----- Original Message -----
From: "Robbie Coull"
Subject: Re: Burnout at the Coal Face
> I can no longer remember the passage by heart, and don't have a copy to
> hand, but it deals with the idea that life IS repetition. Almost every
task
> we perform is repetitive (breathing, walking, working, sleeping etc.). We
> all strive to avoid it, but in fact we will never be truly happy unless we
> can learn to embrace, even enjoy, the repetition in life.
>
> I've found this very useful - much of GP/A&E is seeing 'sore throats',
> 'twisted ankles' and other common conditions. It's normal to become
> irritated and bored by these cases. But by focusing on the rewards of
doing
> small things well, and by immersing oneself in the 'rhythm' of these
> repetitive cases, it is possible to enjoy them.
You're quite right Robbie (GPs are always one step ahead of us when it comes
to touchy-feely matters!). I too enjoy the simple repetetive cases, largely
as they're "no-brainers" which provides a welcome rest between the really
challenging cases. This also allows me to simultaneously enjoy the more
"social" aspects of our cases. GPs testify how important this is to their
careers, and they enthuse about continuous and holistic patient care.
Conversely we enjoy a wide variety of fascinating people, especially in a
place like London, where you can get a real "window" into urban life while
you're examining someone's fifth metatarsal on autopilot. I'm always amazed
at how my SHOs never pick up these social subtleties, probably as they're
still stressed by the prospect of missing that fracture! At the end of the
day, in this business it does help if you're interested in people, and while
it's not possible to like all of your patients all of the time, it helps if
you can at least like some of them some of the time.
> However, I think it is much more likely that it is the PACE at which these
> cases are seen at that is the problem.
>
> It's the feeling of being 'out of control' (as someone else mentioned) and
> 'overwhelmed' or 'overrun' that indicates that you are working above your
> rated capacity (and this varies from person to person, and within
> individuals at different times).
Unfortunately this too is so relevant to emergency medicine. I can enjoy my
social interactions only when the department is well under control, but
sadly most of the time I'm reduced to being monosyllabic, which isn't
pleasant for either the patient or for me!
Adrian Fogarty (still not being very academic either)
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