Prospective medical school students can use volunteer experiences to learn how to care compassionately for dying patients.
[M]ost prospective medical school students set out to become physicians because they want to heal the sick, often forgetting that patients, young and old, sometimes die.
Death is a very real – and natural – part of medicine that you will not only face but also will need to learn how to handle. Before you start medical school, consider how you might care compassionately for a dying patient and how you will cope with the loss.
Some physicians – although very few in my experience – look at death as defeat and cope by emotionally running away from dying patients. For example, in the inpatient setting, they may visit the patient less often or avoid contact altogether.
In the outpatient setting, they might recommend a longer time between visits or, rather than suggest a follow-up appointment, wait for the patient to request one. This coping strategy makes patients feel abandoned.
Other physicians – again, very few – cope by behaving callously or indifferently. Subconsciously, they may be trying to avoid emotional involvement, but their behavior leaves their patients and families feeling hurt and disappointed.
Most physicians find healthy strategies to support their dying patients. These same strategies help physicians keep themselves emotionally healthy, too.
As a future medical student, it’s vital that you prepare yourself to compassionately face death and dying and the complex emotions that follow. One way to do this is by volunteering in a hospice facility or nursing home and honing these six skills.
1. Be authentic: As a volunteer, introduce yourself and express your hope that someday you wish to become a physician. Let patients know you are there to learn more about their experiences.
Ask patients about how they grew up or what they were thinking about at your age. Ask about their work or career – a generally safe place emotionally – and where they have lived or about their family.
Be sure to make eye contact and watch your body language. You’ll use these skills when you’re a physician to develop trust and open communication with patients.
2. Listen with purpose: Practice your active listening skills so that on future visits you can ask patients more about previous conversations.
By bringing up something from a past visit, you will show that you remembered what they told you and that they matter to you as a person. Active listening is another skill you will use throughout your medical career.
3. Allow patients to talk about death: Everyone faces death differently; some people want to talk about it, while others prefer to reflect on their life and accomplishments.
Whether now as a volunteer or later as a future physician, let patients talk about death as they need to. Don’t shut down the conversation by saying, “Everything will be all right.” Instead, ask them to tell you more. Listen to all they have to say, whether it’s about their health, fears or fond memories.
4. Visit or connect consistently: A good physician builds rapport over time, and you can develop this skill through your volunteer position. During extended time between visits, call or drop the patient a note.
This is a good habit to develop so that when you are a physician, your patients – particularly those who are dying – will feel supported. At the end of each visit, thank the patient. You won’t know at the time if it will be your last opportunity to visit, so treasure each interaction.
5. Seek support: Myriad scholarly articles and books are available to help physicians – and all people – accept that death is an inevitable part of life and that grieving is normal and encouraged. For instance, attending funerals help some people grieve, while others seek solace from support groups or counseling.
Social workers also deal with death and dying regularly and can give you advice about how they cope and prevent burnout. Make the social work team part of your professional network. Their support and advice will help you cope as a physician, especially when you lose a patient who had a particular influence on you.
6. Allow yourself to grieve: Over the course of your relationships with patients who are dying, you will learn a great deal about your capacity to care for others. It will likely hurt when patients die.
Remember that it’s important to grieve, and keep in mind that everyone grieves differently. Give yourself the room to process your emotions and to discover the coping mechanism that’s right for you.
Over time, you will gain some insight about your ability to cope. Physicians often cope by speaking confidentially with colleagues and expressing sadness and other emotions in a journal. After omitting a patient’s protected health information, some physicians publish their writings to help themselves and others who are grieving.
Many medical schools also teach students to reflect about their emotions and write them down. Writing and seeing the words help the healing process.
As a future medical student, embrace the opportunity to get to know someone who is dying. It will allow you to reflect on how you may feel when a future patient dies and learn to create a meaningful bond with the people you touch now and in the future.
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