The impact of protective isolation in a hematology unit on staff, patients, and their families

Abstract

In order to study the psychological consequences of isolation measures, we decided to take the example of protective isolation in hematology. Most patients there had arrived as emergency cases. They were still shocked, stunned by the announcement of double jeopardy: a cancerous pathology with a high risk of death and a 5-week isolation period. In addition to carrying out technical monitoring, the medical staff exhibits a high level of personal commitment on a daily basis. The support they provide is very intense, commensurate with the need to pick up any signs of somatic or psychological decompensation. In such a regressive context, there is a necessary lack of differentiation between patients and healthcare staff. The intensity of the care given in the hospital contrasts starkly with the total lack of human support at the point of discharge. Two case studies illustrate how the nature of the relationship between patient and family may be changed by hospitalization. Relatives must be able not only to take a back seat during hospitalization, but also to reassert themselves when their loved one is discharged or, more tragically, reaches the end of life. Unconscious aspects of the familial relationships and of the individual's reactions potentiated by this ordeal are described and analyzed.