Last week I spent some time and effort helping “Jane,” a medical assistant from an outside office, to get a permanent pleural catheter authorized for a patient of mine with Stage IV lung cancer. There were multiple phone calls regarding the authorization, and then more phone calls with the community cancer center radiology staff where my patient lived, which included being put on hold and listening to classic music for close to 20 minutes. I was eventually able to speak to the radiology scheduler and informed her an urgent referral was on its way, and that my patient was symptomatic and already had multiple thoracentesis performed at his local ER.
I felt pretty confident all had been taken care of and called my patient to let him know he should receive a call from the radiology scheduler to set up the appointment for a permanent plural catheter within the next 24 hours. I let him know he should call me if there were any complications, although I did not expect any. Three days later, I got a call from my patient to say he had not heard from the radiology department, and had ended up going to the ER for another thoracentesis over the weekend.
I called Jane, the medical assistant, and found out the referral had never been sent because Jane had been “very busy” and forgot to send it. When I spoke to Jane, she was angry. She told me she was always “too busy to do my job properly and no one understands that.”
She was frustrated, and I was frustrated that we had not provided timely care. I felt even worse when my lovely patient assured me that he “understood” that we were all busy and was okay with the delay. I was not okay with the delay, and could feel my frustration mounting, especially with the angry response from Jane.
What’s the best way to handle conflict at work, especially when staff members are rushed and, at times, frankly overworked, and mistakes are made as a result?
In her column “Don’t Take the Bait: Emotionally Charged Situations at Work,” Helen Meldrum, EdD, MEd, writes, “From a very young age we’re triggered by roles (‘you’re not the boss of me!’) And resources (‘she’s always gets everything she asks for, and I never get anything!) Dr. Meldrum suggests that in an emotionally charged situation at work, each side attempts to place the blame on the other. When that happens, tension mounts in the workplace. Although you think it might be appropriate to vent at that time, doing so can have a negative effect on the person venting, especially if it happens often.
As Dr. Meldrum puts it, when we complain and blame others for mistakes that are made (even when we feel we are in the right), we are at risk of “wearing out our soul.” Instead, we can attempt to use empathy and acknowledge underlying feelings when dealing with an emotionally charged situation at work.
I took Dr. Meldrum up on her advice. When I spoke to Jane about the delay, I acknowledged that she was frustrated because she was so busy that she did not have the time to send the referral. Jane was silent for a moment. Her response: “Yes, that’s exactly it, but nobody seems to hear me or care. I don’t want to make mistakes. I’m sorry it happened. I’ll get right on it — and do it now.” And she did. A few hours later, the patient called me to say he had an appointment made, and actually did very well once his permanent pleural drain was placed.
As an oncology nurse navigator, I spend most of my day communicating with patients and other staff members. Being an effective communicator is one of the skills I need in order to do this job well. I was grateful for the good advice from Dr. Meldrum, firstly for my patient because we were able to rectify the situation in a short time, secondly for Jane and myself because neither of us had worn down our souls.
The experience was a good reminder that when things don’t go the way I plan, I have a choice as to how I will react — and how I react affects everyone around me including, my patients and my colleagues.