Thoughts on talking with patients.
It's been a long week, and we've had some interesting patients.
Keeping with the theme of a fairly recent post... we had a couple of pro-life patients come in for pre-ops this week. Apparently one of them said she had "saved so many of her friends from having abortions" in the past. I didn't see this patient, but I did hear about her. The general feeling around the clinic is that such patients need a swift knock up-side the head with a clue-by-four, since they still don't seem to understand the situation they are in, and how it is likely no different from anyone else's in our clinic. It's aggravating to deal with people who still think abortion should be illegal, that it's bad for women and families, and that it is murder even as they are sitting right in front of you requesting your services. And you'd think that perhaps they'd be more upset than the other patients, but they aren't really. They are just as certain that this is the right decision for them.
Sometimes, they say things like, "I don't really have a choice," which we always delve into. We don't stand for people being pressured into abortion, and we always make sure that ambivalent patients are aware of their other options. As much as they may not like to admit it, they do have a choice... they may not like their options, but they do get to pick which one is the best for them. Some patients just don't like to admit that it really is a choice they made. They want to release themselves from responsibility for their actions, and just not deal with whatever emotions or feelings of hypocrisy might arise from choosing something they actively fought against before.
Sometimes, they stick to the "I'm different" story. They don't come right out and say so, but they imply that their situation is different from those of the other women at the clinic. "I'm different, this wasn't planned." I actually heard that one. As if anyone except the women who found their fetuses have abnormalities planned the pregnancies they are terminating. "I'm different, the condom broke and I couldn't get EC." I have also seen women who refused to use birth control because it is against their religion. So... they just came to my clinic a few times instead.
Now, I never say any of the things I'm thinking when I'm at work. In fact, when I am on the job I don't even feel frustrated by these patients. That's why I have requested that people send difficult patients to me. They don't make me irritable the way they do some of the other people I work with. The clinic is not the place to challenge someone's world view, as far as I am concerned. It is difficult enough to go through the abortion process without someone on the staff being obviously judgmental. If problem patients do something to slow down the day, piss of the doctor, or hurt other patients (emotionally or otherwise), then I would get involved. But if it is just between me and them? It isn't necessary... I just make sure they are sure of what they want to do, and if they want to talk I'll listen and give feedback as needed to help them feel more comfortable with their decision.
Moving on, it is also important to keep in mind that not all of our patients are straight. In fact, one day this week we had two queer gals. One of them was planning her marriage to her fiance (female), which she excitedly talked about during the abortion. All the staff in the room were inwardly wondering the circumstances surrounding the pregnancy, and how that might effect the marriage. My assumption is either that she is polyamorous, or she cheated and was forgiven... or the fiance doesn't know, but it isn't my business so I didn't ask (and no one else did, either). The other gal was a bit younger, very sensitive, and very afraid. I did a lot of hand-holding, positive talking, and whatnot in addition to helping the doctor. I ended up eating lunch with this patient, and when she started talking about how women are better than men, it became clear that she, er, fancied me a bit. It was a rather unusual situation, but I kept things light by babbling about how cool dinosaurs are and other such nonsense.
Anyway, not everyone is comfortable talking with patients when they are in the OR (doing the Patient Advocate job). Just the other day, one of the other people at work was telling me about how she just feels uncomfortable bullshitting with people while they are having their abortions done. I guess I just don't think it is all that strange. I'm sure they know that the talk is meant to help those few minutes to pass more quickly, and to get their minds off of whatever physical discomfort they are having. I know that I have appreciated distracting conversation in similar sorts of situations, so it doesn't bother me that we talk about crap like... who they think the sexiest actor is while their abortion is done. My mom seemed to expect heavy conversations. Life stories pouring out in a matter of minutes, and the deepest darkest parts of the soul being bared to the world... but why the hell would we do that? It's sad and upsetting. Not that we don't get interesting stories from time to time, but we keep things as emotionally positive as we can with each and every patient. Like I've said... it's often difficult enough to have an abortion without making it even worse by getting the patient all emotional.
Interacting with patients is one of the most important thing about this job. I've found that my people-skills and ability to make pleasant small-talk have improved greatly since I started working. I even use the same "techniques" to get along with other people I know when I am not feeling particularly social. I wonder if anyone has noticed.
