Programs help those who live to help others

Interactive courses offer psychological support for medical professionals, as Zhou Wenting reports from Shanghai.

Xu Jiansheng, a psychological counselor, posed a question to a group of doctors and nurses during a lecture at a hospital in Shanghai.

"Imagine that you are in an elevator with an elderly man who is smoking. What would you say to try to make him stop? Please think of two versions typical of both high and low EQ (emotional quotient)."

First, the medical workers proposed a high EQ version: "You are so healthy in your twilight years. I believe that you would be even healthier, if you smoked less."

That was followed by a low EQ response: "Just because you don't mind dying prematurely, it doesn't mean you should also affect us," which prompted a wave of laughter.

The lectures, which feature simulated scenarios about everyday work and life, have been held at the Shanghai Sixth People's Hospital East Area for about four years.

They are part of an employee assistance program provided by professional psychological counselors to counter the rising pressure of work, boost efficiency and foster a deeper sense of career satisfaction.

The topics discussed include stress and the management of emotions, the identification of and responses to common psychological problems, doctor-patient communications, energy management and parent-child relationships.

"The professional image of doctors and nurses is that they are always devoted to other people, but they also need help sometimes. From a psychological point of view, we aim to help medical staff establish better doctor-patient relations and reduce the incidence of tension and conflict," said Lin Zi, vice-chair of the Shanghai Psychological Counseling Association, who founded the psychological consultancy that employs Xu.

A similar program has been in place at Fudan University's Huashan Hospital for six years. Established with the help of the workers' union, the program provides psychological counseling and helps members of the medical team to become more socially adaptable as a means of improving communications with patients.
 

Scenarios

Su Jiachun, who leads the program, said it is conducted using regular interactive scenarios developed in accordance with the theories and practical application of psychological counseling, and at least 39 hospitals across the country have similar initiatives.

"They include major hospitals in provinces such as Guangdong, Shandong and Jiangxi, along with smaller clinics such as community health centers in counties," he said, adding that last year Huashan Hospital founded an association for participating establishments to facilitate the regular exchange of experience and information.

"We believe the association will conduct pioneering work that will establish better ways of providing professional assistance for career-related issues that trouble China's medical workers."

Luo Hong, the hospital's director, said, "I believe the program will eventually raise the overall performance of China's hospitals and give doctors and nurses a stronger sense of satisfaction at work."

Positive communication

The lecture given by Xu focused on skills characteristic of high EQ dialogue, which is particularly important to ensuring respectful and effective communications between doctors, the patients and their families.

"Doctors are usually faced with people in poor physical condition or those who have just received bad news about their health, so positive communication can help reduce the pressures and make everyday work more pleasant," he said.

According to Xu, high EQ communication is characteristically friendly and considerate, while low EQ dialogue suggests a superior standpoint and sounds as though the speaker is giving the recipient a lesson or negating their feelings. Low EQ responses make people less willing to listen and can provoke confrontational attitudes and hostile responses.
 

Yang Lina, head nurse in the ear, nose and throat department at the Shanghai Sixth People's Hospital East Area, has found the lectures helpful because her work often involves resolving conflicts and misunderstandings between medical staff and patients.

"I cannot afford to oppose patients if they come to complain. My efforts to avoid emotional confrontation help to solve problems more peacefully," the 35-year-old said, adding that misunderstandings usually occur because the medical staff and patients are talking at cross purposes.

"Medical workers stick to the language of the scientific world to reduce emotional subjectivity in each patient's case, but the patients are only used to the language used in daily life. We always encourage our staff members to show more empathy and use language the patients will understand," she said.

Su, from Huashan Hospital, said most patients are not aware that before they announce the results of a health check or discuss treatment plans, the doctors decide what they will say, either to avoid misunderstandings or to soften bad news.

"They consider a range of factors, including the patient's educational background, family situation and financial status, when deciding how to convey a message and promote warmer feelings," he said.

Ye Mao, deputy Party secretary and chairman of the trade union at the Shanghai Sixth People's Hospital East Area, has noticed a number of changes in recent years. He said staff members have developed an understanding and trust of the program, and know they can find a source of support when they are faced with personal problems or work pressures.

"Moreover, in each department at least one team member acts as a 'love ambassador'. They are equipped with the basic knowledge to help colleagues who are experiencing problems, and to identify those with potential psychological difficulties," he said.
 

"The proportion was higher among males and the most highly educated employees," she said.

According to Lin, of the psychological counseling association, people with strong sense of responsibility who are committed to the highest working standards are unusually prone to depression and they very often display strong emotional responses to the condition.

Moreover, the pressure on medical professionals is enormous because of their heavy workloads and the uncertainty of medical treatment, she added.

"Patients and their families have a common misunderstanding that they will be 100 percent cured if they go to the hospital, which puts huge pressure on doctors," she said.

"Those who work in the ICU or emergency clinics, where patient deaths are more common, suffer frustration more easily and may begin to doubt the value of their work. If they have to shoulder criticism from patients' families at tense times, they may become confused about their professional identities."

Su said his hospital's employee assistance program began by providing services to nurses, many of whom see their jobs as less valuable than those of doctors and therefore experience burnout more easily.

"In addition, women usually experience more emotional ups and downs, and they shoulder more household duties, so the pressures they feel are equal to those felt by men," he said.

Initially, the program featured regular lectures delivered by university professors and psychological consultants, but now it includes a range of measures.

One strategy involves discussions of fears and anxieties in groups of no more than 10 participants, according to Su, who said common themes are misunderstandings or verbal abuse by patients and the lasting impact they can have.

"Before, staff members could only speak with relatives or close friends when such incidents occurred, but now they have an official platform to provide support. This helps them to open their hearts and discuss the problems with their peers in the working environment," Su said.