This is the 149th #WILTW
-“Stop being a helicopter consultant..”
-“..just standing around and hovering”
I’d been called out by a colleague for something I’d never heard of but which made perfect sense.
There is a perception that Emergency Medicine is a dynamic, all action job in which you are constantly on the go with no time to think or reflect. This can certainly be true but while there are periods of high intensity the reality is not always as shown in popular television series. There are also times when a particular patient or situation can take up a disproportionate amount of time. You might be heavily involved in delivering a treatment or intervention, you might be having difficult discussions with other specialties, or you might be closely supervising a junior member of staff.
But sometimes you’ll find yourself ‘hovering’. This can be an almost subconscious endeavour, perhaps noticed more by other staff than yourself. A sign perhaps of not quite wanting to leave at the end of a handover leaving you just standing at the end of the bed drumming your fingers against the bed rail. The cause of this ‘action in inaction’ is multifactorial (and inconsistent) but there are some common themes:
- Active Thinking
This is typified by a difficult clinical case. You are creating space to weigh up available evidence so that you can make the most informed decision.
- Passive Thinking
This is essentially procrastination. You are not sure what the best course of action is or perhaps feel there is not one best approach. If enough time passes it’s likely the correct management will become clear. While it might appear to others you are deep in thought you are actually just killing minutes.
This is the least easy hover to admit to. Although it may look like you are focused on one patient you are actually listening into a conversation about another. Or another method involves excessive tidying up, or record keeping, allowing you stay and see what happens to a patient you are keen to see the outcome of. Perhaps you feel like you’ve dropped a ball earlier in their care? You don’t need to stay but find a reason to.
The counterfeit hover is not always a bad thing and passive thinking may well be in the patient’s best interest. It is an interesting behaviour though. One I will be watching out for in others, and certainly in myself.
What have you learnt this week? #WILTW