Clinic reflection

I have had a few interesting situations in clinic since term began.

The most memorable being my worst patient encounter ever! I innocently approached a re-exam for a long term patient by starting with a completely new history. The lady was booked in for the assessment by my colleague who was unexpectedly unable to take her at the last minute. It transpired that she did not want this to be happening at all and did not want to answer any questions! She felt let down historically by the medical profession and undeniably had suffered some unfortunate side effects of medical treatment and it became obvious early on that there were yellow flag issues and she hadn't really been taken care of properly. She was extremely hostile and aggressive in her manner and I initially tried to call a halt after about ten minutes. We decided to carry on, but again, after another twenty minutes I stopped taking the history for good this time. I had been on the receiving end of this womans' rage and frustration for too long and she was crying now anyway. A failure of reflective listening! I calmed things down and brought in a tutor who decided we would treat conservatively and worry about the re exam later. I was glad when she left and I referred her back to my colleague, having fully debriefed him!

This is the only time I have really struggled with patient empathy. During the encounter I just found it unbelievable that someone would behave like that and not offer an apology. I felt like an emotional punchbag. I was very disturbed by this encounter and although I can be objective and have some sympathy for the state she has ended up in, I am left with a residual feeling of disgust. I need to work on being prepared for other situations like this so that they do not affect me personally. I should have no residual feeling about this encounter. I feel that I wasn't detached enough. However, it is of slight amusement to me that during a calmer dialogue when she genuinely opened up, I had asked her about her support network (she didn't have one) and suggested that maybe talking these issues through with a professional would be beneficial, only to be BELLOWED at again. The sound of her shouting at me that, "talking about it all was the problem," is still ringing in my ears. I am scarred for life!