My friend texted me the other day that she was thinking of quitting her training program.
Some schedule changes earlier in the year led to her being scheduled for back-to-back month-long night float rotations. She was in the middle of her second straight month of nights and was feeling tired, depressed, and burned out.
Now, this might be a unique situation since night float rotations, on average, are only one to two …
My social media feed has increasingly included stories of friends “quiet quitting.” A term popularized through TikTok, quiet quitting is a reaction to the exploitation of employee labor without providing additional compensation. Simultaneously, my IRL conversations have been filled with stories of the Great Resignation, in which employees have voluntarily resigned, often without other employment secured. A recent report by the U.S. Surgeon General recognized the problem of workplace …
Is there a third pathway of resilience?
In the very realistic fictional world of The White Coat Diaries by Dr. Madi Sinha, a first-year internal medicine resident goes through a harsh initiation into the realities of medical training. Protagonist Norah Kapadia encounters a complication of a penile implant in an elderly patient with end-stage liver disease and dementia. Her senior resident talks her through the problem of causing hematuria as she placed a catheter through an …
Physicians: Are we still the good guys?
As winter approaches and life slows down, it’s a time to pause and reflect on all everyone has had to endure these past few years. To those involved in health care, it has been an especially difficult time… a test of both resolution and inner strength. With my hope that all will see brighter days ahead, I offer the following as my means of giving thanks to all of you …
A blessing for health care workers
When I transitioned into a new role as a training faculty member at an academic medical center a few years ago, it didn’t take long to realize that the program had a problem with psychological safety. There wasn’t much.
As I got to know the trainees and heard specific feedback, I began to understand why. The trainees felt criticized and unsupported by the training faculty. And every time there was a …
Leaders who elevate diverse employees create psychological safety
There is no one prototypical physician. Every physician has their own practice style, their own knowledge base, and their own preferred method of communication. In my role as medical director for case management at my community hospital, I was given 30 minutes during new nursing orientation to provide nurses tips when communicating with doctors.
I put together this list of things that physicians wished hospital nurses knew about them, both good …
Physician secrets that nurses need to know
An excerpt from The Mumbo Jumbo Fix: A Survival Guide for Effective Doctor-Patient-Nurse Communication.
Team building is a popular trend in health care. It promotes cooperation, trust and respect, improves communication, and enhances patient outcomes. Most of the time.
But the camaraderie and familiarity of working with the same group of people …
Communication protocols exist for a reason
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“As a nurse, I know how difficult and demanding the job can be. I’ve had patients try to physically attack me and it’s frustrating and disheartening to face such hostility. When I talk to people outside of the health …
All I ever wanted to be was a nurse [PODCAST]
To: [Group: all employees]
From: Office of the CEO
Subject: A fork in the road
Going forward, we will need to be extremely hardcore to streamline a restructured Health care 2.0 and succeed in an increasingly diseased world. This will mean working even longer hours at high intensity. Only exceptional performance will justify a new N95 mask each week.
Health care will also be much more profit-driven. Physicians and nurses will still be very …
If the hospital CEO emailed employees like Twitter’s CEO
Life is short, so make yours extraordinary. Capitalize on what makes you, YOU, and be your own unapologetic self.
The Almighty designed us as unique but imperfect and flawed individuals, prone to sin and blundering error. But that’s the great part of being human; we’re expected to sin, blunder, and make mistakes. We’re made to err for the sake of learning and growth; otherwise, we’d wither into uninspiring nothingness. Keep this …
Bring the real You to your workplace
An essay posted by Fareeha Kahn, MD (“A hospitalist’s struggle to find teamwork in academic medicine“), raises an important issue. The problem of lack of collaboration is not unique to academic medicine. The problem is the result of misaligned incentives.
Having read the work of Harvard Business School professor Michael E. Porter, I better understand the goals and challenges of value-based care. If we look at the premise …
Why is collaboration missing in health care?
The question of addressing physicians by name has been addressed again. Yet the question about names has not been addressed.
Before addressing the name question, I will talk about how I have evolved with time.
In India, I have been used to formally addressing everyone as either “Sir” or “Madam” during in-person meetings and in virtual communications when I have known them — “Sir/Madam” or rarely …
Why we should end gendered titles
To paraphrase Fat Man’s Law Number Three, “At a code, the first pulse you take is your own.”
Enduring advice, as true today as it was in the early ’70s when Roy G. Basch, MD, and his gang of hapless interns roamed the airless wards of The House of God, the mythical hospital in the infamous novel by Samuel Shem, although almost everything else about practicing medicine seems …
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The pandemic has brutalized health care such that the term “institutional betrayal” (IB) is becoming part of the physician vernacular. This cringe-worthy term is being used to point a finger of shame at health care leaders and systems who presumably are failing to support and protect their workers adequately.
Indeed, we depend on our employers for our safety and well-being. With staffing shortages, lack of supplies and lower revenue, employees bear …
Institutional betrayal vs. courage
As a caregiver or support person for an older parent, partner, or relative, you may be involved in helping that person with medical appointments, perhaps even helping them manage care from several different health care providers. There are a number of strategies that can help you be an effective, respectful advocate for your loved one. These strategies also help ensure that your family member gets the care she or he …
Caregiver? Learn how to support older relatives at doctor’s appointments.
“We use a punishment mindset that exacerbates the trauma (people have already suffered). We have to change that.”
– Bryan Stevenson, Director of the Equal Justice Initiative
In the months preceding the COVID-19 pandemic, our quality improvement team was discussing the safety of providers and staff on a weekly basis. This was not in the context of a communicable disease or sufficient personal protective equipment but instead related to another insidious health …
Breaking the cycle of violence in hospitals: the role of trauma-informed care
I shall translate.
This is her big day! She is meeting with her specialist for the first time, excited to finally hear that she will be cured from her annoying disease.
I am there to interpret back and forth between her and her doctor to eliminate the language barrier.
She has been suffering from this terrible disease affecting multiple organ systems in her frail body for a long time.
Today, she is done!
With her …
There is no cure for your disease
You start off your morning by receiving the patient handoff, then you “pre-round” on the EHR (furiously scribbling down information), then you physically pre-round on patients (or at least the “sick” ones), then you move onto some form of “proper” rounds that are generally attending specific (walk rounds, sit-down rounds, family-centered rounds, etc.), with the aid of the EHR or flying by the seat of your pants (a.k.a. depending on …
The merry-go-round of rounding
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
A nurse is assisting the attending physician in placing a central line in the intensive care unit.
It’s 3 a.m., and the attending is clearly tired, having admitted eight patients so far on her shift. The nurse notices the physician pushing her eyeglasses up her nose – after …
Speak up for safety in health care
After a couple of hours of back and forth, I can finally complete an oxygen assessment on a patient ready to be discharged home. The conversation had concluded on a somewhat sarcastic note. I was left feeling guilty of having almost coerced someone to stay beyond their designated duty hours to attain a desirable outcome for a patient. While this was not entirely true, the encounter had brought forth a …
A hospitalist’s struggle to find teamwork in academic medicine
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