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Quitting work may be the best thing you can do

 

Do you quit work? At least until it’s time to be back in the office, clinic, shop or hospital? Are you constantly taking calls and texts from work even on vacation?

Recreational travel may increase creativity by relieving workers from stress, providing diversifying experiences and increasing positive emotions. Consequently, vacations may boost creativity, apparent in a greater variety (flexibility) and originality of ideas after work resumption. de Bloom  et al

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What did you expect yesterday?

As you walked through the front doors at work yesterday what were your expectations? Were you hoping:

  1. To serve to the best of your ability
  2. To learn something new
  3. To enjoy good company doing something meaningful
  4. To make a difference to someone
  5. To earn a big pay cheque
  6. To pass the time before home time
  7. Something else?

Which was it? How did you feel at the end of the day? How do you think those who interacted with you felt at the end of the day?

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Do you see how that happened?

You may face may challenges or have an unexpected outcome following your interaction with your customer, client or patient. As a healthcare professional these are opportunities to reflect on how an event unfolded, how you were feeling at the time and how you are feeling afterwards. Consider then how those emotions play out through the course of the day. Given that most  outcomes in healthcare are moderated by an interaction with a health professional it is important to ensure that the health professional is attuned to their inner world. We can’t change many things as providers of health services but we can look within.

Know what causes your negative emotions, and which types of feelings you face most often. When those emotions begin to appear, immediately start your strategy to interrupt the cycle. The longer you wait, the harder it will be to pull yourself away from negative thinking. Mindtools

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Mobile phones aren’t allowed in the operating room.

Before a surgeon gets anywhere near a patient in the operating theatre he must wash his hands, put on a gown and gloves. He then drapes the patient and cleans the skin. As he makes his first incision there is no mobile phone on the table, he banishes all distractions and appreciates that the job isn’t over until he has sutured the wound. Whatever you do for a living how do you approach the job? If you adopted rituals would you perform better? Bacteria can destroy a surgeons work. What contaminates your work and how does that manifest in your results?

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Do you know their secret fear?

Do you know why your customer, client or patient chose you today? If you are his doctor John made an appointment this morning because he thinks he may have an inherited illness. His uncle recently died from this condition and it all started with weakness in his arm. John has noticed that he has pain and weakness in his right arm when he lifts heavy things at work. This morning he nearly dropped the kettle when making a cup of tea. He isn’t going to tell you what he is worried about but he expects you will tell him he doesn’t have that condition after all the tests you will perform right? His uncle had lots of blood tests and scans.

In quite a number of contacts with a new reason for an encounter (22%), the ideas, concerns, or expectations of the patient remain undisclosed. A second main finding is that the expression of concerns and/or expectations is correlated with fewer prescriptions (univariate, logistic regression analysis, and also after exclusion of patients without an ‘a priori need for medication’). Although the causal relationship remains uncertain, the observations may indicate that systematically disclosing the patients’ real expectations and concerns could lead to less medication use. Matthys et al

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Would it be easier if I went home and skyped you?

When I am sick or worried I need you to look at me. I know you need to maintain my records doctor but while you are doing that it isn’t helping me to tell my story. Wasn’t that the point of me being here? Would it be easier if we both looked in the same place through a screen?

The non-verbal behaviour of doctors themselves is easily overlooked in communication research. Many instruments for measuring qualities such as patient centredness are designed to be applied to audio rather than video tapes, and questionnaires for patients may not be sufficiently detailed to seek their views on this area. However, an increasing body of work over the last 20 years has demonstrated the relationship between doctors’ non-verbal communication (in the form of eye-contact, head nods and gestures, position and tone of voice) with the following outcomes: patient satisfaction, patient understanding, physician detection of emotional distress, and physician malpractice claim history. Although more work needs to be done, there is now significant evidence that doctors need to pay considerable attention to their own non-verbal behavior. Silverman and Kinnersley

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Small details matter

It’s a small detail. If you are accompanying someone down a corridor as a healthcare professional- don’t stride ahead. Ideally walk alongside the person or let them lead the way if they know where you are headed. If they are wheeling a buggy and carrying a bag offer to help by wheeling the buggy.  Just try it. You might like how they respond. Apart from that you can learn so much about the person even before the consultation begins:

So instead of a doctor assessing a patient’s blood pressure, body mass index, chronic conditions, hospitalization and smoking history and use of mobility aids to estimate survival, a lab assistant could simply time the patient walking a few meters and predict just as accurately the person’s likelihood of living five or 10 more years—as well as a median life expectancy. Scientific American

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Do you monitor your dashboard?

It is unlikely that you will arrive at work every morning energized, rested and looking forward to the day ahead. Last night the neighbour’s dog may have disturbed your sleep. You might spill your coffee as you rush to catch the train. You miss the train and as you run to the bus stop the rain starts and you realise you’ve have forgotten your umbrella. En route you might receive bad news or have an argument with your partner. Nonetheless you will have to get through the day and in healthcare that will mean giving those who seek your help your full attention notwithstanding how you feel. How do you prepare for that?

Jonathan has been refusing medication for diabetes for several months. His weight continues to climb. His blood pressure also warrants treatment as you have advised several times. Today he arrives unannounced to seek a prescription for steroids just in case his asthma becomes a problem over the weekend. He has a loud argument with the receptionist insisting that he has an appointment and besides he thinks his problem is urgent and he needs to see you now. He now looks sullen because he feels he has been spoken to disrespectfully.

It’s close to lunchtime and you are hungry. You have a headache and you are hoping to receive a text from your partner who finds out if his job interview was successful. What now?

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Is this something for today?

How your customer, client or patient responds to your advice, offer or recommendation will depend on factors that may have nothing to do with how these are presented to them.

Susan sat bolt upright glancing at her watch. Although she had only been waiting for ten minutes she was becoming irritated as she was keen to get away as soon as possible. It would be a long day ahead. The staff meeting was likely to be challenging. There was talk of redundancies. She wasn’t sure if her department would survive the purge. It had been a bad start to the year, the sales figures were down at least thirty percent and the company had appointed an external consultant to determine what should be done urgently. She was interviewed last week and she wasn’t sure if the consultant would recommend keeping her section open. Over the past six months she had been drinking more, the glass of wine with dinner was now two glasses. She was also snacking more during the day and the doughnut on the way home which had been a Friday afternoon treat were a daily habit. She was aware that her weight was becoming a problem but right now she just wanted to get through this nightmare. She didn’t come to the doctor often but she needed a script. She had argued with the pharmacist but he was adamant that he would not supply the steroid inhaler without a prescription. Finally the doctor summoned her through and noted that she was much heavier than he remembered. 

What happened next ……your call.

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Let’s do it my way this time

Occasionally your customer, client or patient will come with their mind made up. Nothing you will say will make a difference to what they feel they need. In healthcare if what they want is going to harm them you will be duty bound to refuse just as you might refuse to serve alcohol to a drunk. But occasionally it may be difficult to argue.

Just one other thing, doctor, I need this wart burnt off.

Her doctor noticed the simple wart on her finger.

How about we try something that might be just as good? How about you try taping banana peel on this every night for a week. It will be far less uncomfortable and you might be surprised that the wart will just fall off.

Sure doctor. But today can we just burn it off and then if it comes back we might try the banana?

Picture by Marco Verch