Advocacy Does Not Stop When You Are Exhausted. That Is When It Matters Most.

A few weeks ago I was screamed at by a client's daughter.

I know what you are probably thinking. Healthcare workers get yelled at all the time. It comes with the territory. And honestly most of the time I am pretty good at de-escalation. When a family member or a patient gets angry or upset I can usually find my way through it. But this particular day I was emotionally burnt out in a way that had nothing to do with her. The hour before, I had been yelled at by another family member. My role involves incredibly complex situations and discharge planning and that week had been long in every sense of the word.

She screamed at me and hung up the phone.

I sat there for a few minutes. I breathed. I centered myself. And then I thought about calling her back and everything in me did not want to. I did not want to de-escalate another angry family member. I was exhausted. I just wanted to go home. I did not have anything left.

But I called her back anyway.

Her voice was still elevated when she answered. And instead of explaining myself or defending the situation or running through the clinical details, I asked her one question.

What are you concerned about?

I could hear something shift on the other end of the phone even though I could not see her face. That one question was what she needed. Not a policy explanation. Not a rundown of the system. Just someone asking her what she was actually afraid of.

We were on the phone for 45 minutes. I walked her through everything. The barriers, the concerns, the next steps. I went over Medicare with her. I talked her through ways she could better advocate for her loved one going forward. I answered every single question she had, even the ones that had nothing to do with why she originally called, because they mattered to her and that meant they mattered.

At the end of the call she apologized. I almost told her what I always tell families, that she never had to apologize for advocating. But I stopped myself because I understood that this was not an apology for advocacy. It was an apology for the anger that had been redirected at me. And she needed to give it. So I accepted it. Because meeting someone where they are sometimes means letting them do the thing that helps them move forward, even when you are not required to receive it.

Here is the thing I keep coming back to though. I have ADHD and I am constantly running to the next thing. The next task, the next call, the next hour, the next five minutes. That is just how my brain works. And in healthcare that tendency gets amplified because there is always something else urgent waiting. It becomes very easy to move from one family to the next without stopping to really land in any of them.

That call was a reality check.

Because to me, in that moment, it was just another day. Another complex situation in a long week of complex situations. But to her it was her loved one. It was not just another call. It was the most important call she had made all week, maybe all month. And the gap between those two realities is where families get lost. It is where they feel unseen and unheard and like they are bothering someone who has more important things to do.

They are not bothering us. Their fear is not an inconvenience. Their anger is almost never really about us.

As healthcare workers we become so accustomed to the intensity of this work that we can start to move through it on autopilot. We learn to manage angry family members instead of actually hearing them. We get through the call instead of being present for it. And I understand why. I lived that day. I know what it feels like to have nothing left and still have three more calls on the list.

But I also know what happened when I called her back. I know what one question did for a woman who was terrified about someone she loved and had nowhere to put it.

What are you concerned about.

It costs nothing to ask. And it changes everything when you do.