A Story of Frustration and Despair…and then a Flicker of Hope

We just concluded another great week of learning and inspiration at the Telluride East Patient Safety Summer Camp held at Turf Valley Resort in Ellicott City, MD. Educational discussions led by Anne Gunderson, Rosemary Gibson, Paul Levy, Wendy Madigosky, Patty and David Skolnik, Richard Corder, Rick Boothman, Tracy Granzyk, Kathy Pischke-Winn, Gwen Sherwood, Lisa Freeman – some of our wonderful faculty who gave their time to “Educate the Young” on the importance of Patient Safety, Transparency and Patient Partnership. There were so many great student and resident reflections during the week but one written by Mona Beier captured both the frustration – how the current educational system is “beating down” and desensitizing our next generation of caregivers – and a flicker of hope that they still may be able to salvage the caring spirit they entered their training with…that same caring spirit that will guide them to deliver safe, high quality, patient-centered care.

Realizations

First published August 3, 2014 on Telluride Summer Camp blog | By Mona Beier

First of all, I have to say this will be my first ever blog about anything….so here goes nothing….I have to say these past few days have been eye opening, and dare I say, life changing. I went into the conference not knowing exactly what to expect, but at least thinking that I knew something about patient safety and quality improvement. What I have realized is that my idea of PSQI was so unbelievably superficial. Everyone at the conference has opened my eyes to see that through everything we do in PSQI, it is ultimately for the better of our patients. Maybe because we are all required to do PSQI projects at my institution, I feel that it was always presented to us as how to make YOUR life easier and less frustrating, instead of the patient. Maybe they felt we would only be motivated if we felt we were helping ourselves in some way. These talks, stories, reflections have all made me take a step back and realize what it is all about: our patients. It makes me really sad that in the very little time I have been in training that I have completely lost sight of that.  There is really no excuse for that. I could blame exhaustion, long hours, too many patients in too little time….but at the end of the day, there is no excuse for not putting our patients as our number one priority.

I have had some really negative realizations of myself during these past few days. I hate to admit this, but during a lot of the talks and the videos, I saw things that I had done, and I have seen my colleagues do time and time again. It is almost a daily occurrence that I hear people labeling patients as “high maintenance” if they ask questions about their healthcare or if they “challenge” our decisions and our actions. Instead, we should be celebrating this and saying thank you to them for taking an interest in their own health care. I have replayed imagery in my mind about how many times I have rushed through explaining informed consents, or felt hurried to get histories and physicals because I have 48392 other things to do (seemingly). Or, how many times I have interrupted and not listened. Instead, I should be finding other ways to make my day more efficient so that I will have more time with my patients. Or, maybe I stay an extra 30 minutes a day so that I have that extra 5-10 minutes with patients. Sometimes, a few more minutes can make all the difference. I have thought about times when I have anchored, or had premature closure of patients I was taking care of—and it wasn’t until they were not getting better or something was going wrong that I ever stopped and thought that, hmm I could be wrong or that I was missing something. The talks at the conference have made me realize that I should be doing this every day–stopping, taking time to think–and say, is this what’s going on? what would be the worst thing that I could miss? should I go back and get more history? does this make sense? Moreover, I thought about times when something actually did go wrong–when patients on my team have gone to the ICU or have died. I tried to replay in my mind,  and again, I saw myself saying “oh, they were very sick”–almost trying to justify it to make myself feel better. Being here these past few days is going to make me view this completely differently. I am going to take the time to think about what happened when things went wrong. Was it preventable? Was there something else we could have done? Why did this happen in the first place? What were the series of events that led up to this? Did I call the family? And more importantly, was my conversation meaningful with the family? Did I address their needs and reassure them? Was I there for them like I would want someone to be there for my family member?

Anyway, I could go on and on. There are a lot of other lessons I have learned. All I really know is that I am walking out of here a better person than when I came in. This conference has inspired me to take a deeper look into who I am—what kind of physician I want to be—and what kind of person and role model I want to be to my peers, my patients, and really everyone in my life.  I am inspired to try and break the mold of the culture we have grown so accustomed to—the culture where everything seems to be about me–and remind both myself and others that is not why we are here.