Listen to Episode 2
Episode 2 transcript
Intro
Hello and welcome to Here for Doctors, the RMBF podcast.
In case you don’t know us, the Royal Medical Benevolent Fund is the UK charity for doctors, medical students and their families. For doctors in financial hardship due to illness, injury, disability or bereavement, we provide financial support, money advice, wellbeing support and more.
My name’s Joe Meredith, Senior Communications Officer for the RMBF. In this podcast, I’ll be talking to some great guests who share a common interest: supporting medics in need. I’ll also be sharing expert advice for doctors around mental health, wellbeing, working life and more.
In this episode, I’ll be sharing a guide from our online Advice Hub about an issue that almost all doctors will face in their career: the death of a patient. How can doctors best deal with this difficult aspect of the job? Listen on to find out.
What is it like to experience a patient’s death?
It almost goes without saying that every doctor will react differently to the death of a patient, depending on their level of experience, specialty, personality, and countless other factors. And every patient’s death will be different and significant in its own way.
The area of medicine a doctor works in is likely to make a considerable difference. An ENT specialist is unlikely to experience death frequently in their day-to-day, so if it does happen, it might have more of an impact. Emergency medicine may involve more frequent encounters with death, sometimes traumatic. Palliative care also involves a lot of contact with death, but it is expected.
For a profession where, in most roles, saving lives is part of the job description, the death of a patient is very likely to be bound up with feelings of failure. This can lead to a loss of confidence that affects a doctor’s work. Doctors may feel guilty if they think they didn’t do enough to save a patient, or angry if they feel their colleagues didn’t do enough. The death of a patient may also trigger past feelings of bereavement – of a relative, for example.
Richard, a GP of 30 years, reflects on the deaths he’s experienced in his career. He says:
“The ones I do feel and remember most are when the patient is a child; when I was present at the moment of death; or when I had a high degree of involvement and attachment preceding the death. Also, especially when there was an error or delay in the care of the patient. This really fuels the guilt.”
It’s important to remember that no doctor can save every patient, no matter how much they’ve trained or how hard they work. Death is a part of life, and it is a part of medicine. Doctors have to learn how to remain compassionate and empathetic, while not letting their emotions prevent them from doing their job. Coping with patient death is one component of this balancing act.
Coping with your first patient death
Most doctors will first experience a patient dying while they’re still a student. Medical school is a demanding, competitive environment and students are understandably wary to show any weakness. But it is only natural to experience difficult emotions when someone dies, and it doesn’t mean that you aren’t cut out for the job. Try to acknowledge these emotions rather than shutting them off.
It can also be helpful to talk to someone. This might be a trusted friend or a more experienced colleague – but remember that they’re only human too, and your colleagues will very likely have had painful experiences of their own around the death of a patient.
You may also have to comfort a patient’s loved ones while you are experiencing grief yourself. It’s okay to be human and show emotion in this situation, and it may even be helpful to them, but be careful not to put your grief over theirs.
Strategies for coping with death during your medical career
Doctors know very well that prevention is better than cure, and the best way to cope with the death of a patient is to take care of yourself. If you’re already struggling, the death of a patient may well hit you harder than it normally would.
The best way to prepare yourself for difficult situations is to try and reduce your risk of stress and burnout. These issues are sadly very common among doctors, but they are not inevitable and there are ways to mitigate them.
This can start with self-care. Having strategies that you can employ yourself to relieve stress and pressure is vitally important. But while self-care is important, it’s not realistic to expect that you can cope with the death of a patient all on your own. And it’s important to know what sources of support you can call upon and when.
Informal support from colleagues, like a chat over a cup of tea, is valuable and shouldn’t be discounted. Sometimes more formal support will be appropriate. This might be available through your hospital or your NHS trust, or you might want to talk to your GP if you feel patient death is seriously affecting you.
How to know when you need support
Anyone who witnesses death frequently can become desensitised to it. And it is true that in situations where death is common, some level of desensitisation can be beneficial for survival. But in the long term, desensitisation can harm your mental health and your relationship with others.
It’s better to try and find healthy ways to cope with the emotions that come with the death of patients, rather than relying on switching them off. If you feel you are becoming numb or desensitised, it’s important to seek support sooner rather than later.
Our “Vital Signs” guide gives advice for doctors experiencing stress and pressure, including seven key early warning signs that you might not be coping well at work. There’ll be a link in the description of this podcast to read and download that guide.
What other support is available?
If you’re facing financial hardship due to mental health issues caused by patient death, you may be eligible for financial support from the RMBF. Again, there’ll be a link in the description, or you can just go to rmbf.org and click “Get Help” to find out more.
We have an online wellbeing platform provided by RightSteps, who are workplace mental health experts. This covers a whole range of issues, including stress and anxiety, and there is a variety of content, from quick bite-sized stuff for your lunch break, to more in-depth self-guided support.
We’ve also recently added a range of talking therapies for doctors to the RightSteps platform. Their team of in-house therapists offer a variety of confidential therapeutic approaches for doctors, including integrative therapy, person-centred therapy, and cognitive behaviour therapy. These are available via telephone or video sessions. The RMBF can also provide financial help to access these therapies for those facing hardship.
Don’t forget our Advice Hub, which contains many expert articles on mental health and wellbeing for doctors and medical students. We’ll be sharing some more of them in future episodes of this podcast.
As previously mentioned, there may also be support available through your workplace or your GP. The BMA offers free and confidential 24/7 counselling and peer support services to all doctors and medical students, regardless of BMA membership. The Royal Colleges and other professional organisations for doctors also offer a range of support programmes.
Though the death of patients may be part and parcel of the job, there’s absolutely nothing wrong with seeking the right support to make sure that it doesn’t throw you off course.
Outro
Thank you for listening.
This article was written with the help of Dr Richard Stevens, a former trustee of the RMBF and coach at Thames Valley Professional Support Unit. He also wrote the Vital Signs guide mentioned in the article and several other guides in the same series. They’re all available to read and download on our website.
Please subscribe on Spotify, YouTube, or wherever you’re listening. You’ll get bite-sized episodes every month, an easy way to learn more about how to support doctors.
This episode’s music is “Autumn Day” by Kevin MacLeod, licensed under Creative Commons By Attribution 3.0.
If you’re a doctor or medical student facing financial hardship, you may be eligible for support. Just visit rmbf.org and click “Get Help” to find out more.
Finally, we can only help doctors in need thanks to our generous supporters. We receive no government funding. You can make a donation, or find out how else to support our work, at rmbf.org.
See you next time.