Pastoral Care for Doctors

A doctor’s work is diverse and complex. They require not only medical expertise, but the ability to analyze and diagnose physical and psychological problems, and they deploy a variety of social skills that help coax and reassure their patients as they seek to help them. As part of their work, doctors also devote time to broaden their skills and knowledge of current medical developments.

Pastoral care for doctors aims to offer practical, compassionate, and emotional support for the many difficulties and challenges that may arise in a doctor’s working day, including litigation, disciplinary and inquest proceedings, court attendance, and investigations. This article is however tightly focused on pastoral care as it primarily relates to abusive, aggressive, and violent behaviour directed toward the doctor during the course of their work.

'Minor' Incidents

Distressing events affect people in different ways depending on the incident’s severity and a range of other factors. Someone who has enough rest, is healthy, supported by friends and family, and who enjoys a positive temperament will be more resilient when faced with adversity. Doctors are no different.

Doctors should be routinely debriefed after an incident of abuse or aggression, and in serious cases the prospect of counselling should be offered.

What may be viewed of as a relatively minor incident could arise at the end of a chain of events, or a difficult time outside of work. It is important to always listen to anyone who comes forward seeking care and support, and to treat their concerns seriously, and not to lesson their importance, or think of the incident as something that should be easy to recover from.

As a result of demands on time and a desire to move on as quickly as possible to the many pending issues that await in medical practice, it may be tempting to judge the significance of any given event from the narrative explanation of what took place. This approach however fails to recognize the unique and multi-faceted circumstances of the individual, and that these will also affect the severity of how any given incident is experienced.

It is also possible that what at first appears to be a minor incident turns out to be far more serious on closer inspection. No matter the perceived serious of the incident, a colleague’s request for support should always be respected.

It may be that the physiological impact of abuse or aggression when at work does not surface for some time. Be mindful of the tendency to only provide support immediately following a difficult event. Support should continue to be offered at regular intervals for a considerable time for any doctor who has suffered a traumatic episode.

The Benefits of A Duty of Care

Every medical practice has a duty of care to its staff. Pastoral care neither acts as representative or counsellor, but rather facilitates and supports. Part of the practical assistance pastoral care offers for example is to act as intermediary with external agencies and organizations.

In addition to supporting staff who experience unpleasant and upsetting events, high quality pastoral care may uncover underlying experiences of grief, practical difficulties (financial and familial), loneliness, or other challenges the doctor may be facing in their lives. Identifying these issues not only serves the doctor to address these with the view to doing their work more effectively, it improves the overall service of the practice to its patients.

Medical practices are encouraged to review their pastoral care provision for doctors every six months, as a yearly review may leave some areas of concern unresolved for too long.

Conclusion

The purpose of pastoral care is to support people in their pain, loss, and anxiety. These are emotional, and at times spiritual in nature. That is, pain, loss and anxiety are not confined to a person’s emotional response, but may also relate to their beliefs and values. If for example a doctor experiences verbal abuse, their response may not merely be emotional upset, but also a sense of being harmed more abstractly and more deeply. Their sense of optimism or trust in others may be undermined, and it is often this that needs to be acknowledged by the pastoral care team so that adequate opportunities are provided to discuss these issues at length.

The importance of gently and skilfully relating with an individual’s inner world is not only an invaluable skill for doctors in their work, it is of equal importance that doctors also receive this care should an upsetting or violent event take place.