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‘Some see crying in front of patients as unprofessional. Most see it as being human’ ‘Some see crying in front of patients as unprofessional. Most see it as being human’
(25 days later)
A sense of shared sorrow or a weakness? An NHS chief executive, a paramedic, doctors and nurses weigh in on whether tears are a good thing or not
Sarah Johnson
Thu 12 Oct 2017 10.05 BST
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Working in healthcare can be emotionally fraught. Not only are staff working under increasing pressure but they are faced with humanity at its most vulnerable. They encounter death and witness in a week more than what most people might see over a lifetime.Working in healthcare can be emotionally fraught. Not only are staff working under increasing pressure but they are faced with humanity at its most vulnerable. They encounter death and witness in a week more than what most people might see over a lifetime.
Compassion is also a key part of any role in healthcare. It’s only natural that staff should need an emotional release under such circumstances. But is crying in front of patients a good idea? Does it detract from their grief or does it help professionals seem more human? Six healthcare professionals share their experiences.Compassion is also a key part of any role in healthcare. It’s only natural that staff should need an emotional release under such circumstances. But is crying in front of patients a good idea? Does it detract from their grief or does it help professionals seem more human? Six healthcare professionals share their experiences.
‘I don’t think it helps to cry in front of patients in certain situations’‘I don’t think it helps to cry in front of patients in certain situations’
I was working a long, 14-hour shift in a busy London hospital just before Christmas. I had been looking after a man with heart failure and we were running out of options. The man and his son were well aware of the gravity of the situation. I asked my registrar to re-review when the man started to lose consciousness. When I asked desperately what our next treatment strategy would be, he looked at me carefully, then looked down and said nothing. The realisation washed over me that we couldn’t save him; the man was going to die, and his family would not see him at Christmas. I lost control of my emotions momentarily; [my colleague] put a hand on my shoulder, then asked me to get a cup of tea and sit down, and come back when I was ready. The man passed away that evening.I was working a long, 14-hour shift in a busy London hospital just before Christmas. I had been looking after a man with heart failure and we were running out of options. The man and his son were well aware of the gravity of the situation. I asked my registrar to re-review when the man started to lose consciousness. When I asked desperately what our next treatment strategy would be, he looked at me carefully, then looked down and said nothing. The realisation washed over me that we couldn’t save him; the man was going to die, and his family would not see him at Christmas. I lost control of my emotions momentarily; [my colleague] put a hand on my shoulder, then asked me to get a cup of tea and sit down, and come back when I was ready. The man passed away that evening.
It’s OK to show emotion – positive or negative – and it becomes easier with experience. However, I don’t think it helps to cry in front of patients in certain situations. The emotion of the moment shouldn’t be about the doctor – it’s about the patient and their family. Their grief is what matters most. You also need to keep your emotions under control to make the best decisions for the patient. Ben White, registrar in gastroenterology and general internal medicineIt’s OK to show emotion – positive or negative – and it becomes easier with experience. However, I don’t think it helps to cry in front of patients in certain situations. The emotion of the moment shouldn’t be about the doctor – it’s about the patient and their family. Their grief is what matters most. You also need to keep your emotions under control to make the best decisions for the patient. Ben White, registrar in gastroenterology and general internal medicine
‘Once the feelings fade, so does the passion’‘Once the feelings fade, so does the passion’
Crying in front of patients is part and parcel of nursing. Whether it’s bad news, stress or confrontation, crying has and will always happen. Some see it as unprofessional; most see it as being human. After five years, including a four-year stint in A&E, I still cry after every death I witness. One day I saw this as weakness and said to the doctor I was with, “I can’t believe I still cry every time!” I was embarrassed by my tears. He turned and said: “The day you don’t cry is when you should stop nursing.” Those words hit home. Now when the tears come I’m not ashamed because once the feelings fade, so does the passion. Donna Thomas, spinal surgery wardCrying in front of patients is part and parcel of nursing. Whether it’s bad news, stress or confrontation, crying has and will always happen. Some see it as unprofessional; most see it as being human. After five years, including a four-year stint in A&E, I still cry after every death I witness. One day I saw this as weakness and said to the doctor I was with, “I can’t believe I still cry every time!” I was embarrassed by my tears. He turned and said: “The day you don’t cry is when you should stop nursing.” Those words hit home. Now when the tears come I’m not ashamed because once the feelings fade, so does the passion. Donna Thomas, spinal surgery ward
‘The tears I’ve seen from paramedics are more likely borne from burnout’‘The tears I’ve seen from paramedics are more likely borne from burnout’
I’ve never seen a paramedic crying in front of a patient. The tears I’ve seen and have experienced are more likely borne from the seething soup of frustration, burnout, bullying, fatigue and the chronic, ulcerating ache of rock-bottom morale. I’ve heard more examples of people crying into a mirror as they don their uniform before leaving for work – sobbing to their reflection, trying to convince themselves that they must push through another shift of utter shit.I’ve never seen a paramedic crying in front of a patient. The tears I’ve seen and have experienced are more likely borne from the seething soup of frustration, burnout, bullying, fatigue and the chronic, ulcerating ache of rock-bottom morale. I’ve heard more examples of people crying into a mirror as they don their uniform before leaving for work – sobbing to their reflection, trying to convince themselves that they must push through another shift of utter shit.
I know public perception will favour the image of a weeping paramedic being comforted by her crewmate after failing to resuscitate a young child, and this narrative probably dovetails with the belief that paramedics regularly attend genuine emergencies – but both versions of our story are far from reality.I know public perception will favour the image of a weeping paramedic being comforted by her crewmate after failing to resuscitate a young child, and this narrative probably dovetails with the belief that paramedics regularly attend genuine emergencies – but both versions of our story are far from reality.
