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Wellness Section Newsletter - August 2012

circle_arrowWellness Newsletter Announcements - Wellness Section Newsletter, August 2012
circle_arrowFrom Your Chair - Wellness Section Newsletter, August 2012
circle_arrowWhy Do We Communicate? - Wellness Section Newsletter, August 2012
circle_arrowThe Skills of Communication - Wellness Section Newsletter, August 2012
circle_arrowWe Speak In Code - Wellness Section Newsletter, August 2012
circle_arrowThe Surgeon Who Yelled Too Much: 6 Ways Physicians Yell and How You Can Help Stop It - Wellness Section Newsletter, August 2012
circle_arrowAttend the Sections Showcase during Scientific Assembly in Denver

Wellness Newsletter Announcements - Wellness Section Newsletter, August 2012

 

Make Plans to Attend the Wellness Section Annual MeetingSA2012DenverLogo at Scientific Assembly!

Wellness Section
Date: Tuesday, October 9, 2012
Time: 4:00 pm – 5:30 pm
Where: Hyatt Regency Denver (HQ Hotel)
Room: Capitol 1, 4th Level

Elections for Section Officers

This is the year to elect a new team of section officers for the Wellness Section. We will be electing a Chair-Elect, a Councillor, and a Secretary/Newsletter Editor. If you are interested in helping to direct the future of the section in the upcoming years, please email me: Lori Weichenthal or Marilyn Bromley. Watch the elist for further announcements on section e-voting.

 

Fall Wellness Newsletter

The Aurora, Colorado tragedy has brought to the fore the difficult work that we do every day and the witness that we serve to human suffering. In our next newsletter, we will discuss how working with victims of violence impacts our work and our personal lives. If you have stories to share, please send them to Lori Weichenthal.

 

Wellness-Related Items of Interest During Scientific Assembly

Wellbeing Committee
Date: Monday, October 8, 2012
Time: 4:00 pm – 5:30 pm
Where: Hyatt Regency Denver (HQ Hotel)
Room: Capitol 3, 4th Level
Parents with Infants Lounge
Date: Mon-Wed, October 8-10, 2012
Time: 8:00 am – 5:00 pm
Where: Colorado Convention Center
Room: Room 202

Meditation Room
Date: Mon-Wed, October 8-10, 2012
Time: 7:00 am – 5:00 pm
Where: Colorado Convention Center
Room: Room 204

Guided Yoga will be available from 11:15 –
noon in the Meditation Room

Alcoholics Anonymous and Narcotics Anonymous meetings will be held at the Convention Center on Monday and Tuesday morning. Please check the on-site schedule for meeting locations.


From Your Chair - Wellness Section Newsletter, August 2012

Lori Weichenthal, MD, FACEP

Weichenthal510The “dog days” of summer have settled into the central valley of California where I live and I know that the heat is on in much of the country. I hope that you all are finding ways to stay cool and well. We decided to make communication the focus of this newsletter. You may ask why? Aren’t we all more connected than we have ever been? We can text, twitter, tweet, Facebook, email and stay in constant states of connection 24/7. But does all of this electronic messaging actually equate to communication? Just yesterday, I sent two text pages to a consultant and never heard back. Did she never receive the page? Did she receive it and decide to ignore me? Did she receive it but she is not the person on call and thus her pager is in the kitchen drawer at home?

As is discussed in the Skills of Communication, in order to truly be communicating, we must send clear and concise messages and someone must correctly hear and understand the message we are sending. This is much easier to do face to face and remarkably, the majority of what we communicate does not require words at all.

In Why Do We Communicate, we discuss all the reasons that we engage in the art of communication and what we are seeking to accomplish.

In addition, we are happy to share some articles by Rick Winters, MD, MBA, a section member who is a practicing emergency physician, Chair of his EM group, and president of his hospital’s medical staff. He is also an executive coach for physician leaders and has much to share regarding the challenges of communicating in our complex work environment. If you enjoy his articles, I recommend that you visit his website at www.richardwinters.com for more helpful information.

Finally, we are looking forward to directly communicating with you all at our annual meeting in Denver, CO. If you are coming, please check out all of the lectures related to physician wellness. In addition, the wellness booth will be up and running inside the exhibit hall; and there will be a daily meditation practice in the morning and yoga practice offered during the lunch break (11:15-12:00) by section members trained in meditation and yoga. Our section meeting will be on Tuesday, October 9 from 4:00 pm - 5:30 pm at the Hyatt Regency Denver, Capitol 1 room, 4th level. We will have a business portion of the meeting but will also be offering an exciting wellness activity that we will announced soon. If you will be in Denver, we look forward to interacting with you.


Why Do We Communicate? - Wellness Section Newsletter, August 2012

Lori Weichenthal, MD, FACEP

We are constantly communicating. It may be through speaking, writing, texting, gesturing, or any other number of methods. Even if we try to avoid communicating we are sending a message. Many of us have experienced “the silent treatment” which no doubt is a powerful method of communication that requires no speech, facial expressions, or other action. Most of these interactions, verbal or silent, have a purpose.

