Description | Examples |
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Working alone to prepare and inform and guide patients. | ‘Everybody [patient and family] went with me to the quiet room… And I just spoke to all of them, like giving a speech.’ (Resident physician) ‘… I was sort of leading the meeting and the neurologist was just somewhat of a Silent Sam, just allowing me to lead the discussion and not offering a whole lot in the way of support or guidance, which was frustrating because patients who have this condition, this is how the condition goes. By and large this is how their life ends.’ (Staff physician) |
Reacting to (non) decision-making discussions, rather than working together to support and create conditions for dialogue. | ‘Often we are picking up the collateral damage of non-decision-making, of non-discussions. Now things are really not going well. A decision needs to be taken right now. So we are more often in that mind frame. It's rare that we are ahead of the ball.’ (Nurse) |
Feeling unprepared for challenging discussions about existential issues and end of life. | ‘And I can say this with certainty, that there are people, and I've seen it with colleagues as well as students, who are afraid of this: who are afraid of talking about anything related to end of life with people.’ (Staff physician) |
Nurses remain in the background, behind the scenes. | ‘I will usually stand behind the curtain and not go on the other side of the curtain and be present with the conversation that's happening. I'll just listen. I won't be a contributor in that conversation. I don't know why I do that.’ (Nurse) ‘It's usually always been the physician that has that conversation and then we just, reinforce the conversation afterwards.’ (Nurse) ‘It's out of my hands whether or not it's taken into consideration or not. You can tell residents all they want but if they have something set in their mind that this is going to happen then that's going to happen. Most of the times we can't change their minds. But you never know.’ (Nurse) |