110. A Strategy Mid-Shift Overwhelm | Conquer the deluge and get home on time
Oct 2, 2023
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In this coaching session, Dr. Brit Long learns how to navigate mid-shift overwhelm, become more efficient, lower stress levels, and experience more joy in his career. The podcast covers developing a framework for managing mid-shift overwhelm, prioritizing tasks, managing critical patients, efficient triage and documentation, and overcoming challenges for well-being and career longevity.
The framework for dealing with mid-shift overwhelm in the emergency department consists of prioritizing tasks, delegating responsibilities, and ensuring an efficient workflow to avoid leaving late.
Recognizing the trigger moment when overwhelmed workload takes a toll, the suggested approach focuses on stabilizing critical patients, assessing new patients, batching results, running the board, calling consultants, managing patient dispositions, and completing necessary documentation.
Implementing the framework may be challenging, but strategies like bringing a workstation into patient rooms, setting boundaries with colleagues, and using alarms or reminders can help ensure timely chart completion and efficient workflow.
Deep dives
Framework for Mid Shift Overwhelm
The podcast episode discusses a framework for dealing with mid shift overwhelm in the emergency department. The framework consists of five layers: stabilization of critical patients, assessing three new patients and documenting their H&Ps in real time, batching results review and consulting with the team, managing patient dispositions and completing documentation, and addressing rate-limiting procedures. The framework aims to prioritize tasks, delegate responsibilities, and ensure efficient workflow to avoid falling behind and leaving late.
Identifying the Trigger and Implementing the Framework
The podcast highlights the importance of recognizing the trigger moment, referred to as 'releasing the cracking,' when the overwhelming workload starts taking a toll. The suggested approach is to focus on stabilizing critical patients, assessing new patients, batching results, running the board, calling consultants, managing patient dispositions, and completing necessary documentation. It emphasizes the need for intentional decision-making, managing interruptions, and using alarms or reminders to stay on track with the framework throughout the shift.
Challenges and Solutions for Effective Implementation
The episode acknowledges potential challenges in implementing the framework, such as discomfort with real-time documentation or interruptions from socialization. It suggests strategies like bringing a workstation into patient rooms, setting boundaries with colleagues, and using alarms or reminders to ensure timely chart completion. The importance of being aware of personal mindset and pushing through 'the wall of pain' in order to achieve more efficient workflow and reduce stress is emphasized.
Continual Improvement and Accountability
The episode highlights the role of experimentation and data collection in refining the framework over time. It suggests having a dialogue about the effectiveness of the approach with a spouse or accountability partner after each shift. This ongoing evaluation and adjustment process encourages continuous growth and improvement in managing mid-shift overwhelm and achieving better work-life balance.
Summary
The podcast episode presents a framework for addressing mid-shift overwhelm in the emergency department. It emphasizes the need for intentional decision-making, prioritization of tasks, effective communication with the team, and timely documentation. The framework aims to optimize workflow, reduce stress, and improve work-life balance for emergency department physicians.
In this real-life coaching session, we walk Dr. Brit Long through building a framework to help navigate being overwhelmed during the middle part of an emergency department shift. Since this session, he has become more efficient, gotten home earlier on a consistent basis, lowered his stress level, felt less burnout, and experienced more joy in his career.
Guest Bio
Brit Long is an assistant professor of emergency medicine in San Antonio, Texa, and Editor-in-Chief of Clinical Content at emcdocs.net. He is one of the most published authors in the field of emergency medicine. In addition to that, he is a father of two and works in both academic and community settings.
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