Expectations
I had a recent encounter with a family who had expectations for me that I didn't meet. They called for their unconscious family member. Having met this patient before, I work very hard to not fall into 'The boy who cried wolf' mode. I take every call seriously until otherwise informed.
This person was unconscious. Or were they? It is my job to figure out why they're unconscious. I see they are breathing sufficiently, I pry open their eyelids and look at their pupils. I feel their pulse on their wrist. I pull out the glucometer to check their blood sugar. This is when the yelling started. "Why are you doing that?!" When I fail to match their anger, they get angrier. "I don't know why you're doing that. [they] don't have a sugar problem!" Again, my answer is too calm. I continue my assessment, take their blood pressure, and wait for my partner to return with a device to get their limp body out to the ambulance. More abuse comes my way "I don't even know why we called you." and "You know what? I don't like you!" is shouted at me. Meanwhile they were refusing to answer any of my questions, produce medications the patient was on, or tell me anything of any use including the patients birthdate. An observer may have thought that I stood there with my arms crossed and did nothing. They may have thought I was smothering the patient. They may have thought I was requesting unreasonable things.
The whole thing really took me aback. I really didn't know what to say, knowing that anything I did say would spark more anger, so I landed on "I'm sorry I'm not meeting your expectations." But really I meant, "Please tell me what you want me to do?" "This is standard assessment and treatment for the unknown unconscious person (who isn't dead)." "There are only two of us, I'm here assessing this patient and my partner is getting ready for transport, this is how it works."
But are these people thinking "I wish that the people I called to help us were as hysterical as I am."? Did they want me to throw the patient over my shoulder, carry them down the stairs, across the yard and into the ambulance? Did they want me to inject a miracle elixir? I really don't know, and frankly, I don't think they did either. Somehow, even though they call us for our expertise and experience, that isn't good enough unless they hear what they want to hear.
So where does the solution begin? I wish I could tell you that I counseled these people and they came around and we all held hands and skipped through a field. But I don't know how to fight such unearned anger. They don't know that their expectations are skewed, but I am certainly not telling anyone that in the heat of the moment.
Patients are usually non medical folk, they're scared, they're at the end of their rope with chronic illness. There is certainly a lot more heartache and trouble in their lives than in mine, but does that mean I have to answer for that? All medical providers are just the patsy, the scapegoat. We are people who can be blamed for problems larger than ourselves. We are in a society where more emphasis is placed on the temperature of a drink than the quality of patient care; it's hard out there! An individualistic society that blames all problems on everyone else. A society that forgets that there are 6 billion other people who are all trying to be the lead in their on life story.
Okay, I'm sorry. I rant. I think I only wrote this down to make me feel better. I guess I do. The problem still goes unsolved. On this small scale, I decide to fight anger with kindness. Maybe one day it will work.
This person was unconscious. Or were they? It is my job to figure out why they're unconscious. I see they are breathing sufficiently, I pry open their eyelids and look at their pupils. I feel their pulse on their wrist. I pull out the glucometer to check their blood sugar. This is when the yelling started. "Why are you doing that?!" When I fail to match their anger, they get angrier. "I don't know why you're doing that. [they] don't have a sugar problem!" Again, my answer is too calm. I continue my assessment, take their blood pressure, and wait for my partner to return with a device to get their limp body out to the ambulance. More abuse comes my way "I don't even know why we called you." and "You know what? I don't like you!" is shouted at me. Meanwhile they were refusing to answer any of my questions, produce medications the patient was on, or tell me anything of any use including the patients birthdate. An observer may have thought that I stood there with my arms crossed and did nothing. They may have thought I was smothering the patient. They may have thought I was requesting unreasonable things.
The whole thing really took me aback. I really didn't know what to say, knowing that anything I did say would spark more anger, so I landed on "I'm sorry I'm not meeting your expectations." But really I meant, "Please tell me what you want me to do?" "This is standard assessment and treatment for the unknown unconscious person (who isn't dead)." "There are only two of us, I'm here assessing this patient and my partner is getting ready for transport, this is how it works."
But are these people thinking "I wish that the people I called to help us were as hysterical as I am."? Did they want me to throw the patient over my shoulder, carry them down the stairs, across the yard and into the ambulance? Did they want me to inject a miracle elixir? I really don't know, and frankly, I don't think they did either. Somehow, even though they call us for our expertise and experience, that isn't good enough unless they hear what they want to hear.
So where does the solution begin? I wish I could tell you that I counseled these people and they came around and we all held hands and skipped through a field. But I don't know how to fight such unearned anger. They don't know that their expectations are skewed, but I am certainly not telling anyone that in the heat of the moment.
Patients are usually non medical folk, they're scared, they're at the end of their rope with chronic illness. There is certainly a lot more heartache and trouble in their lives than in mine, but does that mean I have to answer for that? All medical providers are just the patsy, the scapegoat. We are people who can be blamed for problems larger than ourselves. We are in a society where more emphasis is placed on the temperature of a drink than the quality of patient care; it's hard out there! An individualistic society that blames all problems on everyone else. A society that forgets that there are 6 billion other people who are all trying to be the lead in their on life story.
Okay, I'm sorry. I rant. I think I only wrote this down to make me feel better. I guess I do. The problem still goes unsolved. On this small scale, I decide to fight anger with kindness. Maybe one day it will work.
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