Abstract
Context
Doctors caring for patients with life-limiting illness are often exposed to emotional
distress.
Objectives
We aimed to explore the experiences and perceptions of junior doctors working full
time in a palliative care rotation. We examined the lessons junior doctors learnt
in managing their emotions as they face patients' death on a daily basis.
Methods
We conducted a qualitative study with seven focus group discussions involving 21 junior
doctors (medical officers and residents). Data were analyzed using qualitative thematic
analysis to identify the themes related to the perceived challenges of these junior
doctors and how they managed the struggles. Interviews were conducted with junior
doctors who spent at least two months in a palliative care unit in a tertiary hospital
or an inpatient hospice.
Results
Junior doctors caring for dying patients in a palliative care rotation faced internal
conflicts. Conflicting feelings arose because of differing expectations from their
preconceived notions of their roles as doctors. Two main themes of internal struggles
were professional distancing and emotional detachment as well as prognostic uncertainty
and when to withhold and withdraw medical treatments. Coping strategies that helped
included mentoring and role modeling provided by palliative care physicians, reframing
their care experiences and reflection to find meaning in their work.
Conclusion
A palliative care rotation exposes junior doctors to emotionally overwhelming experiences.
With proper guidance, this exposure is useful in teaching junior doctors important
coping strategies, allowing learning to occur at a deeper level.
Key Words
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Article info
Publication history
Published online: April 07, 2020
Accepted:
March 27,
2020
Identification
Copyright
© 2020 Published by Elsevier Inc. on behalf of American Academy of Hospice and Palliative Medicine.
