Immediate and delayed emotional impact
| Theme | Illustrative quote |
|---|---|
| Distraction and reflection | Certainly I think there’s a big temptation to distract yourself with something unrelated … to watch TV or a movie or play video games. It can help for a time. But I think that if you’re using it to avoid emotions that you haven’t fully explored yet, that’s probably not the best thing. But if it’s something that’s just too painful for you to think about and you need something to take your mind off it, then I think that’s a perfectly reasonable coping strategy. (P6) Journalling helps because it gives me a structured way to reflect on things. Once I put [my thoughts] in writing, [it solidifies] this is actually how I was feeling at that time. (P8) |
| Rumination and hypervigilance | [After the patient died], there was something at the back of my mind, but I still did everything normally. When I went home, though, is when it started to really hit me. I was telling my family [about it], and then I broke down on the phone. (P10) [The death] played on my mind, feelings of guilt … what could I have done differently? What happened? It was a hard situation that was playing in the back of my mind and definitely made me more anxious on my next few calls. (P12) |
| Depersonalization, loss of empathy and avoidance | I don’t feel as affected as much anymore. I don’t think I’ve cried since [that patient death]. It’s an unconscious detachment … I don’t let myself go into that mental space where I think about the family members and what they’re feeling. I do feel bad about it. There’s an element of guilt. But then I rationalize to myself that this is a defensive mechanism. (P1) I think [the patient’s death] impacted the direction that I want my career to take … I think it’s impacted my interest, where I now have no interest in [obstetrics]. (P16) |