During a recent night shift I was called to a patient who obviously was acutely ill. She had been transferred from the ICU to the ward today. Further workup showed she didn’t have urinary tract infection (UTI) as suspected, but: necrotizing fasciitis.
Every time you end your shift, you’ll be criticised. Your colleagues and bosses try to understand why you did what you did.
That’s why they will question why you
That’s OK: Three doctors, four opinions. However, many doctors take that form of criticism personal and react defensive. Here are my four steps to handling criticism, so you profit from it:
When you start off as a doctor you depend on the nurses. Oh man, some of them saved my butt several times, I can tell you. There were times when they suggested adequate therapies when I had no clue what to do next. It depends almost entirely on you, whether they help you out or make your life a living hell.
Here is what I learned during my first years in residency. More.
“Do you have any more questions..?” Every good doctor patient conversation ends with this question. But what if you don’t have an answer yet? At the beginning of my career I found myself rushing out the patient’s room because I didn’t want to answer any more questions.
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Last week I received this voicemail from the principal’s secretary of my son’s elementary school: “Hello, this is the elementary school. Your son Jonas … [ten second pause] … unfortunately …[ten second pause] has on his head [twenty second pause] a little bruise after colliding with a classmate playing soccer….”
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If you want your patient to follow your medical advice, you need her to feel respected by you. There are easy-to implement things we can do reach that goal.
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Question: What gives you the feeling to not be respected by a doctor? Leave a comment below!
When I implant a central venous catheter, the patient’s face is covered with drapings. Many patients who are conscious during this kind of intervention are very nervous. I can only imagine that it’s not much fun to have your face underneath a blanket, it’s 40°C, dark and you are waiting for some guy to put a needle in your neck. There are definitely things more fun to do, I imagine.
Since I started studying medicine I got to know numerous different work environments. I counted up to twenty different internships, hospitations and rotations, most of them lasting only a couple of weeks. They enable you to get to know different fields but also require you to integrate you fast, if you want to be taught something. If you want to learn something during your internship, you need a plan:
During my first clinical clerkship on a nephrology ward, we went on rounds and the chief resident attempted to explain to a patient why her kidneys didn’t work: “…your disease is of inflammatory origin.”
I thought: “What? Inflammatory…as opposed to…? I have no clue what he just said! OK I’m still a beginner. I have only studied two years of medicine, but odds are.. that’s more than the patient studied!”
Six years or more we spent to learn how to use the medical language. And it is important to use it when talking to colleagues to minimize risk of misunderstanding.
But to make sure that we are also understood by the patients, we have to learn a different skill: we have to switch from medical to nonmedical tongue.
So, how can we make sure, the patient understands us?
In the beginning of my career I thought I had more than enough to do with handling ONE patient. Having relatives around seemed to me like having additional “opponents”. They appeared like someone who has additional demands and wishes. Turns out I was wrong. The truth is that the patient’s relatives are our allies.
