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Blogs relating to What I learnt this week

What I learnt this week: #Everybodycounts – really everybody does! #WILTW

This is the fourteenth #WILTW

The story is told of how President John Kennedy once visited NASA. He came across a cleaner and asked him what his job was. The cleaner replied: ‘My job is to help to put a man on the moon.’

This is an oft quoted story which may not be based in truth. It does emphasise an important point, however cheesy, that knowing your value to an organisation is very important. The Emergency Care pathway involves patients from the moments they become unwell, onto health seeking behaviour, to urgent or emergency care settings, into hospital and then back into the community. Although ‘Emergency’ makes people instantly think of  the Emergency Departments role; we are only one part of the puzzle.

Everybody Counts

Leicester Hospitals have just launched #everybodycounts. A campaign to energise staff to improve and celebrate the care we provide for patients who receive emergency care wherever they are on the pathway. A few videos have been released demonstrating the little things that can be done to improve the quality of care provided (I apologise to Kate Granger for mistaking Leeds to be in the “North-West”).  It’s deliberate we have a nurse, junior doctor, and play specialist all contributing – they are all part of the process. In fact in some respects they are far more important  than the consultants and matrons who set strategy.  It is the hands on, patient facing, staff who will be the arbitrators of patient experience, quality of care and delivery of standards.

Everybody Counts – Debs Dakin – Successful Introduction of the Sub-Wait from Leicester’s Hospitals on Vimeo.

I have written previously about how anyone can make simple mistakes on obvious tasks that demonstrate compassionate care. And it is the same simple things, performed by any member of staff, that can brighten up a patients otherwise miserable day.

#everybodycounts – all the time, every time.

What did you learn this week ? #WILTW

What I learnt this week: Organisation is more than files and folders #WILTW

This is the thirteenth #WILTW

Effective time and administrative management is vital in any leadership position but when part of your job role takes you away from the ‘office’ for potentially significant parts of the working week it becomes even more important. In clinical medicine managing your time away from the shop floor is therefore a vital skill. Although this is becoming increasingly recognised in training programmes, it is still the case that very little time is spent on training health care professionals how to be more efficient and effective in administrative tasks. The Academic Life in Emergency Medicine series: How I work smarter provides some brilliant tips and techniques in this regard. Since writing some of my own thoughts on this subject I have been mulling over how efficient I actually am.

One of the things I have always aimed to keep on top of is my file and folder system, both on my work desktop and home laptop.

Desktop Crowding

 

That is not a picture of my desktop…. But I do start to get nervous when files start to pile up. One of the light bulb moments I had this week was how much time I was potentially wasting trying to be organised. 

One of the very worst uses of time is to do something very well that need not to be done at all.”- Brian Tracey

Just a small reminder of the ongoing learning that being a new consultant has brought with it. 

 

What I learnt this week: It’s not what you say it is how you say it #WILTW

This is the twelfth #WILTW

What could directly link a peer reviewed academic article in a medical journal and a comedy sketch on eyebrows?

The importance of being able to read facial expressions.

One of my favourite comedy sketches is performed by Jim Eion

Published in the Emergency Medical Journal last month was this article 

EMJ

 

Essentially patients with serious heart diseases lacked facial expression variability and surprise in response to certain stimuli which should provoke grimacing/laughter etc. I am uncertain at the moment what implications this will have for medical practice in the future but I am sure it is an important finding.

I try to stress to the junior doctors in our department, especially as we have a completely new set with us for the August handover, that it is important not just to take a history but really listen to what is being said. Often parents of children who are unwell have concerns that they don’t always fully express with words. Furthermore a great deal of communication is delivered through body action and facial movements rather than actual language. For example the subtle withdrawn demeanour of the mother who has post-natal depression is only noticed if you are actively observing for it [Further examples of this can be found in my quick guide to managing the febrile child]

It is not just with patients that observation of facial expression is vital. In dealing with colleagues at meetings and handovers it is vital that you are constantly observing the way things are said as well as what is said. The inability to read others tone and facial expression is a common reason for the development of poor working relationships in my humble opinion.

