The Hospitalist Shift From Hell, and How to Fix It
Posted Feb 03 2009 12:08am
I came home from my last 12 hour hospitalist shift exhausted. My eyes were bleary eyed from staring at the EMR , and I was in the state of beatendownness where you have been totally crushed by admissions, cross cover, your coworkers, staff and patients. Owning a coffee shop was looking better and better, and hey, I love coffee. However, looking back at the shift from hell is helpful.
Here is a list of what went wrong,and how I will fix it:
I didn’t have a check list in front of me. I was rushed and frazzled, and didn’t go through my usual mental check list.
I didn’t take a break. I should have handed the shock box, I mean pager, to one of my co-workers and walked outside for a moment of peace.
I ate too much crap. Yes, crap. In my frustration I just put my face in to the fridge in the physician lounge and went for it. Sigh. I should have brought something from home.
I doubted myself. I spent a lot of time justifying my thinking to myself. (I had just finished reading How Doctors Think, and was trying to double check my thinking.) Doubt slowed me down to the point where I began to question everything. Solution: hmm, brain transplant?
I wasn’t wearing my scrubs. I was trying to look more doctor like, so I had on a nice sweater, pressed pants, and the white coat. (You men wouldn’t understand…) Next time, forget fashion, I’m wearing scrubs.
I let my colleagues get to me. We were all crabby from the heavy workload. Next time I will take a deep breath and remember we are all getting crushed, and put on the lens of perspective.
I was quick to anger. I got mad when a patient didn’t have a call button close to him, and I found it on top of the sharps box. He had just had a total knee replacement, for pity’s sake! I asked the nurse if the staff had a check list they followed when they cleaned the room, so this wouldn’t happen. She indicated that “they’re pretty good at putting the call light where it should go. I don’t think they need a check list…” Ha I say! How many times am I trying to find the blankety-blank call light for the patient?! Time for another big breath! (BTW, check out If Disney Ran Your Hospital. Good ol’ Walt would see it my way!)
I was exhausted from the get go. My own mom was in the hospital recently and I spent a lot of time with her, which was good but tiring. It was eye opening to be on the other side of the bed. I tried to do too much, and should have gotten help from friends and family, AND NOT FELT GUILTY FOR ASKING! (Yes, this is a woman thing,doctor thing, mother thing, brought up Catholic thing. I’m working on it.)
I wasn’t wearing the no complaining bracelet. I have a bracelet that I wear to remind me not to complain. If I do complain, I move it to the other wrist as a reminder to stop carping. I will wear it today.
I worried too much. I was worried about patients, my daughter, my dog being in a cold dog house, the dinner in the oven that would be waiting for me when I got home at 9:00 p.m. And yes, I forgot to set the oven. By focusing on worry, it was harder to place the focus where it belonged: on the patients. The daughter and dog were fine, my husband turned on the oven, and the patients were okay. Today I will leave my home worries at the door of the hospital when I go in. They will be there waiting for me when I walk out late tonight.
By the way, the ED docs I worked with were great! They knew we were getting crushed, and were kind and gracious in the face of the united hospitalist of grump coalition they faced. Today will be better, I’m sure!
And lastly, I’m only human.
Disclaimer: I have no association with the authors mentioned above, and recieve no financial gain in mentioning their books.