Maintaining the excitement in emergency medicine

These notes are taken from a 45 minute lecture by Greg Henry, originally presented at ICEM2012, and available for viewing at Free Emergency Medicine Talks (wonderful resource!). Without any further ado, here are some of the quotes that I wanted to keep:

Patients don’t come to us for judgement. They come to us for care.

You have intrinsically interesting work!

Quality is what you sense when your patient walks out the door. ‘Did I actually make a connection that made somebody better?’

We get to the point where we can perform a mechanical act without involvement of ourselves.  We sometimes forget we do them to a human being.

The people we are least kind to in our lives are our families and each other.

We have to deal with the world not the way we would like it, but the way the world is. Beaten children, battered wives. And that affects you. We see a lot of innocent suffering. And we tend to be, again, mechanical.

Sometimes we have to separate out our job, our goal, from our knowledge base. What I do is apply a small amount of knowledge (some may think it’s desperately small) to basic human problems.

(We need) a fundamental shift from “detective” to guide, advisor, comforter.

Sometimes the way we train does not turn out the best, most caring, the most compassionate physicians. Why? Because we don’t know how to be nice to each other.  Suggestions: give 10x as many compliments as criticisms; give good news in public, criticism in private; thank people for giving great care to patients.

Burnout comes not from the work or the patients, but from unmet expectations because we don’t know what expectations to set.

Things to try:
+ call patients back (feedback, learning, continuity)
+ abandon intern mentality (“I’m just working here”)
+ thank people and be grateful (this is still the best job in the world)
+ nothing replaces caring
+ treat everyone as a volunteer
+ every moment is magic
+ shorten shifts, lighten the load
+ teach something, anything.
+ be the role model, not the critic
+ be the doctor/nurse you’d want your family to be seen by
+ limit your information sources (all change is not progress)
+ vary the experience (community work), be honest about what you really like, plan a maturing career
+ set new markers for success
+ treat pain

Recommended reading: “London” by Blake, “Bleak House” by Dickens.

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About tamarahills

ED nurse working on the beautiful Sunshine Coast, Australia.
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