Thursday, April 16, 2009

Dealing with emotions: challenge

Today I want to gather my thoughts on what happens sometimes when I am faced with trying to help a patient who is suffering emotionally and so the consult ends up being about more than just finding information. When this happens, not too often thankfully, I am sometimes left with the feeling that I could and even should have done something differently, but at a loss as to how.

Health care professionals are formally taught how to communicate and establish trusting, humanistic relationships with their patients (though of course not all will excel at this).1 2 3 4 For obvious reasons, librarians/info professionals do not get such training. We are taught how to conduct a reference interview, sure, but not exactly what to do if a patient is referred to you and then angrily questions what you can do for them. They look from you to the computer and flat out state (with maximum scorn) that they could do what you are about to do for themselves and with the same results. They are not a "problem patron." You know they are suffering from anxiety, or depression, or have just been diagnosed with colon cancer and that their emotions are understandably running high, but you have no script, no checklist to smooth the interaction. Do you sympathize? Do you try to lighten the situation? Do you engage or remain impassive and try to conduct business as usual?

In situations like these my instinct is to throw the idea of finding information out the window in favour of just listening. I know a little bit about active listening (from life as well as from library school) so I try to paraphrase what is being said to me, while repeating as many times as possible that I understand their frustration, that I *might* be able to find something they have missed in the course of their own searches on Google (or at least validate that their search was well done), and that I will be available when they are ready if today is not good.

But this just an instinct. And once in a while I get flustered. Then I forget the above and I try to forge ahead, to prove myself by finding something useful, sometimes unsuccessfully (because of aforementioned flustered-ness). This of course undermines the trust that I am hoping so much to establish, and leaves me feeling inadequate and inadequately prepared.

Either way I have no real formal training to deal with such situations, and no way to establish whether my instincts are correct except based on how the situation resolves itself (i.e. are they still angry when they leave? Did they come away with something useful?). My thinking is that some of the literature developed for health professionals might be of service (just the reading from today was helpful). I wonder if any other information professionals working in my area of speciality have faced this kind of problem and how they have sought to resolve it. Your thoughts are welcome.

1 Branch WT, Kern D, Haidet PWeissmann P et al. The Patient-Physician Relationship. JAMA 2001;286(9):1067-1074. Accessed April 16 from:
2 Gask L, Usherwood T. ABC of psychological medicine: The consultation [clinical review]. BMJ 2002;324:1567-1569. Accessed April 16 from:
3 Bedell SE, Graboys TB, Bedell E, Lown B.. Words That Harm, Words That Heal [commentary]. Arch Intern Med. 2004;164(13):1365-1368. . Accessed April 16 from:

4 Hastings A. The Good Consultation Guide for Nurses. s.l.*:Radcliffe Publishing;2006.

*As a total aside- how come both Google Books and Amazon do not include location in their records? Very frustrating. I do not have the patience to check more than 3 sources today (also checked McGill's catalogue to see if they had a copy but no luck). Hopefully my readers will forgive my laziness:-b


Michele Matucheski, Ascension Wisconsin Librarian said...

I wonder if some of the chaplaincy literature might also be helpful.

I have found myself in some of these situations, too. Forget about finding them some info, if what they really need is someone to listen.

Most often, they are appreciative that someone took the time to hear them out.

FF said...

Hi Michele,

That's a good suggestion. I'll have to look into it! Did you have anything particular in mind? I'm not familiar with the literature and would welcome a recommendation.