Who are we? Our professional ideals, termed Professional Identity, is a complex construct. Ideally, to name a few qualities, in the situation presented in our January 7 post, informing our patient and her family of her Stage IV malignancy, we are kind and supportive, our language is skilled, clear. When our friendly colleague enters and interrupts, ideally, we communicate with her in a way that shows we are committed and caring in all of our roles. We want to gain control to support our patient simultaneously being kind, skilled, and clear with our colleague.
Skilled communication is not genetic. We learn it over time, often without instruction or coaching except for those lessons our parents taught us years ago.
In medicine, we have a compelling origin: at our core, in deciding to go into medicine, we wanted our lives to stand for something good; we wanted to do positive, productive, constructive work for others. When we sift through the complexities of today’s healthcare environment, this core is our evergreen. We do not want to shed it no matter what urgency or emergency confronts us.
Any new situation gives rise to dual responses to varying degrees: emotional and cognitive. Our goal in the myriad contacts - relationships - we have each day in healthcare is for our cognitive response to determine our reactions, not our emotional response. The clearest example is the code. We expect ourselves to be in control and thinking, not emoting, because we know the lives depend on it. Likewise, how we relate to others sets the stage for their cognitive/emotional response in future happy, irritating, or emergent situations.
Gaining skill and control and staying kind and supportive requires deliberate practice of reflection. I won’t go further this week because this is a moment when some of us say, “Oh, this is touchy-feely.” It is not. It is our emotional responses - not well thought out - not in tune with our professional ideals - that are touchy-feely and get us in trouble. Our cognitive responses, aligned with our professional ideals, are what allow us the continual improvement in skill that we seek in all areas of practice.
I will stop right there this week. Please: Can you accept my earlier premise that our work is done in the context of myriad brief or deep, single or longitudinal relationships? Does it ring true to you that we often wish we knew the perfect response in the moment? Does Cognitive Load Theory make sense to you? If you accept these premises, let’s move forward together next week to consider deliberate practice of reflection. Following that, we will flesh out the concept of professional identity, then problem-solve our response to this or any Wait…What??!! or Slowing down moments.