We use it to give or provide information. On a basic level, we communicate our plans i.e. when we are going to the store, for what, and when we plan to return. Providing this type of communication is good for relationships. At work our patients provide us with information regarding their symptoms and we provide them with information regarding their diagnosis and treatment.

Another reason to communicate is to obtain information. We might need directions to a particular place or wish to obtain information regarding use of a particular computer program. At work we often need to obtain specific information from others to help us care for our patients. We question the paramedics to obtain details regarding the mechanism of an accident and about the victims involved.

Communication is used to persuade. Every advertisement on TV is trying to convince us to buy or use a particular product. In this election year the political advertisements are filled with verbal and nonverbal forms of communication to sway us to vote for a particular candidate or a proposition measure. Take note, as there may be some forms of communication that you can use at work to persuade your consultants to admit your patients!

Finally, communication is used to express our emotions. This is often a very spontaneous interaction which includes facial expressions and gestures as well as words. You can imagine the forms of communication involved and the effect of a message that tells the kids that there will be no family vacation this summer. On the other hand, there is great ease in the telling and jubilation in the receiving of the information that a winter trip to Disneyworld has been planned. Emotions in the emergency department can be intense and we are constantly interpreting cues from patients, family, friends, and co-workers. We experience those who are distraught, anxious, dying, angry, impatient, and every other emotion. Just thinking about it will make you tired because, at our best, we must be master communicators, both in the messages we send and in the experiences we share and receive.

Take some time to think about why and how you are communicating-at home as well as at work. Pay attention not only to the words that come out of your mouth but to the tone of your voice and your body language. Think about what message you really want to send with your words, intonations and gestures. Some awareness and small adjustments can make you more effective in connecting to your family, patients, colleagues and others who are important to you.


The Skills of Communication - Wellness Section Newsletter, August 2012

Lori Weichenthal, MD, FACEP

I am going about my business during a very busy shift in the ED when a colleague from another department pulls me aside to share his impressions of one of our EM residents. My first response is two-fold: I am too busy to deal with this and I don’t really want to hear what you have to say. Then, I take a deep breath and remind myself that this is my job; whether it is listening to my patient, a family member, a colleague, or another member of the health care team, communication, both sending and receiving, is a major part of what I do.

So, what does it take to truly communicate? Multiple studies show that, first, someone must send a clear and concise message and, then, someone must hear and correctly understand the message that that person is sending. This may sound simple but all of us that communicate with others on a daily basis know that it is far from simple.

When we send out a message, we need to be aware that what we say is only a small part of the message that we send. In fact, how we say it and our body language is far more important. Multiple studies have shown that nonverbal messages account for over 55 % of what is communicated in an interaction.

For a message to be communicated effectively it must be: Brief, succinct and organized; free of jargon; and designed to not create resistance in the listener. It is important to identify the key issues quickly and to not ramble or those you are speaking with will lose interest. It is also important to frame issues in a positive manner. There is a big difference in the response that you will receive if you tell your colleagues “you all are dismal at documentation and I don’t know what you are thinking” versus “I know that documentation is a difficult part of what we do but we need to look at ways to improve so that we can communicate better with our consultants and also receive the reimbursement we deserve for the work that we do.”

Even if we are the best “smooth talkers” we have to remember that much of what we say is non-verbal. This includes our facial expressions and our body gestures. Our facial expressions are probably most important and also the most difficult to control. How we hold our bodies; in disinterest (crossed arms with no eye contact) versus openness (arms at side, chest open with direct eye contact) are important. Our vocal intonations, whether abrupt, rapid and high pitched, or slow and disinterested, all sent a message.

Finally, for true communication to occur, someone must be listening. They must not only hear your words but interpret the non-verbal messages that you are sending. To do this, the listener must give full physical attention to the speaker and be aware of non-verbal messages. They must also pay full attention to the words and feelings that are being expressed.

Thus, only if both parties are fully engaged in the process of creating an interaction can true communication occur. Can this occur through electronic media? Certainly. Is it most effective and enjoyable in person? I believe so.


We Speak In Code - Wellness Section Newsletter, August 2012

Rick Winters, MD, FACEP

We use the same words. We mean different things.
The same words mean different things.

For example, in the hospital we talk of whether we are “fully staffed,” “overstaffed” or “understaffed.”

Fully staffed.

What could they mean when they say “fully staffed”?

• All of the scheduled shifts are assigned.
• Nobody has called in sick.
• We are on budget.
• I like to hear the sound of my own voice.
• We were never in over our heads.
• There is no wait.
• There was the correct number of patients to staff.
• I don’t know how to get more staff.
• There is a balance of patient sickness to staff ability.
• Our staffing is comparable to similar hospitals.
• I go home on time and have all of my breaks on time.
• That is one well-equipped wizard.

“Fully staffed” may mean all, none, or some of the above. It depends on your point of view. The specific meanings of your words depend on your life experience.

Translate

We speak in code. Our words translate our point of view. Our words are shortcut interpretations of our life experiences. “Fully staffed” is code.

Decipher the code in conversations to get to productive outcomes. Clarify the words and their specific meanings.

