In honor of the first EM walkabout, I thought it was only fitting to start with an inspired article from the BroomeDocs. Some of the greatest “thank-you” moments I have had exploring online EM education comes from people sharing bits about how they practice the daily art of caring for patients. Maybe it’s a validation of something you have done unconsciously for years, but never had it pointed out to you, maybe it is the relief of knowing others struggle with the same issues, maybe it is a moment of clarity on a topic that never quite solidified until now.
Whatever its origin, the momentary sense of community, clarity, and gratefulness is without equal in education. I happened to have one of those moments with this post by Casey Parker. Consult Skills 2: When Agendas Collide or “Physician Know Thyself”. This post on dealing with the patient who may have a radically different agenda than yours got me thinking about how I interact and share with patients, and how the subtle tone of that has changed over the years for the better, making the number of good days in the ED far outweigh the bad ones for me.
Surviving a 12 hour shift in the ED is all about charting your course for smooth sailing. From the moment you start taking sign-out, to the last patient you see 15 minutes before your shift ends, I have learned the hard way that confrontation sets you up for failure. Now I’m not saying you don’t drop the hammer when you need to, or stand your ground when you feel it is in the best interest of patient care, but if you do it the wrong way, even if you win you lose.
Whether you walk out of your shift emotionally drained looking for a quiet place to curl up in a fetal position, or come home happy and sane with the energy to go for a run with your dog all depends upon the subtle ways you learn to interact with your patients, colleagues, consults, lab techs, and everyone else essential to your daily practice. So this EM walkabout will be dedicated to all those moments when I learned something about how to find smooth sailing during my shifts in the ED. Thanks Dr Casey Parker for giving us a great starting point.