DEVON: Hey, Rashad! It’s been a while. How’re you doing?
RASHAD: Not great, honestly. Pretty stressed.
DEVON: Yeah, I was going to say, you look a little upset. What’s up?
RASHAD: Just one of those, I don’t know, one of those days where absolutely nothing goes right.
DEVON: Don’t worry, you get used to the pace of things after a while.
RASHAD: (sarcastic) Yeah, just like how I got used to the terrible coffee here.
DEVON: Yeah! I used to hate the stuff, but now I can’t live without it. But, like, yesterday I had a patient swear he didn’t have a pulse, and that the machines were wrong and I didn’t know what I was doing. What a total waste of time. But that’s just how it is sometimes.
RASHAD: Ugh, that sounds awful. This patient was just yelling at me about vaccines. I couldn’t reason with her ’cause I was just thinking about how behind I was. I’m still pretty upset about it. But I guess that’s just something I’ve gotta get used to.
COACH: You tried to reassure Rashad his experience was common, but he felt a little dismissed, like he was making too much of his feelings. Instead, try asking an open-ended question that invites him to share his experience.
DR. HILLIARD: There’s a difference between day-to-day stress, like having a busy schedule, and moral distress, like doubting your professional integrity. We can navigate day-to-day stress and move on. But, the doubts and guilt of moral distress tend to linger and build on each other. If Rashad tries to ignore any of these feelings, he’ll likely feel worse and worse. Instead, help him identify any distress that goes beyond the everyday and think about how to address it. That could help him feel better.
DEVON: Can’t you just forget about it and move on?
RASHAD: I mean, I wish it could be that easy for me. I’m just not like that, I guess.
COACH: “Can’t you just forget about it and move on?” was a closed question that sounded like criticism. In response, Rashad felt defensive and unsupported. An open-ended question like “What about this is making you feel upset?” would have encouraged him to share more.
DEVON: So you couldn’t overcome some misinformation. It’s okay, it happens a lot, unfortunately.
RASHAD: It’s not just that, though. If I’d had time to explain, and she still disagreed, I could move on. It’s the fact that I couldn’t take the time I needed.
COACH: You tried to reassure Rashad by saying “It’s okay, it happens a lot.” In response, Rashad felt dismissed. Next time, try using an affirmation that accepts Rashad’s experience and feelings as valid.
DEVON: It sounds like you’re just stressed.
RASHAD: I mean, I am stressed. Maybe that’s part of it. But I feel like it’s more than that. I don’t know, maybe I’m crazy.
COACH: You tried to reassure Rashad by saying “It sounds like you’re just stressed,” In response, Rashad felt dismissed. Next time, try using an affirmation that accepts Rashad’s experience and feelings as valid.
RASHAD: Well, anyway. I gotta get back to work. See you around.
COACH: A few days later, the next time Devon catches up with Rashad.
DEVON: Hey, Rashad! Man, I cannot wait to go home and watch the new episode of Courts of Justice. It’s this show about lawyers who play basketball.
RASHAD: (distracted) I don’t know it. Sorry, Marsha called me in this morning and got on my case. Apparently that patient I was talking about last time, they made a complaint about me.
DEVON: Oh, I’m sorry to hear that.
RASHAD: And now, the other few times I’ve asked about vaccination history, my palms get all sweaty, and I can’t stop thinking about the last time. I’ll have to rush the conversation, they’ll get upset, and there won’t be time for an informed discussion. Like is this just what our job is now? Rushing through cases?
DEVON: It sounds like this is really impacting you. I think you might be experiencing moral distress. Do you know what that is?
RASHAD: Kind of?
DEVON: Well, it’s like, when you’re upset because you know the right thing to do, but you’re unable to do it because of outside circumstances.