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Dr. Mark’s Journey to Less Stress and Better Care
Mark works as a cardiologist staff specialist in a large metropolitan hospital. The department is understaffed, and he is busy all the time. There have been many times when there is no one else to see patients, and he feels the pressure. He is conscious of working with people who have had cardiovascular events and the link generally with stress. Recent research has endorsed mindfulness practices for people with cardiovascular disease. Mark has been trying to role model mindfulness to his patients by taking a little more time with them.
Initially, he was very agitated that his experiment was showing him to be naive and unrealistic! However, after the first anxiety provoking month, he told me that it was now taking him about the same time to see his patients - he goes home from work at the same time as he used to. He said it wasn't what he was doing that was so different, more how he was doing it. Mark said that the main difference to come out of his experiment was that he feels much less stressed.
He is no longer agitated about the time and has a feeling of space in his day. Mark began his experiment because he thought it would be good for his patients, and he discovered that it's also good for him. His experiment con-tinues. He is more curious than ever to observe what happens for the patients and himself now that he has let go of the 'I haven't got time' story.
Dr. Tyler’s Path from Confusion to Competence
Tyler received some feedback at the end of his first rotation in the ICU. His supervisor collated the feedback from various colleagues and consultants and compiled their comments into one assessment. One of the consultants said he was disorganised. Tyler did not know which consultant had said this, so couldn't ask them more about what this meant or how he could improve. There was no specific information provided about when or in what context he had been disorganised. He was not given any behavioural examples from his work and no structures or tools were offered for him to use so that he could improve. The feedback was given on his last day at the hospital, at the end of his shift and right as his supervisor was starting her shift. There was not much time to talk.
In the absence of specific information, this feedback is threatening to Tyler, so his brain interpreted it negatively. The whole situation was unhelpful for Tyler.
He was no wiser about what was expected or how he could improve. In fact, it damaged his confidence significantly. He took most of the next rotation to regroup and work up enough courage to ask his new supervisor to help him improve how he presented at handover and manage his on-call conversations with the consultants. She told him about K-ISBAR and some other tools, which made all the difference. As a result, Tyler could take some proactive steps to improve.
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