The emotion of the moment ​​shouldn’t be about the doctor – it’s about the patient ​and their familyThe emotion of the moment ​​shouldn’t be about the doctor – it’s about the patient ​and their family
Although a crying paramedic would be unreservedly comforted by their colleagues, once out of sight and earshot, eyebrows would be raised, shoulders would be shrugged and their mental resilience would be questioned. Crying would probably be considered a sign of weakness.Although a crying paramedic would be unreservedly comforted by their colleagues, once out of sight and earshot, eyebrows would be raised, shoulders would be shrugged and their mental resilience would be questioned. Crying would probably be considered a sign of weakness.
During my nine years of frontline experience, sometimes I did feel like crying, but I would usually stamp on whatever the trigger was. Robin Ibbott, former paramedic, now a locumDuring my nine years of frontline experience, sometimes I did feel like crying, but I would usually stamp on whatever the trigger was. Robin Ibbott, former paramedic, now a locum
‘Loss of professional composure helps nobody’‘Loss of professional composure helps nobody’
There would be nothing worse than someone feeling that they were the subject of the saying, “laugh and the world laughs with you, weep and you weep alone”. However, “weep with” feels different from “weep in front of”. A sense of shared sorrow might be comforting; loss of professional composure helps nobody. The answer might be different for patients and for relatives – and remember that the sorrow and loss will be much more enduring for any who are bereaved than it is for those who provided professional care. Paul Gray, chief executive, NHS ScotlandThere would be nothing worse than someone feeling that they were the subject of the saying, “laugh and the world laughs with you, weep and you weep alone”. However, “weep with” feels different from “weep in front of”. A sense of shared sorrow might be comforting; loss of professional composure helps nobody. The answer might be different for patients and for relatives – and remember that the sorrow and loss will be much more enduring for any who are bereaved than it is for those who provided professional care. Paul Gray, chief executive, NHS Scotland
‘It’s difficult to say when crying is OK and when it’s not’‘It’s difficult to say when crying is OK and when it’s not’
I was sitting across from the mother of a child who was terminally ill. We were talking about planning for the end of her life. I’d known this family for a number of years and no one was ready to lose her.I was sitting across from the mother of a child who was terminally ill. We were talking about planning for the end of her life. I’d known this family for a number of years and no one was ready to lose her.
As her mother showed me photos of her child smiling – something we thought she might never do with her complex and life-limiting condition – she cried and I cried with her. I was there to comfort and support her, not the other way round. But this felt right. It was an acknowledgement of how much this child and her family meant to me and how much I cared.As her mother showed me photos of her child smiling – something we thought she might never do with her complex and life-limiting condition – she cried and I cried with her. I was there to comfort and support her, not the other way round. But this felt right. It was an acknowledgement of how much this child and her family meant to me and how much I cared.
I’ve only ever cried with patients and families when they have been crying too. It feels right when my feelings and responses are mirroring theirs, when we’re sharing the same emotions. There’s solidarity in that. For me, as a nurse, it would feel wrong to be more upset than the family. It’s their moment, not mine. It wouldn’t be right if they felt the need to comfort me or if I was visibly distressed and they weren’t. At those times I go to colleagues for support.I’ve only ever cried with patients and families when they have been crying too. It feels right when my feelings and responses are mirroring theirs, when we’re sharing the same emotions. There’s solidarity in that. For me, as a nurse, it would feel wrong to be more upset than the family. It’s their moment, not mine. It wouldn’t be right if they felt the need to comfort me or if I was visibly distressed and they weren’t. At those times I go to colleagues for support.
It’s difficult to say exactly when crying is OK and when it’s not. So much of this is about gut feeling and going with what feels natural and right in the moment. Becky Platt, matron for children’s servicesIt’s difficult to say exactly when crying is OK and when it’s not. So much of this is about gut feeling and going with what feels natural and right in the moment. Becky Platt, matron for children’s services
‘I heard one story that made me sob. I felt so unprofessional’‘I heard one story that made me sob. I felt so unprofessional’
I have always cried too easily. When I was pregnant this became ridiculous – I cried when the man in the red shirt on Star Trek died and if anyone criticised me. I would well up when patients told me a sad story, but at eight months pregnant one lady told me such a harrowing story of motherhood that made me well up, weep and then sob. She cried too and we sat with tissues between us long after the appointment should have finished. I felt so unprofessional and didn’t want anyone else to see. I blamed my red eyes on pregnancy allergies and told no one the truth for a long time. I left soon after on maternity leave, but when I returned I said hello to her in the waiting room. She had an appointment with another doctor that day but asked if she could come back for her next appointment to my list. She said that I understood what she had been through. Hilary Kinsler, consultant psychiatristI have always cried too easily. When I was pregnant this became ridiculous – I cried when the man in the red shirt on Star Trek died and if anyone criticised me. I would well up when patients told me a sad story, but at eight months pregnant one lady told me such a harrowing story of motherhood that made me well up, weep and then sob. She cried too and we sat with tissues between us long after the appointment should have finished. I felt so unprofessional and didn’t want anyone else to see. I blamed my red eyes on pregnancy allergies and told no one the truth for a long time. I left soon after on maternity leave, but when I returned I said hello to her in the waiting room. She had an appointment with another doctor that day but asked if she could come back for her next appointment to my list. She said that I understood what she had been through. Hilary Kinsler, consultant psychiatrist
Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.
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