Posted on

Why you need a “stop-doing-list”! And 5 things to write on it.

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!
But rarely does this lead to improvement of my work, because as it turns out:  Time is limited. The day only lasts 24 hours. and cramming too much in these 24 hours only leads t overwhelm.

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):

When I started my career,  urgent matters constantly kept coming up, most of them caused by my lack of organization. All of these things were urgent and showed up as emergencies.

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.

Question: What habit goes on your Stop-Doing-List? Leave a comment below!
Posted on

Four Easy Ways To Connect With Your patient. 

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.
Posted on

How To Deal With Three Critically Ill Patients At The Same Time

Everybody has had these shifts: in the ER, the ICU or on the ward: the phone won’t stop ringing, several red alarms at the same time and everybody calls your name and is mad, that you won’t show up.

Here is my eleven-step-strategy to stay on top of things – even when times get rough.

Posted on

Sleepless On Call – 5 Things To Do Before You Wake Up Your Boss

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.”

“I’ll take care of the problem, why don’t YOU go to bed.”

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:

Posted on

Why Physical Examination Is More Important Than Ever. 

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.

Photo courtesy of IStockphoto.com

But there is one skill that you don’t get much credit for, even though it is indispensable:

Physical Examination.

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

  • a CT scan to exclude pulmonary embolism or even
  • intubation.
Posted on

5 Reasons I Expect Medical Conferences Will Become Obsolete In Ten Years – If They Don’t Change

I just got back from a medical conference -THE- nephrology conference in the world: the ASN renal week. When I left San Diego, I left with mixed feelings.

On the one hand I was glad I went, because I got to present our data. On the other hand I was really disappointed of many sessions, many of them were a complete waste of time.

In my opinion medical conferences could soon be obsolete. And here is why.

Posted on

6 Keys To Getting The Most Out Of Your Next Medical Conference

Every other year, depending on my scientific efforts, I get to go to a conference abroad. Going to a conference is kinda like going to Disneyland: Countless things to do, but only very little time.

The opportunities there are overwhelming. There are

  • numerous great presentations
  • interesting topics
  • amazing researchers
  • great speakers you can get to know.Time is very sparse and it’s easy to lose focus. Many times I felt depressed because I felt I missed out on  so many great things. To avoid this feeling, here are my 6 steps to getting the most out of your next conference.
Posted on

Three Questions I Ask Every Intern

(Before I Let Them Touch A Patient...)

On the ICU we get many interns and it is our responsibility to make sure they learn as much as possible. Before I let them see patients on their own or do any procedures I want to get to know them and get an impression on where they are in their career.

That’s why I ask a series of at least three questions: 

Posted on

Do we really need more doctors?

Ask ten people in the hospital how to improve patient care and nine people will more than likely tell you: more staff, more nurses and definitely: more doctors.

I’m not sure whether this is true.
Posted on

4 Thoughts On Why I Document My Patient’s Favorite Soccer Club

The nurses made fun of me the other day because I wrote down my patient’s favorite soccer club in the chart. “Patient is a fan of Fenerbahce Istanbul, while his best friend cheers for Galatasaray“ I filled in social history part of the digital chart.

I didn’t have a deeper intention when I did, but I noted I had conversations with four different nurses on the patient’s background, his interests and his life.

1. He cared, so I cared.

The first question the patient asked me,  (after admission to the ICU!) was whether I could look up the latest soccer results of the turkish soccer league.  It seemed to matter to him and played a more important role than the job he had for many years.

2. A deeper connection.

It aroused the attention of the nurses in the patient (and mine to).  If that’s what it takes to get myself and the nurses interested in a patient and thus make a personal and maybe even an emotional  connection with the patient possible: I’m in.

3. A goal to work towards.

Let’s say the nurses and doctors know more about the patient. Let’s say the patient has a cat, he walks once a day, or he has a rose garden he needs to take care of: Now the doctors and  nurses have a more concrete goal to work towards. The goal changed from „Let’s make him healthy again“. Instead it is: “Let’s do everything, so he can take care of his rose garden.”

4. The patient will like you more.

Sympathy is the foundation of trust. Patients, who like their doctors will trust them more and adhere to treatment plans more.

And by the way, he will find you way more interesting, too.

From now on I’m going to ask for the patient’s hobbies, their favorite TV show and the name of their hamster and document it. Let the show begin and stay tuned for some fun stuff.

Nurses and doctors, who connect on some other level with their patients for the least have more fun at work. Probably they make a better performance, too. (No statistic available, sorry)