Salam alaikum,
Much has been going on this past week in my head (& in real life ofcourse :p), specially since a journal dead-line is fast approaching & the time is neigh.
I was mulling over multiple speedy options including
telecommuting (which - unlike the general perception - needs a lot of freelance selfemployed selfdiscipline), specially when my dean will be on a hiatus, flying off to france pretty soon, only to return next month - inshAllah.
It was close to getting all overwhelming & before i'd freak out, I was provided with this nice read by my consort from one of her med handbooks & clinical training manuals.. & somehow it all made quite a relevant sense to me in these times, even though i've nothing to do with this field whatsoever.
Here goes the refreshing read;
On being busy: Corrigan’s secret door;
“
I work much better in chaos”..
- Francis Bacon.
Chaos is not always an enemy: certainly there is no shortage of it in hospitals, consulting rooms, and other battle-grounds.
Can we prepare ourselves to use chaos well? Being fore-warned allows us to be fore-armed, enabling us to adapt to being busy, or at least to wink at each other as we slide down the cascade of long hours--> excessive paperwork--> too few beds--> effort_reward_imbalance--> compromised care from too few resources--> trouble with superiors--> difficult patients--> too many deaths--> failure to reconcile personal and family life with professional roles.
Thus, Logistic regression shows our consequent problems are predicted by 5 stressors:
1 Lack of recognition of own contribution by others.
2 Too much responsibility.
3 Difficulties keeping up to date.
4 Making the right decision alone.
5 Effects of stress on personal/family life.
We may think that it is modern medicine that makes us ever busier, but doctors have always been busy.
Dr. James Paget, for example, would regularly see over patients each day, sometimes travelling many miles, on his horse, to their bedsides.
Dr. Dominic Corrigan was so busy 180 years ago that he had a secret door made in his consulting room to escape the ever-growing queue of eager patients.
We are all familiar with the phenomenon of being hopelessly over-stretched, and of wanting Corrigan’s secret door. Competing, urgent, and simultaneous demands make carrying out any task all but impossible: the junior doctor is trying to put up an intravenous infusion on a shocked patient when his ‘bleep’ sounds. On his way to the phone a patient is falling out of bed, being held in, apparently, only by his visibly lengthening catheter (which had taken the doctor an hour to insert). He knows he should stop to help but, instead, as he picks up the phone, he starts to tell Sister about “this man dangling from his catheter” (knowing in his heart that the worst will have already happened). But he is interrupted by a thud coming from the bed of the lady who has just had her varicose veins attended to: however, it is not her, but her visiting husband who has collapsed and is now having a seizure. In despair, he turns to the nurse and groans:
“There must be some way out of here!!”..
At times like this we all need Corrigan to take us by the shadow of our hand, and walk with us through a metaphorical secret door into a calm inner world. To enable this to happen, make things as easy as possible for yourself—as follows;
First, however lonely you feel, you are not usually alone. Do not pride yourself on not asking for help. If a decision is a hard one, share it with a colleague.
Second, take any chance you get to sit down and rest. Have a cup of coffee with other members of staff, or with a friendly patient (patients are sources of renewal, not just devourers of your energies).
Third, do not miss meals. If there is no time to go to the canteen, ensure that food is put aside for you to eat when you can: hard work and sleeplessness are twice as bad when you are hungry.
Fourth, avoid making work for yourself. It is too easy for junior doctors, trapped in their image of excessive work and blackmailed by misplaced guilt, to remain on the wards reclerking patients, rewriting notes, or rechecking results at an hour when the priority should be caring for themselves.
Fifth, when a bad part of the rota is looming, plan a good time for when you are off duty, to look forward to during the long nights.
However busy the ‘on take’ or 'on call', your period of duty will end.
For you, as for Macbeth:
'come what come may,
time and the hour runs through the roughest day.'
Riding the wave;
In Macbeth, toil and trouble go hand in hand, but sometimes we work best when we are busy. This is recognized in the aphorism that if you want a job done quickly, give it to a busy (wo)man. Observe your colleagues and yourself during a busy day. Sometimes our energy achieves nothing but our own inundation. At other times, by jettisoning everything non-essential, we get airborne and accomplish marvellous feats. As with any sport, we have to break into a sweat before we can get into the zone, where every action meets its mark.
But note that what keeps us riding the wave of a busy day is not what we jettison but what we retain: humour, courtesy, a recognition of the work of others, and an ability to twinkle.
A smile causes no delays, and reaches far beyond our lips.
In our public medical personas, we often act as though morality consisted only in following society’s conventions: we do this not so much out of laziness but because we recognize that it is better that the public think of doctors as old-fashioned or stupid, than that they should think us evil. But in the silences of our consultations, when it is we ourselves who are under the microscope, then, wriggle as we may, we cannot escape our destiny, which is to lead as often as to follow, in the sphere of ethics. To do this, we need to return to first principles, and not go with the flow of society’s expectations.
To give us courage in this enterprise, we can recall the aviator’s and the seagull’s law:
'it is only by facing the prevailing wind that we can become airborne, and achieve a new vantage point from which to survey our world.'
Our analysis starts with our aim: to do good by making people healthy. '
Good' is the most general term of commendation, and entails four cardinal duties:
1 Not doing harm. We owe this duty to all people, not just our patients.
2 Doing good by positive actions. We particularly owe this to our patients.
3 Promoting justice—i.e. distributing scarce resources fairly and respecting rights: legal rights, rights to confidentiality, rights to be informed, to be offered all the options, and to be told the truth...
4. Promoting autonomy.
Don’t think of good and evil as forever opposite; good can come out of evil, and vice versa - this fundamental mix-up explains why we learn more from our dissolute patients than we do from saints..
[...so on & so forth]
Source
~*~*~*~*~~*~*~*~*~
.jpg)
