[Magdalen] Prayers - breakthrough in work conflict

[Sally Davies]

Dear list friends

When I think that this time last year, I was swinging in the Golden Hammock
with a possible cancer diagnosis hanging over our family, I realise how
petty today's problems seem to be.

And yet I'm feeling hugely stressed by something that's blown up at
work...the nub of it is that one of my close (much younger) colleagues is
married to another psychologist who is trying, recently, to build a
practice in the hospital where I work as a rehab psychologist in tandem
with an OT from the same outfit, and in association with other therapists
who work in the acute hospital.

I've said many times that they should use psychological services better in
the Acute hospital, and not only when a patient stops eating and wants to
die. But it can and does cause complications with rehab patients, because
an individual therapist working "in a bubble" tends to see things rather
differently to those of us who are part of an interdisciplinary team.

So we were asked by the doctor to assess and commence the transfer process
for a patient my colleague's husband was already seeing as a psychologist;
he'd been called in by the staff in the ICU because of the extreme trauma
she'd experienced, and had seen her a couple of times.

I expected my involvement to be no more than a basic assessment and a
couple of check ins to help with our case management.  I gave him feedback
from the assessment and had the impression that he wasn't too pleased to
hear from me...so should have taken warning from that in hindsight...but
I've worked with him before, he'd been a locum for us, and I thought he
understood our position. Perhaps he did, but I certainly didn't understand
his, until it was too late...

The following week I looked in (to see how the weekend had gone and results
of the scans etc, only to find the patient angry, in pain, and distressed,
saying that she had not seen the other therapist in the past week except
once when he'd come in, found the nurses busy with dressings, and said he'd
come back but failed to do so. And she said she wanted to confront him.
That was really difficult for me. I spent a bit of time listening to this
as helpfully as I could, reassured her as best I could, and later that
afternoon I called him to say that the patient needed to see him and was
upset. He was sick (and sounding dreadful), which made me feel even more
uncomfortable with the situation.

The next day I saw him in passing in the hospital and he mentioned he'd
seen the patient but they clearly hadn't had The Talk she had in mind, so I
thought perhaps they'd sorted it out, at that point she had her own room so
there was a least a bit of privacy. She then went for her surgery and was
taken to the ICU. The next day, he went to see her there and she let him
have it - but didn't, as far as I know, tell him why she felt so let down,
just that she doesn't want to see him anymore.

Well, he was furious and yelled at me on the phone for about 20 minutes,
accusing me of taking over his patient and generally venting his feelings.
He wouldn't let me say anything in response and maybe that's just as well.

 He has also now complained to my immediate boss and even to the manager of
the hospital for which I work, which is not the one I actually work IN.
The psychologists at the rehab hospital will also have to get involved and
my boss (an OT) has spoken to them (I haven't, yet, and am dreading that,
though apparently the senior psychologist doesn't think I didn't anything
wrong).

I'm so stressed by this. It is very possible that I HAVE done something
wrong in terms of the somewhat Byzantine ethical rules that govern our
professional work; but I cannot think how I might have done differently,
without either letting the patient down myself, or looking as though I were
deliberately trying to get my colleague's husband into trouble (for
instance, if I'd not listened to the patient but had gone straight to the
ward sister to intervene and sort it out).

And I am certain that if he HAD showed up to see her more/sooner, and had
spoken about what she wanted to speak about, things would have gone to
plan. It's not just the patient's word on that, her mother (who's been with
her all along) also had the same experience and the same complaint. And
she's not ill, medicated or in any way compromised in her testimony.

My boss is supporting me, which only serves to make the guy more angry and
I'm sure he plans to report me to the professional board. That's bad
enough, as I haven't sorted out any insurance and probably won't be able to
if there's a complaint pending...but what worries me just as much, is that
I can't see a way to maintain a cordial, co-operative relationship with my
colleague whilst at the same time having this nightmare unresolved. And I
can't see a way to resolve it because I don't know what the heck he wants -
me to be sacked perhaps? Sanctioned by the Health Professions Council?
Resign? Make a formal apology (Hell no, I'd have to be crazy to do THAT no
matter how badly I feel).

 If he makes further complaint, that will be a huge pain for me as these
things are laborious and expensive...and not just for me, he could get into
far worse trouble if the patient or patient's mom specifies her complaints
in the same way she did with me.  But he won't listen, either to me or my
boss, and therefore doesn't seem to realise this. In his mind, the only
problem is me, and it's likely my colleague thinks the same. She adores her
husband and thinks he's the fount of all wisdom. If he ends up in trouble
or just looking foolish, I don't think she'll get over it any time soon.

But I can't put that in front of the patient's needs, and I can't assume
that her best interests are other than what she's clearly expressing them
to be. Even though I know this is exactly what mental health professionals
often do...

After I spent most of last night sleepless and most of today fretting on
and off about this mess, Keith said "Why don't you ask Magdalene to pray? -
and I realised that he was right.

Sorry for the ramble...tired and emotional as they say. But i would
appreciate prayers for everyone involved - for me, for my colleague and her
husband, for his practice to find a better way to thrive, and of course for
the patient who has spent three weeks in the seventh circle of Hell,
compared to which all of this pales into insignificance.

Sally D