On my first day in the OR during an internship in NY a physician’s assistant briefed me: “You know, the surgeon we are going to spend the next 6-7 hours with yells. A lot.
Keep in mind he is not yelling at you. He is just yelling…“ As it turned out he was right and the advice he gave me was valuable.
Basically, there are two strategies of spending your day on the ward:
- Go with the flow and look what’s coming up.
- I have a well-structured plan. When unexpected things come up, I modify my plan.
I am a big fan of strategy number 2. Over the years I have learned that structuring your day gives enormous value to the patient, the nurses and myself. With the right plan, you can get more things done and don’t have to put out fires all day long. Here is my plan:
In this post I would like to share with you how you can plan your day proactively and an ideal schedule of your own. I have created an excel template, that you can download for free here.
So here is how to create a schedule for yourself and the day on the ward.
Never has it been this easy to train your clinical skills on the subway, on the bus or on the toilet. All you need is a smartphone and this app.
How? Have a look at this Videoblogpost.
I don’t know about you, but I have a big problem listening to patients. I mean real listening.
Our daily workload increases all the time, our days become more and more procedure- and action-focused.
Over the years I’ve gotten more and more effective in getting things done. I am totally focused on my stuffed to-do-list and listening closely to a patient rarely is on it.
Rarely do I ask an open-ended question and just wait for the patient to talk for a little while. Usually I just ask for complaints, 1-2 minutes of closed-ended questions and I am off to the next task.
If you’re hoping this blogpost ends with the resume that doctors absolutely must have the apple watch or they can’t fulfill their obligations: I have to disappoint you.
I didn’t purchase the apple watch, my wife gave it to me as a gift when I finished my residency training. I was really thrilled even though I didn’t have clear expectations regarding the service this gadget would provide for me during the day-to-day work…
But there are a couple of features that are quite nice:
Since lack of time is a major concern in every hospital, I’m quite amazed how time is wasted during handovers. Anecdotes and stories not only distract us from the important facts but cause major delays.
I am not against a joke or story from time to time, I like a friendly atmosphere at work. But I prefer a focused, concentrated handover and a little bit of smalltalk afterwards, if time allows it.
Over the years I have come to learn that there are 4 main principles for a focused handover. Here they are:
On any ward I have worked there are constant interruptions by colleagues, students, nurses, relatives and patients. Almost all of their inquiries are legitimate and necessary but the sum of them will drive you crazy!
No moment during which your brain can rest. There is no chance to finish a thought. Not only introverts (like me) are worn down by this chronic noise and try to escape.
Whenever I want to improve the quality of my work, my first urge is doing more:
- Read more journals!
- Attend more conference!
- Write more case reports!
If you really want to improve in your field, you have to the opposite. Doing less is often more. So stop doing the wrong things, so you can focus on the important tasks.
You need a stop-doing-list: So what should be on it?
1. Stop regurgitating information.
Sometimes I have the feeling we are talking 80% of the time about what we are planning to do and why, instead of just doing it.
Does it really make sense to discuss a patient with the colleague from the previous shift, with your boss, another consulting doctor and the radiologist? Remember, nothing gets done by talking.
2. Stop talking:
Easy on the smalltalk: I know, I know, keep the atmosphere nice, having a chat with the patients and the nurses is important. But I only use it as a time-filler, when I have to spend time with the patient. (during procedures etc). But besides that, I focus on the job.
3. Stop over-documenting:
Document only relevant things. The little amount of time left over after talking about our patients and what we are going to do with them is easily consumed by our legal obligation to document.
This was well meant, but as Tucholsky said: well meant is the opposite of well-done. So keep it focused, short and simple.
4. Stop letting others interrupt you:
Easier said than done. Of course you have to answer the phone. But many times I’ll ask: „What’s up, this an emergency? I’m in the middle of something”
At least the caller gets to the point right away. Many times they don’t call me again. Also, keep your door closed. Leaving your door open is like begging to be interrupted.
5. Stop confusing „chaos” with pseudo-emergencies (which will again cause interruptions):
Better organization, preparation and pro-active thinking would have prevented most of them:
- Patient goes to angiogram and has no IV-Line.
- Patient about to get a pacemaker but written informed consent is missing.
By the way, I’m not opposed to working hard and much. We just have to spend our time with things that are useful and avoid ineffective working habits.
Having a good connection to your patient has a positive impact on your work in several different ways:
Connecting to a patient on a personal level helps you..
- to keep in mind that you are dealing with people, not with body parts or diagnoses.
- to remember other important information about him. (Your brain makes a connection)
- to have a lot more fun at work.