Keeping with the theme of a fairly recent post... we had a couple of pro-life patients come in for pre-ops this week. Apparently one of them said she had "saved so many of her friends from having abortions" in the past. I didn't see this patient, but I did hear about her. The general feeling around the clinic is that such patients need a swift knock up-side the head with a clue-by-four, since they still don't seem to understand the situation they are in, and how it is likely no different from anyone else's in our clinic. It's aggravating to deal with people who still think abortion should be illegal, that it's bad for women and families, and that it is murder even as they are sitting right in front of you requesting your services. And you'd think that perhaps they'd be more upset than the other patients, but they aren't really. They are just as certain that this is the right decision for them.
Sometimes, they say things like, "I don't really have a choice," which we always delve into. We don't stand for people being pressured into abortion, and we always make sure that ambivalent patients are aware of their other options. As much as they may not like to admit it, they do have a choice... they may not like their options, but they do get to pick which one is the best for them. Some patients just don't like to admit that it really is a choice they made. They want to release themselves from responsibility for their actions, and just not deal with whatever emotions or feelings of hypocrisy might arise from choosing something they actively fought against before.
Sometimes, they stick to the "I'm different" story. They don't come right out and say so, but they imply that their situation is different from those of the other women at the clinic. "I'm different, this wasn't planned." I actually heard that one. As if anyone except the women who found their fetuses have abnormalities planned the pregnancies they are terminating. "I'm different, the condom broke and I couldn't get EC." I have also seen women who refused to use birth control because it is against their religion. So... they just came to my clinic a few times instead.
Now, I never say any of the things I'm thinking when I'm at work. In fact, when I am on the job I don't even feel frustrated by these patients. That's why I have requested that people send difficult patients to me. They don't make me irritable the way they do some of the other people I work with. The clinic is not the place to challenge someone's world view, as far as I am concerned. It is difficult enough to go through the abortion process without someone on the staff being obviously judgmental. If problem patients do something to slow down the day, piss of the doctor, or hurt other patients (emotionally or otherwise), then I would get involved. But if it is just between me and them? It isn't necessary... I just make sure they are sure of what they want to do, and if they want to talk I'll listen and give feedback as needed to help them feel more comfortable with their decision.
Moving on, it is also important to keep in mind that not all of our patients are straight. In fact, one day this week we had two queer gals. One of them was planning her marriage to her fiance (female), which she excitedly talked about during the abortion. All the staff in the room were inwardly wondering the circumstances surrounding the pregnancy, and how that might effect the marriage. My assumption is either that she is polyamorous, or she cheated and was forgiven... or the fiance doesn't know, but it isn't my business so I didn't ask (and no one else did, either). The other gal was a bit younger, very sensitive, and very afraid. I did a lot of hand-holding, positive talking, and whatnot in addition to helping the doctor. I ended up eating lunch with this patient, and when she started talking about how women are better than men, it became clear that she, er, fancied me a bit. It was a rather unusual situation, but I kept things light by babbling about how cool dinosaurs are and other such nonsense.
Anyway, not everyone is comfortable talking with patients when they are in the OR (doing the Patient Advocate job). Just the other day, one of the other people at work was telling me about how she just feels uncomfortable bullshitting with people while they are having their abortions done. I guess I just don't think it is all that strange. I'm sure they know that the talk is meant to help those few minutes to pass more quickly, and to get their minds off of whatever physical discomfort they are having. I know that I have appreciated distracting conversation in similar sorts of situations, so it doesn't bother me that we talk about crap like... who they think the sexiest actor is while their abortion is done. My mom seemed to expect heavy conversations. Life stories pouring out in a matter of minutes, and the deepest darkest parts of the soul being bared to the world... but why the hell would we do that? It's sad and upsetting. Not that we don't get interesting stories from time to time, but we keep things as emotionally positive as we can with each and every patient. Like I've said... it's often difficult enough to have an abortion without making it even worse by getting the patient all emotional.
Interacting with patients is one of the most important thing about this job. I've found that my people-skills and ability to make pleasant small-talk have improved greatly since I started working. I even use the same "techniques" to get along with other people I know when I am not feeling particularly social. I wonder if anyone has noticed.