. How can we keep ourselves awake to this internal side of life, while we try to deal with all our work responsibilities? Seems like a good question to me! I really don't have any magic answers here, but I am hoping this commentary can start a discussion that we can keep going, maybe as a part of this newsletter. Let's start with this: Do you agree that this inner world of thoughts and feelings is really a legitimate concern -- that it is a part of our work lives which we have to include in the equation of providing effective nursing? I want to go back to the example of the family and the patient's room that I started out with. Here are some questions I'd like to ask myself before I go into this room: Could the family be stressed by the admission of a loved one? Is the diagnosis serious? How do I feel about the doctor who admitted the patient? How has my day been going? In short, questions like this can get me ready for the emotional side of the situation I am entering. These questions are really important assessment tools. They will affect what I do in the room and how effective I will be. In this example, giving the emotional side of the situation some thought beforehand could lead to a different approach, like taking a co-worker into the room. This may help the family keep themselves calmer and ask questions differently. It may also help me to take the time to reflect and answer the questions more sensitively, and perhaps somehow re-direct things in a more positive way. This has been a short commentary about how feelings can affect us, moment to moment, in a work situation. For me, asking myself questions before I step into a situation can sometimes really help. I am interested in hearing about how others try to deal with this side of our work. Meg is currently employed in Urgent Care, and also provides locum tenens to small rural clinics in Oregon. She received her NP certification from Good Samaritan Hospital & Medical Center (Portland Oregon), Dec 1980. She received her Bachelor’s Degree in Social Science from Portland State University in 1995. She is currently an Associate member of AFCE (Association of Certified Fraud Investigators) and a frequent writer for Confident Voices eNewsletter. To contact Meg: mmhelgert47@comcast.net What Lies Beneath the Surface? A Case for Self-Reflection By Meg Helgert RN, FNP Have you ever been in this situation? You walk into a patient’s room and several family members are there. The air is thick with feelings and emotion and everyone wants to talk. The daughter starts telling you about how badly her mother’s doctor treated her while in the office earlier in the day. The patient complains about the food, the husband “hates hospitals” and the complaints go on, nothing seems right. So you listen and nod, offer some thoughts and leave the room only to feel “bad” for some reason -- you can’t quite put your finger on the feeling. One second later, a co-worker asks you if you’ll cover her/his patients for lunch, and you say you will despite a tone and body language that reflect irritation. She in turn goes to lunch and complains that the food workers are day dreaming and not taking her order, and she gives a snarky remark to the check-out person, who in turn yells at the clean-up person for not cleaning the tables fast enough. We are all affected by internal thoughts and feelings, our own and others -- even when the surface behavior we are dealing with doesn't acknowledge this side of life. Paying attention to how we are feeling each moment takes some practice, but it can make us more effective, for the good of both others and ourselves. Similarly, watching for the emotional tone in our patients and co-workers can guide the way we respond to them, and this will usually lead to a better outcome for everyone. How can we keep ourselves awake to this internal side of life, while we try to deal with all our work responsibilities? Seems like a good question to me! I really don't have any magic answers here, but I am hoping this commentary can start a discussion that we can keep going, maybe as a part of this newsletter. Let's start with this: Do you agree that this inner world of thoughts and feelings is really a legitimate concern -- that it is a part of our work lives which we have to include in the equation of providing effective nursing? I want to go back to the example of the family and the patient's room that I started out with. Here are some questions I'd like to ask myself before I go into this room: Could the family be stressed by the admission of a loved one? Is the diagnosis serious? How do I feel about the doctor who admitted the patient? How has my day been going? In short, questions like this can get me ready for the emotional side of the situation I am entering. These questions are really important assessment tools. They will affect what I do in the room and how effective I will be. In this example, giving the emotional side of the situation some thought beforehand could lead to a different approach, like taking a co-worker into the room. This may help the family keep themselves calmer and ask questions differently. It may also help me to take the time to reflect and answer the questions more sensitively, and perhaps somehow re-direct things in a more positive way. This has been a short commentary about how feelings can affect us, moment to moment, in a work situation. For me, asking myself questions before I step into a situation can sometimes really help. I am interested in hearing about how others try to deal with this side of our work. Meg is currently employed in Urgent Care, and also provides locum tenens to small rural clinics in Oregon. She received her NP certification from Good Samaritan Hospital & Medical Center (Portland Oregon), Dec 1980. She received her Bachelor’s Degree in Social Science from Portland State University in 1995. She is currently an Associate member of AFCE (Association of Certified Fraud Investigators) and a frequent writer for Confident Voices eNewsletter. To contact Meg: enigma462003@yahoo.com

What Lies Beneath the Surface?

A Case for Self-Reflection

By Meg Helgert RN, FNP

Have you ever been in this situation?

You walk into a patient’s room and several family members are there. The air is thick with feelings and emotion and everyone wants to talk. The daughter starts telling you about how badly her mother’s doctor treated her while in the office earlier in the day. The patient complains about the food, the husband “hates hospitals” and the complaints go on, nothing seems right. So you listen and nod, offer some thoughts and leave the room only to feel “bad” for some reason -- you can’t quite put your finger on the feeling.

One second later, a co-worker asks you if you’ll cover her/his patients for lunch, and you say you will despite a tone and body language that reflect irritation.

She in turn goes to lunch and complains that the food workers are day dreaming and not taking her order, and she gives a snarky remark to the check-out person, who in turn yells at the clean-up person for not cleaning the tables fast enough.

We are all affected by internal thoughts and feelings, our own and others -- even when the surface behavior we are dealing with doesn't acknowledge this side of life. Paying attention to how we are feeling each moment takes some practice, but it can make us more effective, for the good of both others and ourselves. Similarly, watching for the emotional tone in our patients and co-workers can guide the way we respond to them, and this will usually lead to a better outcome for everyone.

How can we keep ourselves awake to this internal side of life, while we try to deal with all our work responsibilities? Seems like a good question to me! I really don't have any magic answers here, but I am hoping this commentary can start a discussion that we can keep going, maybe as a part of this newsletter.

Let's start with this: Do you agree that this inner world of thoughts and feelings is really a legitimate concern -- that it is a part of our work lives which we have to include in the equation of providing effective nursing?

I want to go back to the example of the family and the patient's room that I started out with. Here are some questions I'd like to ask myself before I go into this room: Could the family be stressed by the admission of a loved one? Is the diagnosis serious? How do I feel about the doctor who admitted the patient? How has my day been going? In short, questions like this can get me ready for the emotional side of the situation I am entering. These questions are really important assessment tools. They will affect what I do in the room and how effective I will be.

In this example, giving the emotional side of the situation some thought beforehand could lead to a different approach, like taking a co-worker into the room. This may help the family keep themselves calmer and ask questions differently. It may also help me to take the time to reflect and answer the questions more sensitively, and perhaps somehow re-direct things in a more positive way.

This has been a short commentary about how feelings can affect us, moment to moment, in a work situation. For me, asking myself questions before I step into a situation can sometimes really help. I am interested in hearing about how others try to deal with this side of our work.

Meg is currently employed in Urgent Care, and also provides locum tenens to small rural

clinics in Oregon. She received her NP certification from Good Samaritan Hospital &

Medical Center (Portland Oregon), Dec 1980. She received her Bachelor’s Degree in

Social Science from Portland State University in 1995. She is currently an Associate member of AFCE (Association of Certified Fraud Investigators) and a frequent writer for Confident Voices eNewsletter. To contact Meg: mmhelgert47@comcast.net