Your role is to advocate and support the patient. If you are feeling pressure from their family members imagine what the patient is feeling as well. 1. Look for the positive in what the family members are doing or saying and find a way to pivot that to putting the control back in the patient’s hands. “I imagine you just want the best for Silvia and it is probably very frustrating to feel there is nothing you can do. Your support here in silently letting Silvia have her voice to share what she wants is a great way to support her. So Silvia, let’s talk about…” 2. Look for the environment that is best for the patient and gently point out how their intent is not aligning with that.

It's a Herculean task juggling between what's best for the patient, what the patient wants and what the family wants. Its one of those scenarios where we physicians MUST strike a balance between the first two and try to accommodate the family as much as possible. One lovely practice that has turned out to be highly effective is requesting them to please be patient and have a sit-down meeting away from the patient where we explain the situation clearly. Usually the few moments it takes to go sit down and get comfortable diffuses a lot of tension as moments pass and they are able to articulate their concerns better and we are able to address them better. The act of coming together for patients benefit has been immensely helpful!

As a psychologist, I have observed that challenging behavior from family members often stems from fear or anxiety; hence, this requires a delicate balance of empathy and professionalism. I would validate their emotional experience, de-escalate tensions and redirect the focus towards the patient's well-being and fostering a collaborative approach to care. Secondly, in terms of navigating my own emotional responses, I recommend utilizing the inside out approach that I introduce in my book ‘Connect to Thrive’. This approach to emotional regulation allows me to navigate difficult situations with resilience, ensuring that I remain a supportive and effective advocate for both the patient and their family, even amidst intense emotional landscapes

Au quotidien, nous vivons des situations difficiles. Je dirais également qu'il faut passer la main quand on se sent dépassé. La deuxième chose c'est également d'en parler avec un acteur neutre qui peut nous aider à prendre du recul. Dans des moments difficiles et délicats il m'arrive de sortir la famille pour me concentrer sur la prise en charge du patient.

Remember the equation: E (the event) + R (your response) = O (the outcome) You have zero control over the event (the challenging family member/how they handle updates etc. etc.) BUT you have complete control over your response, and whatever your response is will dictate the outcome

En Pediatría es muy habitual encontrar situaciones "tensas" con los familiares de nuestros pequeños pacientes, muchas veces, desproporcionadas con respecto a la gravedad clínica de la patología que padecen. No hay una fórmula mágica para enfrentarse a ellas, pero lo que suele funcionar es simplemente, ser humano: Validar su sentimiento por desproporcionado que nos parezca "entiendo tu preocupación porque impresiona mucho ver a un hijo con fiebre" y a continuación explicar los motivos por las que como profesional, no ves motivo de gravedad, dar herramientas para enfrentarse al reto de asumir la enfermedad de su hijo y por último, asegurarnos que nos han entendido y disponibilizarnos para atenderles nuevamente si así lo consideran.