More than two months after he died, his name still adorned the whiteboard of the hospital room he inhabited. As I stood there and gazed, recalling the memories he left me with, the nurse who tended to him entered the room and started to cry. Her love for Eric, she told me, did not enable her to erase his name.
He was disheveled, non-compliant, and plagued with multiple morbidities when first …
It was 2:21 a.m., and the pager exploded in my ear like I had forgotten to turn the volume down before plugging in my headphones. The nurses told me your heart rate was getting faster, and your oxygen was dipping lower. When I made it to your room, you were laying in urine because you were too weak to stand. Your breathing was rapid and shallow, like you were caught …
Burnout. We define, measure, and talk about it endlessly but do little to fix it. Unchecked, it can lead to medical mistakes, career dissatisfaction, early retirement, provider suicide, and excess costs. With the recent pandemic, the public has become more aware of it, but action to fix it is still lagging.
Feeling underappreciated, feeling one’s work is meaningless, feeling powerless to make changes, and feelings of moral injury are but a …
Violence against health care workers has escalated to unprecedented levels in the last decade. The pandemic seems to have accelerated outbursts against health care providers online, in print, and in person.
A man from Tulsa, Oklahoma, recently angry over back pain, killed his surgeon and other health care workers before ending his own life.
Many health care workers report they are used to working in environments that are …
Some years ago, I had the privilege of serving as chief of staff of my community hospital. One of my responsibilities was to review complaints directed at doctors. Ten to twenty “occurrence reports” came across my desk every week. Most were from nurses who felt doctors had unfairly reproached them.
Hospitals are required by their deeming organizations — ours is The Joint Commission (TJC) — to adjudicate each item with due …
This episode was during my elective time in India in the late winter of 2017. It was a patient-centered learning opportunity for students around the world who has an interest in medicine. I was excited about this because of my earliest clinical exposure to patient encounters as a medical student. I was excited to meet the patients, talk to them, and help them despite the uncertainty and emptiness in my …
Early one morning in 1996, after a sleepless night on call, I stood with my team in the VA hospital, outside room 102. I was a 28-year-old intern in the general medicine service. We were making rounds on twelve patients that my intern partner, myself, and our supervising resident had admitted overnight. We would walk room to room, and the intern would present the information regarding the patient by gathering …
I was warned about it before we walked into the room.
So when I did walk in, I made sure my eyes stayed focused on his eyes, my gaze high and attentive. I smiled, possibly more than normal, to make sure he felt comfortable. Like a puppeteer holding up his doll, I knew it wasn’t time for me to drop down my eyes yet.
The resident with me began the routine visit …
Congratulations on our leading academic medical institution (LAMI) yet again making it to the top ten list of the U.S. News & World Report!
You have taken the reins in perilous times (globally and domestically), and what you do and what you stand for will determine if this great hospital will not just survive but survive with its brand and reputation intact. Getting hired as a physician who grew up in …
An excerpt from The Evening Hero.
This was apparently not to be a Yungman-only meeting. It was in their conference room, same one where had their monthly morbidity and mortality conferences, and it was packed with doctors. In fact, there was just one chair open, and Yungmans best friend Ken the …
Medical mistakes are as old as the practice of medicine itself, but it wasn’t until 1999 that the United States started paying more attention to them.
Over twenty years later, we may be reducing medical errors — a recent study published in the Journal of the American Medical Association found significant decreases in mistakes in cases of pneumonia, acute myocardial infarction, heart …
Imagine that you are a brand-new attending in a hospital. You have your new starched white coat and stethoscope around your neck. Before you enter your patient’s room, the nurse says, “Whew! Good luck! The patient’s dad is really angry! He’s been yelling for the last ten minutes!”
Are you prepared? Do you know what to do?
The boundaries of unacceptable behavior have eroded in the past few years. Politicians, law enforcement, …
Over 30 years ago, this man began working for our hospital system.
He was assigned to our ICU/CVICU units. Though some health care employees hadn’t even been born yet, Charles was a tried and true “lifer.”
He was our housekeeper. And he was our friend — our family.
He was a man with energy and stamina. He was a hard worker. Relentless. He could spin circles around a pack of 20-year-olds put together.
His …
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New resident physicians who have earned their MD degrees will be heading to hospitals to start their residencies during the last two week in June and the first week in July. What can a beginning doctor do during the first month of internship to get his or her career off to a good start, and in so doing, also learn to provide the best care to patients? Here are 10 …
The first week of my big attending job, I saw a patient with fever, sore throat, no cough, and tonsillar exudates. Well-trained to manage septic shock, but having no idea how to practice in a primary care clinic, I crafted a vast array of infectious and inflammatory diagnoses. With a quick glance, my senior partner said, “You don’t know that this is strep?” Flushed and wanting to hide, I thought, …
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.
A decade of working in quality and patient safety has taught me a painful lesson: Don’t say “quality” or “patient safety” to frontline health care workers. Too often, they become immediately defensive or evasive. How did q#^l&ty and s^f*ty become four-letter words? …
Imagine that you hired a teenager to sell hotdogs at the local fair, but the teenager started telling customers that hotdogs were really not very healthy, that the price was ridiculously high, and that they could find healthier, cheaper options just around the corner. Is he wrong? From a business perspective, he’s a nightmare, but from a human perspective, he’s absolutely correct.
Where does your current work setting fall …
At age 33, I got my first job as an outpatient pediatric attending. With great pay, nice coworkers, and exceedingly better hours than in training, to everyone around me, I had finally “landed.” Soon after I began working, however, I woke up with trepidation every morning, forcing myself to get out of bed.
Why wasn’t I relishing the fruits of my labors? After all this time, I no longer trailed the …
Many providers enter medicine to comfort patients and their loved ones. However, much of what I do doesn’t live up to that intention. In the past few months and particularly the past few weeks, I’ve spent most of my afternoons making little difference in the course of my patients’ hospital stays, and instead of having multiple conversations with the loved ones of these ill patients, providing daily updates, reiterating expectations …
After being a coach for a couple of years now, there is an immediate danger I see right now.
Many of you are doing too much. Unsustainable, dangerous amounts of work. Dangerous to yourself and dangerous to others, which makes it dangerous for you, too.
I’m not trying to be overdramatic, but I am shocked by how much overworking we are accepting.
Everyone’s definition of “overwork” will vary. And the hustle culture and …
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