January 2017 VOL 8, NO 1

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AONN+ Annual Meeting

Don’t Take the Bait: Emotionally Charged Situations at Work

Dealing with emotionally charged patients and peers can be taxing for all parties involved, particularly in the oncology setting, but effective communication can alleviate stress at work and improve patient and provider satisfaction. At the Academy of Oncology Nurse & Patient Navigators 7th Annual Navigation & Survivorship Conference, Helen Meldrum, EdD, MEd, engaged the audience with tips and tools for dealing with emotionally charged situations at work.

“It’s always something or someone,” said Dr Meldrum, Associate Professor of Psychology at Bentley University in Waltham, MA. “But whether you feel hooked and drawn in by a patient or by a peer encounter, knowing what hooks grab you can help you to avoid taking the bait.”

She said the events that trigger people at work tend to eventually wear them down and lead to burnout, and these triggers are as likely to come from peers as they are to come from patients. But when communication skills are improved, disagreements can be diffused well and early on, before they escalate into petty bickering or heated arguments. “High stress is a sign you’ve taken the bait a few too many times, and playing into it only makes you more stressed,” she said, and research shows that promotions in the healthcare setting occur more frequently for employees known for diffusing “difficult” people in the workplace.

High emotions and tension in the oncology setting only add to workplace conflict. “As oncology providers we often feel uncomfortable, on edge, and embarrassed, and without interpersonal skills it translates to cold, insensitive, and brutal,” she said. “A lot of it has to do with what hangs in the backdrop.”

Why Do People Become Emotionally Charged?

According to Dr Meldrum, when healthcare service providers are set for success, they keep their focus on the patient, maintain high energy and flexibility, and allow others to be right. When providers are floundering or failing, they’re headed toward burnout. They feel depressed or stuck at their job, exhibit a blasé attitude, demand attention, prefer predictable events, and always need others to know they’re right.

She cautioned that burnout can cause people to say all the wrong things and gave the audience tips on what not to say to an emotionally charged person. Waiting times tend to cause patients the most frustration in the healthcare setting, and when a patient is told, “I’m sorry I didn’t call you about this, I got stuck in a meeting,” what they hear is, “I’m sorry I didn’t call you about this, you’re not very important.” “If something goes wrong, patients want to hear that you’re not going to let it turn into a cascade,” she added.

In an emotionally charged setting, individuals feel 1 of 4 emotions: mad, sad, glad, or scared, she said, and recognizing where a person is coming from and practicing active listening can keep a disagreement from getting out of hand. “But in real life, we tend to judge, advise, quiz, and placate,” she warned.

She tells healthcare workers to use empathy-based diffusing by acknowledging what the other party is feeling in an attempt to reach a resolution, rather than judging, advising, quizzing, or placating them. She told the audience to remember CLEAR: Clearly describe, Listen, Express emotion, Assert, and Results expected, but to set reasonable limits and be assertive when necessary.

Conflict Escalation in the Workplace

“From a very young age we’re triggered by roles (‘you’re not the boss of me!’) and resources (‘she always gets everything she asks for, and I never get anything!’),” Dr Meldrum explained, and adults in the healthcare setting often find themselves arguing over these same triggers with patients and coworkers.

When a dispute escalates and the disagreement is internalized, each side attempts to fix the blame. Eventually, retaliation is sought, and the point of the original disagreement is lost as both parties fight to win. Coworkers often bicker to one another about these encounters, only adding to the tension in the workplace. “You think you’re helping yourself by getting it off your chest, but if you do it every day you wear out your soul,” said Dr Meldrum. “After that person is gone, try to ask yourself if you judged, advised, quizzed, or placated them, because we all play into these escalations.”

Finally, she urged the audience to think about their lasting legacy to their coworkers and patients. “A lot of your legacy will be influenced by interpersonal skills you can apply right in this moment,” she said.

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