• In what way are we “fully staffed”?
• How specifically are we not “fully staffed?”
• When are we “fully staffed?”
• What does it mean to you to be “fully staffed?”

Then have a more cogent discussion.


The Surgeon Who Yelled Too Much: 6 Ways Physicians Yell and How You Can Help Stop It - Wellness Section Newsletter, August 2012

Rick Winters, MD, FACEP

The surgeon and I sat at the table.

“The nurses said you were yelling,” I explained.

“I never yell; you can ask anyone,” she coldly remarked with fierce eyes as she pounded the table to punctuate each [bang] word [bang].

She was right: She didn’t raise her voice. However, her piercing glare and table thumping would rattle all but the most modulated professional.

Try not to use the word “yelling” when describing an incident: It’s too vague and raises too many questions. It’s a messy word in our messy world of human interactions. You’ll be more effective if you can get to the root of what was experienced and be clear about what needs to change.

The Yelling Experience

People often use the word “yell” when they’ve felt intimidated. “He yelled at me.”

It’s key to understand that this intimidation is not just verbal; it is also nonverbal. It can be a loud volume or a subtle glance that taunts people to fight or retreat. When this occurs in healthcare, key information may be withheld to avoid confrontation, and the result to the patient can be tragic.

As physician leaders, we can use accusations of “yelling” to reveal to our colleagues key insights about how they are being perceived. We can unroof the emotions that lie beneath the “yelling” experience to effectively figure out what’s going wrong, and we can help improve it. But first, we need to stop using the messy word “yell,” and we need to get to the real experience of what occurred.

6 Ways That Physicians Yell:

1. The Mad Dog Look
“Are you eyeballing me?”
You know the look. Locked eyes. No blinking. Piercing stare. Furrowed brow. The intent is to melt the person with powerful eye rays, and it occurs with or without flashing gang signs. When physicians use the Mad Dog Look, they are intimidating, and they are “yelling.”

2. Pounding on the Table
Whoa, pounder. Stop the percussion. Every time you pound on the table to accent a negative word, you are “yelling.”

3. Interrupting
When physicians stop their colleagues in mid-sentence to disagree, they are interrupting. Controlling the conversation by speaking over them is, perhaps, “yelling.”

4. Personal Attacks
When physicians make disagreements personal, they say things like
• “Those nurses are all lazy!”
• “Why can’t you do it correctly?”
• “Your grandma wears combat boots and smells of elderberries!”
They are making personal attacks, and they’ll be perceived as “yelling.” It won’t help solve problems, and give my grandma a break.

5. Violate Personal Space
If you can feel someone’s breath on your nose, or their hand gripping your arm, let’s hope it’s consensual. Otherwise, the drill sergeant is likely “yelling.”

6. Raised Voice
Yes, sometimes “yelling” is when someone emphatically speaks in a loud voice. If you feel like you’ve been “yelled at,” you probably weren’t with someone shouting, “Go team!”

Investigating a Yelling
When you research the negative events, ask about the six forms of yelling to uncover the specifics of what occurred. The more detail you can get, the more helpful you’ll be to the physician accused of “yelling.” You’ll want to be able to paint the experiences of those involved in the most accurate manner.

Putting It Together
The surgeon and I sat at the table.

“I spoke with the nurses. They were concerned about a recent interaction they had shared with you. They experienced a number of things that made them feel uncomfortable and as a result they are afraid at times to call you to update you on your patients’ status. They felt that you had loudly made personal attacks by telling them that ‘they always call you about trivial things,’ you interrupted them when they attempted to respond, and you gave them a Mad Dog Look.”

In these situations, you’ll want to listen closely to the physician’s response, because as I wrote previously, you will lose your credibility if you pounce on the basis of an incomplete report. No doubt the physician’s experience was also negative, and you’ll want to be able to discuss her point of view with the other individuals involved. By addressing valid issues of communication and care, we can make the physician’s job and the patient’s experience better.

In my experience, by avoiding a simple accusation of “yelling,” by using a bit of subtle humor (“Mad Dog Look”), and by listening closely, you can help stop the yelling. Most individuals do not want others to experience them in a negative way. Most want to do a good job, and they want to take excellent care of the patient. You can help them find that insight.

Later That Day…
It’s time to put my daughters to bed.
I tell my six-year-old daughter, “Time to go to bed, honey.”
She screams, “Dad, I know! Stop yelling at me!”
And then there are those times when you’ve asked someone to do something that she doesn’t want to do. Yelling.

Things You Can Do Now
Read Nonviolent (Empathic) Communication for Healthcare Providers. It will teach you how to facilitate the flow of information so that you can help your colleagues work cooperatively and resolve differences effectively.


Attend the Sections Showcase during Scientific Assembly in Denver

 

Sectionsshowcase

Find your niche.
Build your network in Emergency Medicine. 
Visit the Sections Showcase!

Wells Fargo Lobby D, Colorado Convention Center
Tuesday, October 9
11:15 am - 12:15 pm

Underwritten by JDRF and the University of Florida, College of Medicine

 


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