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When faced with a busy schedule and overwhelming tasks, it is important to prioritize and break down the workload. By reflecting on the most common problems and setting realistic expectations, one can better navigate the chaos. Starting a shift strong with clear objectives and focusing on one task at a time helps with success. Taking strategic pauses during the shift to reassess priorities, delegate tasks, and collaborate with the team can lead to better outcomes.
In high-stress situations like trauma resuscitations, mental preparation through mental rehearsal and visualization is crucial. Talking through the specifics of a procedure, reinforcing positive self-talk, and reframing priorities help build confidence and manage stress. Creating a shared mental model within the team and effectively communicating priorities helps everyone stay focused and on the same page. Tactical breathing techniques can also help regulate stress response and maintain situational awareness.
To build resilience and situational awareness, ongoing mental practice, simulation practice, and communication are key. Mentally rehearsing procedures, such as chest tube insertion or airway management, helps solidify priorities and actions. Tactical breathing exercises help regulate physiological responses to stress. Engaging in cognitive reframing and discussing priorities with the team foster a shared understanding of the situation and encourage collaboration. A combination of these strategies helps build a padawan's ability to manage stress and navigate high-stakes situations with equanimity.
Taking time for reflection before starting a shift and prioritizing mental and physical preparation can set a positive tone for the day. Rituals like exercise and downtime before work can help center and ground oneself. Collaborating with the team, sharing information, and seeking input from others improve situational awareness and decision-making. Acknowledging individual concerns and effectively communicating priorities ensure a shared mental model and foster an environment of trust and support.
In challenging work environments, such as the emergency department, it is crucial to manage workload, prioritize tasks, and maintain work-life balance. Setting realistic goals and using cognitive reframing techniques help in achieving success. Engaging in deliberate pauses during busy shifts to reassess, regroup, and prioritize tasks allows for effective time management and collaboration. Providing explanations, acknowledging input, and maintaining open communication contribute to building strong and cohesive teams that function efficiently in high-pressure situations.
Chris Hicks, MD
Chris is an emergency physician and trauma team leader at St. Michael's Hospital in Toronto. He has innovated in several areas of resuscitation and psychological skills, including mental practice, stress inoculation training. These days he enjoys a quieter life, free from the problematic corporate jib-jab of academic deliverables. In 2018, as a partial rebuke of the status quo, Chris co-created and chaired resusTO, an inter-professional simulation-based resuscitation conference in Toronto with international acclaim. In 2020, he co-founded Advanced Performance Healthcare Design, consulting with hospitals and industry using simulation to inform the design of systems, spaces and teams. Chris is an avid speaker and lecturer, staunch #FOAMed supporter, occasional runner and cyclist, fledgling boxer, semi-retired pianist, and proud father of three lunatic boys.
Thom Mayer, MD
Dr. Mayer is the Medical Director for the NFL Players Association, Clinical Professor of Emergency Medicine at George Washington University and a Senior Lecturing Fellow at Duke University.
Dr. Mayer was named the ACEP Outstanding Speaker of the Year in the second year the award was given and has twice been named ACEP’s “Over-the-Top” award winner.
On September 11, 2001 Dr. Mayer served as one of the Command Physicians at the Pentagon Rescue Operation, coordinating medical assets at the site. Dr. Mayer has served on the Department of Defense on Defense Science Board Task Forces on Bioterrorism, Homeland Security and Consequences of Weapons of Mass Destruction. Dr. Mayer also serves as a Medical Director for the Studer Group.
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The Driveway Debrief
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