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:
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?
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.
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.
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.
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.
Better organization, preparation and pro-active thinking would have prevented most of them:
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..
A couple of weeks ago I was on call in the ICU and I was called by a 2nd year resident. “Mr. Miller isn’t well and has desaturated repeatedly.”
How was I supposed to reply?
“Thank you for the information, good night.”
Obviously, the way this piece information was presented neither helped me, the patient or the poor guy on the other side of the phone.
When you wake up your boss during the middle of the night, you should be a little more prepared than someone, who calls 911.
So what can you do to make your boss happy at 3 AM in the morning. Let’s try these six steps:
In medicine skills are almost like a status symbol. Whether your colleagues will speak highly of you greatly depends on whether you are able to perform angiograms, ultrasound or other procedures.
But there is one skill that you don’t get much credit for, even though it is indispensable:
Ask ten fourth-year-students, what they rather want: a lesson of lung auscultation or to visit the cath lab? More than likely nine of them will choose the cath lab.
Let’s say you have a patient with dyspnea, who is admitted to the ICU. Many times before a thorough physical exam unexperienced doctors will suggest