Medical Resident – Peer Support Scenario – Jeffrey T.

Scenario: Jeffrey contacts the Staff Wellbeing program in Human Resources, to ask about their Peer Support Program:

Jeffrey: Hello, I’m just started my 2nd year as an Emergency Medicine resident and I’m in the certification program in Internal Medicine and Emergency Medicine. I was hoping to talk to a peer informally about some experiences at work that have been bothering me.

Administrator: Certainly. I’ll find match you with someone and they should contact you soon.

You: Hello, Jeffrey. It’s [say your name]. I heard you wanted to talk to someone about things you’ve been going through. Is this a good time?

Jeffrey: Yes, Hello. Now is a good time. I do want to talk about something.

You: Want to go somewhere quiet? Maybe get coffee?

Jeffrey: Sure. The courtyard would be good, since it is nice out today, let’s head there.

Jeffrey: That’s a good word for it, “intense.” And chaotic, too. I’m doing okay. It’s just that it’s exhausting when the overtime continues and there’s no end in sight.

You: I hear you. The CCU has not had the flood of patients like the Emergency Department and ICU, but we’ve had our share. You can only sprint just so long.

Jeffrey: Right! And besides the exhaustion, there are some sad patient stories.

You: Those sad stories can stick with you.

Jeffrey: Yes, they sure do. In fact, that’s one reason I wanted to talk to someone – not some counselor, but someone who understands what we deal with.

You: That makes sense. Well, that’s why I’m here.

Jeffrey: Thank you.

You: The Wellness Office probably explained, but I just want to repeat that this is confidential and limited to giving you some support right now as a peer, not doing therapy.

Jeffrey: Right, I understand.

You: What sad stories are on your mind right now?

Jeffrey: There was this patient, around my age. He said he and his wife were trying to have a baby. My wife, Monica, and I are trying, too, so…[Breaks off, looks like his emotions are too strong to say more about it.]

Jeffrey: [He nods.]

You: It sounds like exhaustion and sad patient stories brought you here, wanting to talk with someone who may have been through something similar.

Jeffrey: Yes. [Looks sad] My patient didn’t say much after that, because he couldn’t. And I don’t want to go into all the details. But the bottom line is that he didn’t make it. We did everything. Some people just don’t make it. But his dying blew me away worse than other patients I’ve experienced, because of our similarities.

You: It makes sense you would feel more grief since you had some things in common. You were at a similar time in life so possibly had similar dreams. [This intervention uses “naming the feeling” of grief and “normalizing the experience”]

Jeffrey: Yes. So, I really felt the loss. [He breathes a heavy sigh.]

You: Yes, a tremendous loss. Your grief is understandable, especially if you were identifying with him. [Pauses for a few moments so that Jeffrey can process the discussion and the feelings it evoked.]

You: That’s a tough story, and you’ve also been working long hours. I just want to check on how you are doing if that’s okay.

Jeffrey: Sure.

You: How’s your sleeping?

Jeffrey: Not too bad. Just a little trouble sleeping from thinking about this.

You: Eating?

Jeffrey: No problem there.

You: How about being able to complete your basic responsibilities, here and at home?

Jeffrey: That’s okay. I’m pretty good at keeping up with responsibilities.

You: So, you’re still able to do your job and other responsibilities, but you are feeling the grief strongly enough to want to talk about it.

Jeffrey: Yes, that’s it. The team did talk about it that night, but like I said, I still wanted to talk about it some more.

You: I’m glad you reached out. Many of us need some extra support now and then. How has your mood been?

Jeffrey: It’s fine, except the sadness I told you about.

You: And how’s your social support?

Jeffrey: Right now it’s mainly my wife, Monica. We just got married last year after dating for 8 years. And there are my work friends, of course. I didn’t want to talk to them about this because I see myself working in the department here someday, and I want people to see me as capable and showing promise.

Jeffrey: Right. I just don’t want to take the chance.

You: I understand.

You: What do you think would be most helpful right now?

Jeffrey: Talking to you has helped. I’m not over it, but it’s helped a lot. Thank you.

You: You’re welcome. I’m glad I could help. These things take time. Remember, you are not in this alone and you are not the only one going through it.

Jeffrey: Yes, I know.

You: You may find the Wellness Center’s grief support group helpful. You can go to one or more sessions. I went last year for a couple of sessions. Just stop by the center or sign up online.

Jeffrey: Yeah, they told me about the support group. Thanks. I’ll think about it.

Jeffrey: Yes, I’d like that.

You: Hello Jeffrey. It’s [give your name]. Do you have a little time to talk?

Jeffrey: Yes. Now is fine.

You: I wanted to check on how you are doing since we talked.

Jeffrey: I’ve been doing okay. I think it helped to talk. I still feel a little sad at times, but it’s managable. And I feel a bit overwhelmed with the workload at times, but I’m coping.

You: Sorry to hear the workload is still overwhelming at times [empathy], but given that you’re still in the same work circumstances, it’s not too surprising [normalizing]. How about that grief group? Did you feel you need that?

Jeffrey: Not right now, really.

You: We didn’t get a chance to talk about what coping skills you already know and use.

Jeffrey: No, I don’t think we did talk about that.

Jeffrey: I did learn some coping skills in the wellness classes I took here at the medical center, but I forget to use them. Like taking deep breaths and taking breaks to get grounded.

You: What sort of breaks or grounding is most helpful for you?

Jeffrey: I just need to get outside. If I can get outside and see the sky, I sort of reset, you know. I miss playing basketball, but I can still shoot a few baskets when I get home.

You: So, you know at least two things you can do when you need a break: going outside and shooting some baskets. Now you just have to remember to do them. You’ve got to take time for yourself, you know.

Jeffrey: Thanks for the reminder! I’ll give it a try. And thanks for the phone call. It means a lot.

You: You are welcome. I’m glad we talked.