What I learnt this week: Rejecting the notion of the Emergency Department referral ‘bomb’ #WILTW

This is the 35th #WILTW

At my recent appraisal I was constructively challenged about #WILTW

It’s a pretty unique method of reflection but does it really need to be public?

It is definitely a fair question. Not everything that I can reflect on can be published online and there is no real inherent value in sharing them. I explained the very process of having to think through a regular blog is extremely helpful to me for making sense of, what can often be, very chaotic weeks. The fact that not everything I learnt can be reflected on is irrelevant as I still take time reflecting on those events. In fact, I argue more so, as I have to make value judgements not only on what I have learnt, but what value it has had to me and whether it is appropriate to share with others i.e. the time spent contemplating what the key learning is; is valuable in itself.

I did add that the sharing of #WILTW sometimes prompts learning and its sharing in others. And so was nice to see the response to last weeks piece:

Pro and I must have some obsession with C’s (Pro and I have a vodcast on “coffee and compassion” and I have blogs on the 6Cs of creating FOAM and the 6Cs of rhizomy  [written with Daniel Cabrera])

What this tweet highlights is that communication is critical in Emergency Care. It is also very difficult to do consistently well. Conversing and interacting with patients is clearly one aspect of your job. But working with colleagues is another.  Over time you learn the best methods of communicating effectively with the people you work with on a regular basis. However in Emergency Medicine you spend time speaking to other professionals you may never have met. The art of ‘referral’ is a skill that the Emergency Medicine practioner must master. I recommend Iain Beardsell’s post “Making a referral” in this regard.

In the referral process, especially during the busy winter period, it is easy for those working in emergency care to lose site of the patient, so we mush be vigiliant of this and also remind our in-patient colleagues that it is not bombs were are referring!

The rush to move people around the system, either to assist in flow, meet targets, or reduce your work load results in some patients being hot potatoes – being bounced backwards and fowards with no-one taking overall responsibility or control. Countering this involves the referrer being positive, succinct and reasoned in the referral and those accepting embracing the challenge regardless of the heart sink that ‘another’ admission may bring. While this may pay lip service to the pressure the health service is currently under, acute services internally falling out with themselves is no help to anyone, especially the patients we are caring for.

What did you learn this week #WILTW

(the analogy used in this piece was prompted following a reunion of my university friends last weekend where we played ‘pass the bomb’)

Pass the bomb


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