Mark Rickenbach looks at how doctors can take ownership of their feelings of “heartsink” to improve care Do you recognise that heavy sensation of feeling weighed down when you can’t see the way forward in a consultation with a patient? If the situation happens repeatedly, the feeling can become anticipatory and associated with just thinking about the scenario. Described as “heartsink” by O’Dowd in 19881 after Ellis outlined it in 1986,2 this experience became widely known by the term “heartsink patient.” This phrase is a misnomer and has rightly had pushback. Labelling a patient with a negative term can be picked up by the patient and see doctor-patient interactions stall, leaving consultations stuck in an unhelpful loop. Furthermore, although the feeling may be associated with a particular patient presentation, the patient does not own it, their doctor does.3 It’s key for doctors to recognise their agency during these “heartsink” moments and that there are steps they can take to overcome the feeling. The heartsink feeling is important to tackle as it can harm both the clinician and the patient. It contributes to stress, tiredness, frustration, anger, and burnout in the clinician.4 The clinician can become defensive and adopt social limiting …

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重新定义“心沉”的感觉可以帮助医生找到解决方案


马克·里肯巴赫 (Mark Rickenbach) 着眼于医生如何掌控自己的“心沉”感，以改善护理质量 您是否认识到在与患者会诊时看不到前进方向时那种沉重的负担感？如果这种情况反复发生，这种感觉就会变得具有预期性，并且与仅仅思考该场景有关。在埃利斯于 1986 年概述之后，奥多德于 19881 年将其描述为“心沉”2，这种经历以“心沉病人”一词而广为人知。这句话用词不当，理所当然地遭到了抵制。给患者贴上负面标签可能会被患者发现，导致医患互动陷入停滞，导致咨询陷入无益的循环。此外，虽然这种感觉可能与特定的患者表现有关，但患者并不拥有这种感觉，而是医生拥有。3 对于医生来说，在这些“心灰意冷”的时刻认识到自己的作用是关键，并且他们可以采取一些措施来克服这种感觉感觉。处理心沉的感觉很重要，因为它会伤害临床医生和患者。它会导致临床医生感到压力、疲劳、沮丧、愤怒和倦怠。4临床医生可能会变得防御性并采取社交限制……