During our educational didactics this morning, we were discussing the care provided to a patient and asking how we could improve on it from various aspect. We were using different well known and accepted tools: the fishbone.
Borrowed from: https://www.google.com/url?sa=i&url=https%3A%2F%2Fwerryworkforce.org%2Fquality-improvement%2Fcause-effect-diagrams&psig=AOvVaw0rBAzWYhMIqwdUMZUz9FIt&ust=1613165004554000&source=images&cd=vfe&ved=0CA0QjhxqFwoTCJid8ovi4u4CFQAAAAAdAAAAABAS
and then is hit me, why didn't we do a medical time out much like they do in the operating room prior to a surgery?
In 2016, from the AMA journal of ethics, was noted that formal surgical time outs were started to improve communication lines at high stress points for both clinicians and patients. This process was found to impact patients outcome in a variety of unintended ways. For example who would have thought that better OR communication would decrease central line infections? and while this idea was met with several skeptics as to how it would impact the stringent OR culture and hierarchy.
However, I feel this was important to remember that anyone can see danger, and everyone deserves a chance to voice their needs, concerns and wants. Therefore this culture shift was very beneficial. this is much like my life as been for the past many years.
As a medical student, tests and study dominated my time and life, that didn't change much in residency and has continued to squash my life as I continue to progress in my life and career. Then one day, watching my daughter angrily crawl, and in her 5 month rage smash my computer, I realized how much of my life was being silenced; Embodied in her rage were those aspects finally able to voice their need to be acknowledged and treated.
But even that was enough for me to act, I realized that just as I give my daughter a 'time out' when she is misbehaving or causing pain to others. I need to give my 'medical' life a time out, to keep it in it's place. In the past I have used journal as a way to help me think through thoughts and release them to the world. Through that process I have sometimes found new insights and different ways to think about things.
I also believe in giving Medicine it's rightful role and position in life. That is what I hope this blog becomes: a way for me to work though and share my insights as I learn how to have a medical time out. Sometimes it may be a new 'survival technique' or others maybe an interesting medical article. but for right now: I just hope I learn how to have a medical time out and listen to all parts of my life.
AMA J Ethics. 2016;18(9):925-932. doi: 10.1001/journalofethics.2016.18.9.stas1-1609.
