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sticksIn this post, I explore what it’s like for the healthcare professional with a patient or survivor who makes a choice the healthcare professional doesn’t feel is in the patient/survivor’s best interest with oncology nurse, Tracy Whitworth.

When a healthcare professional has a situation such as a survivor who chooses not to do preventative testing, what are some of the challenges that can come up for the professional?

Most of us in healthcare have chosen this profession because of a desire to help people, to make a difference and improve lives.  When we are presented with a situation where a client is noted to be in distress and recommendations that have been made are not being followed, it can be very difficult for providers to accept this.  Part of our training is to prevent, protect, due no harm.  It becomes very personal at times when this occurs.

What kind of toll can it take on healthcare professionals if they internalize stress they may feel when a patient makes a choice that is potentially not in their own best interest?

If we take this personally, it can create great stress and perhaps also self-doubt in our abilities — even anger.  These feelings can transcend to unhappiness in our careers, relationships and life.  However, what I’m learning through my coach training with iPEC is that it can also be an opportunity.  If we don’t judge the choice as right or wrong, and instead meet the patient with curiosity, we can use other coaching skills to investigate. 

For example, a patient who continually reschedules or misses check-up scans, may  possibly be dealing with a fear around recurrence.  Instead of becoming frustrated at what may appear to be ambivalence about their health, we can be curious and ask clarifying questions to ascertain what is motivating their lack of action.  Just because we think it is a fear of recurrence, doesn’t mean it is.  Some patients report being fearful of the financial consequences of a scan that reveals new progression or recurrence.  Some fear an impact on personal or intimate relationships.  If we assume and judge, we miss an opportunity to support them and get to the core of the obstacle. Instead, we can possibly help them choose prevention from an empowered place versus avoiding preventative care.

Personally, I understand and respect the survivor’s right to make their own decisions about care.  My late husband refused a bone marrow transplant when that was eventually presented as his only medical option left.

I absolutely agree with you, Tambre, or as I like to say, “I hear where you are coming from.”  In order to not take these decisions personally, we need to first check our judgments and beliefs at that so called “door.”  This doesn’t mean we forget them, but we need to be aware of them. Ultimately we need to be open to what our clients’ needs are and respect their decisions.

From a coaching perspective, I know I can honor a client’s needs but that doesn’t mean I won’t engage them in a dialogue about their choices.  It is up to them to choose however I can play a role in helping them understand if they are deciding based on fact or fear.

What in your coach training would you see as a tool, perspective or approach that could help that professional have some ease and peace of mind around honoring a patient’s choice?

We don’t always know what’s around the corner, but that doesn’t mean we stop living and being proactive in the things we do know.  Now I can work with my patients to design choices that are proactive, yet in alignment with their values and vision for themselves and their lives. They don’t have to sit and wait for a curveball that may never come. Instead, we can generate a plan for survivorship that is empowering and creates the best quality of life for them possible.

What other thoughts, if any, do you have that might help other healthcare professionals out there who have a lot of compassion for their patients/survivors with regard to keeping a balance and reducing stress around the choices the patients/survivors make?

I would like to leave you all with one thing and that is: meet your patients where they are. 

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