Failing Up

It as a given that we will fail.  All of us.  Medical or not.  We are all human, which means we make mistakes. So once we accept this as fact, we can then move towards failing better.

When we make a medical error we have a few choices:

 

1. Live in perpetual doubt

Blame yourself and practice defensive medicine

 

2. Ignore the error and do nothing, stop caring

 

3. Failing up – learn from the fail

-       Learning from your medical error takes effort, consideration and time -makes one even more accountable, compassionate and competent.

-       We are all going to fail.

-       When one sweep failures under the carpet, one cannot learn from them effectively and neither can one heal from them effectively

-       Learning to accept this eventuality and incorporating it into our daily life, will allow us to grow as individuals, to more effectively teach others and to take better care of our patients.

-       Strive for post traumatic growth and thriving after failure instead of feelings of shame and isolation.

 

 

Failing up strategies:

-       Find a Failure Friend: An empathetic work friend who understands the context; someone who is your safety net and in return you can be their safety net.

-       Be a good Failure Friend to a colleague: Listen/hear them out and empathize/provide affirmation rather than giving advice or solutions. Use reflective listening like you would with a patient and then come up with a joint plan.

-       Teach from your mistakes: Give talks around your difficult cases that incorporate personal strategies on how to cope after the fact, rather than only concentrating on the medical aspects of the case. Talk with peers, residents and medstudents

 

Watch this excellent FeminEM talk by Dr Sara Gray: https://www.youtube.com/watch?v=aGS6O98p4Q8

 

References:

https://emergencymedicinecases.com/preventing-burnout-promoting-wellness-emergency-medicine/

https://www.entrepreneur.com/article/331332

https://saragray.org/2017/03/07/failure-friends/

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Box Breathing Technique   

Box Breathing Technique   

Next time you’re on shift and get a notification for a baby in arrest or have to prep the neck for a cric take a minute to do some Box Breathing to get you prepped and mentally ready

·      Easy, Quick and Navy SEAL approved

·      Effective in anxiety, insomnia, pain management and even labor!

·      Box breathing with this 4-4-4- ratio has a net neutral energetic effect

·      It’s not going to charge you up or put you into a sleepy relaxed state. But it will, as mentioned, make you very alert and grounded, ready for action.


Box breathing.gif

 

·      To begin, expel all of the air from your chest.

·      Keep your lungs empty for a four-count hold.

·      Then, inhale through the nose for four counts.

·      Hold the air in your lungs for a four-count hold.

·      When you hold your breath, do not clamp down and create back pressure. Rather, maintain an open, neutral feeling even though you are not inhaling.

·      When ready, release the hold and exhale smoothly through your nose for four counts. This is one circuit of the box-breathing practice.

·      Repeat this cycle for at least five minutes to get the full effect.  

 

References

 

Dr Arlene Chung

TIME

https://www.mindfulwellnessrochester.com/single-post/2017/06/02/Box-Breathing-for-Anxiety-Stress-Reduction

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Looking at wellness: "Happiness and Resilience in the Life of an Emergency Physician"

Today’s POTD will be focused on wellness.

I will attempt to briefly summarize an amazing piece on “Happiness and Resilience in the Life of an Emergency Physician” from ACEP Wellness Guidebook. But more importantly the piece is written by our amazing and hardworking wellness advocate Dr. Arlene Chung in collaboration with Dr. Rosanna Sikora and Dr. Laura McPeake.


The first paragraph is talking about defining happiness and resilience. My favorite quote is “Engagement and meaning appear to be the strongest contributors to living a happy life” and that “You can strengthen happiness and resilience by practicing”. But at the end of the day it is very individualized and we, ourselves “ must choose what is most meaningful in our lives along the way to be happy”. 

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The part that I would like to draw your attention to are the suggested specific strategies by the authors that can help to build resilience in the practice of emergency medicine:


Writing a journal or recording oral narratives. 

Transforming your traumatic experiences into a written or recorded piece will not only help you to cope with difficult emotions but also put the situation in perspective and even learn from it. 


Meditation or mindfulness exercises. 

Mindfulness can be as simple as taking in a deep breath and exhaling very slowly, resulting in a parasympathetic charge of feeling peaceful and settled.


Peer mentoring.

Discussing stressful events with a supportive and empathic colleague is some of the best medicine that we have, and if our emergency medicine atypical humor is involved, all the better. Humor is a great coping strategy. 


Niche development. 

“Research has demonstrated that physicians who have developed a niche within emergency medicine have lower rates of burnout, better career longevity, and more career satisfaction.” This one is specifically very important for the senior class. Thinking about what can improve your clinical practice after graduation (and I am not only talking about fellowship) but rather looking into different areas of interest that can potentially become your niche.

Education. 

I’ve heard teaching is rewarding and improves doctors satisfaction :)



Personal coaching. 

Develop a mission statement and a career plan and the examples that authors suggest: personal organization, time management courses, and learning to say “no” to obligations outside your mission statement.



Focus on empathy. 

Consider books, workshops, and podcasts. Connect with your family, friends, and co-workers outside of the fluorescent lights of the emergency department. 




Take care of your own needs. 

We need to take care of ourselves before we can care for others. Remember to MOVE your body: “A jog a day keeps depression away.” Make time for what you enjoy. Place it on your calendar and treat it like a shift.


Limit stressful downtime.

Balance your high-stress activities with low-stress activities. 



Please read the full article at ACEP emergency physician-focused wellness guide 



https://www.acep.org/globalassets/sites/acep/media/wellness/acepwellnessguide.pdf