I wasn’t kidding the other day, with my post title that my mantras are efficient. These are a few that I’ve been collecting the last few months. I write them down when I think of them or hear about them.
Here is my latest compilation:
I had a patient recently who had a rough course after a surgery and because I had the time and she was inclined to ask about it, we talked a lot about why certain things were done at certain points and why they were not repeated later and what different things were done later in her course. It was interesting to have such an engaged patient asking specific questions and wanting to understand more in depth what had happened and why we had decided to do the different things we had done.
When you have a resident taking care of you, she is absolutely going to be part of a multi-resident team that is led by an attending physician. “Attending” is anyone who is out of residency to whom residents report, usually it is a faculty member. (Physicians who are out of residency but don’t have a regular teaching role in a residency program are called “privates”)
In the morning, one of the residents will “round on” you. That means they will be familiar with your history, your overnight course and the general trajectory of your hospital stay. They will do a brief physical exam, maybe check out your incision if you had surgery and talk to you about how things went overnight and what might happen during the day. Then they will leave your room. They’ll have a note to write to document the encounter and they will present your case to the other residents and the attending where a final decision will be made on the plan for the day. Then the attending will come into the room (ideally, sometimes we can’t get to everyone before the first surgery of the day then we have to come back later in the morning). The attending will say hi, share the gist of the conversation that was had amongst the team and finalize the plan. And yes, when the attending talks, the resident is listening. Not talking.
When you have a resident care team, there may be multiple plans formulated in the morning before the final plan is communicated to you. And unfortunately different attendings make different plans so your plans might change from one day to the next. This can make the care of a resident team seem confusing. But it is also a case where lots of people are thinking about your care, attendings are trying to teach residents how to manage cases like yours and they are careful to be making thoughtful plans that are backed by as much research and experience as possible. There are downsides to being on a teaching service but there are also upsides. It is absolutely your right to understand the care you are getting, who the members of the team are and what their roles are in your care. If you don’t understand what is happening, always, always ask!
What if I wanted to be a sillier, more joyful person? How does one go about making that sort of change? I spent some time yesterday with a friend who is silly and I was reminded how much I enjoy that sort of interaction and wishing that I could manifest that more in my life proactively instead of waiting for someone silly to come along. I am going to have to think about this.
It turns out that one of the best things to do to be a more joyful person is to decide you want to be a more joyful person! And embrace the process of re-defining your daily experiences - sure teens can make me crazy but am I going to gnash my teeth or am I going to find the poignant humor available to me now that I’m not the one experiencing adolescence in all its power. And choose who you call when you are having a crazy time - call the friends who have easy laughs and can find the humor even when it is gallows humor.
I want my house to smell good. Vanilla, tea tree, cinnamon, lavender, amber (not all mixed together!). I want to come home and be able to smell that I’m home. But I hate chemically smells and air fresheners. That’s not what I want. And I can’t do lots of incense, in the dry air it irritates my respiratory tract. I need to make a smells plan!
- No Matter What
- Be here now
- My life is mine
- This too shall pass
- Comparison kills
- The next right thing
- Context
- “True joy is a serious matter”
- Ebbs and flows
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As a part of these conversations, it came out that she disliked some of the people who had taken care of her over her >1 week stay. Actually it was more that she disliked what they were telling her (like that she was stable for discharge when she didn’t feel stable). And she asked me why when some of those people came in the room, I never said anything. It was interesting for her to learn some of the power dynamics and roles of a resident care team. I thought I’d share some of the insights with you.
When you have a resident taking care of you, she is absolutely going to be part of a multi-resident team that is led by an attending physician. “Attending” is anyone who is out of residency to whom residents report, usually it is a faculty member. (Physicians who are out of residency but don’t have a regular teaching role in a residency program are called “privates”)
In the morning, one of the residents will “round on” you. That means they will be familiar with your history, your overnight course and the general trajectory of your hospital stay. They will do a brief physical exam, maybe check out your incision if you had surgery and talk to you about how things went overnight and what might happen during the day. Then they will leave your room. They’ll have a note to write to document the encounter and they will present your case to the other residents and the attending where a final decision will be made on the plan for the day. Then the attending will come into the room (ideally, sometimes we can’t get to everyone before the first surgery of the day then we have to come back later in the morning). The attending will say hi, share the gist of the conversation that was had amongst the team and finalize the plan. And yes, when the attending talks, the resident is listening. Not talking.
When you have a resident care team, there may be multiple plans formulated in the morning before the final plan is communicated to you. And unfortunately different attendings make different plans so your plans might change from one day to the next. This can make the care of a resident team seem confusing. But it is also a case where lots of people are thinking about your care, attendings are trying to teach residents how to manage cases like yours and they are careful to be making thoughtful plans that are backed by as much research and experience as possible. There are downsides to being on a teaching service but there are also upsides. It is absolutely your right to understand the care you are getting, who the members of the team are and what their roles are in your care. If you don’t understand what is happening, always, always ask!
***************
What if I wanted to be a sillier, more joyful person? How does one go about making that sort of change? I spent some time yesterday with a friend who is silly and I was reminded how much I enjoy that sort of interaction and wishing that I could manifest that more in my life proactively instead of waiting for someone silly to come along. I am going to have to think about this.
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I want my house to smell good. Vanilla, tea tree, cinnamon, lavender, amber (not all mixed together!). I want to come home and be able to smell that I’m home. But I hate chemically smells and air fresheners. That’s not what I want. And I can’t do lots of incense, in the dry air it irritates my respiratory tract. I need to make a smells plan!
I diffuse therapeutic grade essential oils in a cool mist diffuser.
ReplyDeleteI got one of those! I love it! I plan to fill the house with them and make it smell wonderful!
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