The next time you talk a history from a patient or have a discussion with another speciality: Are you just listening to what is being said or watching as well?

What did you learn this week? #WILTW

What I learnt this week: The importance of being part of a team (Sir Bradley Wiggins says so!) #WILTW

This is the eleventh #WILTW post

Hours after winning a silver medal at the Commonwealth Games Sir Bradley Wiggins gave the following interview to the BBC:

http://www.bbc.co.uk/sport/0/commonwealth-games/28477534

It was a honest account of what the team had achieved in Glasgow. He also noted that he had struggled with the “not-so-niceties” of the highly competitive nature of the Tour-de-France. What stood out for me was his comment about looking forward to returning to being part of a true team. The team pursuit is dependant on everyone, not just a one highly skilled individual.

Emergency Medicine is very similar. When it gets very busy, with large patient volumes and high acuities every health care professional plays a vital part in ensuring patient safety and a quality experience for all. It is that collaborative experience that makes emergency medicine such a fun place to work. I can try and see as many patients as possible but without the health care assistant, nurse, ward clerk and manager all playing their roles it will be a deeply unsatisfying experience. Even during the busiest periods, a quick joke and a smile between members of staff makes a huge difference.

We are one Team

So I’m with Bradley – while the individual reward may be worthwhile in the short term nothing beats a team effort…

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What I learnt this week: Learning not to be as busy as a “Backson” #WILTW

This is the tenth #WILTW post

On the long journey to and from our holiday in Wales our girls were entertained with an iPad playing a variety of disney films and Peppa Pig episodes. One of their favourite films is Winnie the Pooh ( 2011)

It features a catchy song about the Backson

Owl:         Christopher Robin has been captured!
[all]:        What?
Owl:        By a creature called “The Backson.”
[all gasp]
All:          Captured by the Backson!
Tiger:     What’s a Backson?

Owl:       A horrible creature! Malicious!
Tiger:     You don’t say.
Owl:       Ferocious!
Tiger:     Fero… ?! Ooh!
Owl:       And worst of all, terribly busy.

(I suspect you’ll find it impossible not to sing along after you have listened a couple a times)

I used to take pride in the fact that I was always busy. A badge of honour almost. Having spent a week away from work and being able to properly relax I realise I have no less work to do now than I did before I left (and probably more). However I am now infinitely more chilled and less stressed about my to-do list.  While I’m unlikely to completely change all my working habits I am going to try an hold on to the image of the ‘terribly busy’ Backson to remind me of the importance of a good holiday 🙂

Beach View

 

What did you learn this week? #WILTW

 

 

What I learnt this week: Feel the fear and do it anyway #WILTW

The ninth #WILTW post

I recently visited the Wellcome Trust exhibition: “an idiosyncratic A to Z of the human condition“. I thoroughly recommend it as, not only is it free, but it does really get you thinking about different mindsets and idiologies. I was struck by this particular exhibit

dustbin

I would not generally think of myself as someone who is afraid to do things but it was interesting that I thought of many fears I would like to put in the bin. My transition to being a consultant has generated a great deal of self-reflection and I hope self-efficacy (thanks to Helen Bevan for highlighting the difference)

selfefficacy

 

Actually there are many things I have been afraid to do – but by not recognising them as fears I have not challenged them. Hoping the rubbish bin approach will help me be more honest in future!

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What I learnt this week: It’s not you, it’s me #WILTW

This is eighth #WILTW

An interesting week which demonstrated that my learning, in many aspects of medicine, really has only just begun. This tweet resonated:

Although the context of the tweet was about #FOAMed and information transfer I read into this a more generic point:

The importance of not dropping a level to that of a potential antagonist but developing an ability to move up one level instead.

Engagement, Quality, Delivering shared values will always be a problem given the challenges of human nature. I am reminded of the need to reflect not on what others have done, but on what I can do to improve.

What have you learnt this week? #WILTW