Rotated into my ED job 3 weeks ago (in the UK you spend your 1st 2 years out of med school as a foundation doctor rotating through jobs every 4 months before entering a specific specialty training programme once you've had a taste of various specialities.) I absolutely love it, enjoying it more than any job i've worked so far despite the shift patterns being dreadful.
The sheer number of OD/alcohol excess cases is mind blowing. A large majority accept the help offered and will talk to mental health/alcohol liaison services after sobering up in our short stay unit. However, there are a select few who completely stone wall you. Refuse any bloods, refuse to give you a history, refuse everything basically. They just sit there on the trolley and usually (if they have capacity) self discharge after a while. I find myself getting frustrated as I find myself both wanting to help them and telling them to get out of the department! Very quickly learning how important a good poker face it. Internally I am screaming and I really have to bite my tongue to stop myself saying anything unprofessional.
My question is; how do you keep up a professional demeanour with these patients whilst encouraging them to accept help and/or leave? I know it's early days for me but any tips would be great.
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