Off Days

Sorry I haven't written the update to the last ethical scenario yet. In the scenario JP described, she states that the patient chose to stop dialysis of her own accord the following day and died within the next two days. This was over a weekend, so she was not able to assess how the family handled their mother's decision.

I will write more on decision making and family dynamics in a future post. You all had excellent thoughts on the situation. Thank you, as always, for your contributions to the dialogue.

I have had a few "off days" lately. It's hard for me to accept myself having an "off day." I'm suppose to be "on" and my best at all times. How did I know I was having an off day? Well, often I don't recognize them - especially their degree of "off-ness" until after the fact. I knew I was having an off day because I was finding myself particularly challenged by two anxious families. Normally anxious patients and even anxious families are a welcome challenge for me. But last week I was really struggling to find the patience to work with these particular families. I'm back working with one of these families again today. And here is how I see the measure of just how "off" I was. Today, I have one of these same families again. But this morning, I immediately reconnected with my sense of compassion.

In opening up my heart and mind and entering the patient's room with a fresh approach, the patient reciprocated and presented new information to me. Her son who has been so anxious will have no living family members once she dies, except for his wife. And his wife had a stroke five years ago - at the age of 46 - and has been in a non-responsive ever since. This new information certainly gives me perspective and a new appreciation for her son's anxious behaviors towards me. I am quite fond of the patient.

But as usual, I must also have compassion for myself. I can give myself permission to have "off days" now and then.