Friday, April 02, 2010

up to the challenge

embarking on a journey
i woke up with renewed energy today. i really meant what i posted yesterday -- and i feel ready to get out of the rut i've been experiencing lately and work on overhauling my overall mindset.

searching for some inspiration, i cracked open gretchen rubin's the happiness project. only a few pages in, i had an immediate positive reaction to her voice and what she has to say about happiness -- and life. while we have slightly different backgrounds and exist at different points along our own journeys, there were things she wrote about -- even just in her introductory chapter! -- that sounded like they came STRAIGHT out of my own head. it was almost uncanny.


i don't have a specific plan of attack for the next 49 days -- not yet, anyway. but i think the countdown itself serves a purpose, in terms of reminding me of how short life really is, and yet how much can be accomplished when projects are tackled just one step at a time.

one thing i do want to do is to go back to using my page-a-day miniplanner to set [realistic!] intentions/goals for the day AND also to acknowledge some of the things i am thankful for: both little and big things that make life great.

i'll share some of these pages once i have my system more underway. yesterday's props went out to:

warm sunny days
podcasts
extended family

today
i get to kick it up a notch and work on bringing the principles in my manifesto to work. the busy setting of the ED on a friday night? a challenge, to say the least. but i will do my best to practice patience and find a good flow. two specific things i am going to try to work on are:

being present in the room as i go to assess each patient. of course, the ED is all about multitasking -- you nearly always have 4-5 rooms 'going' at once. as in: while i go see a 2 year old with possible ear infection in room 1, there's an ortho consult pending for a broken leg in room 3, a baby with labs pending to determine need for further workup in 5, a psych patient hanging out waiting for placement in 8, and an asthma exacerbation between albuterol nebs in 10.

this model demands efficiency and constant 'running of the list' -- ie, checking to see what's going on with everyone at regular intervals. however, this doesn't mean that your mind needs to actually BE in a million places at once. when i'm seeing the 2 year old, i can just see the 2 year old and the rest will be waiting for me when i exit that room. of course, anything truly emergent gets first priority, so interruptions happen (and are to be expected).

but really, even though you have to switch gears frequently, in each moment, you can only take care of one patient at a time. i am going to aim for this kind of focus tonight.

taking it as it comes. things i generally don't like in the ED: traumas, anything MESSY/procedural, patients who come in thinking that TONIGHT is the night when their mystery diagnosis will finally be made. i would like to handle these things tonight without the sense of panic/dread/overwhelmed-ness that typically arrives when i see these things pop up on our board.

why don't i like these things? because they're difficult. either due to lack of experience (traumas + procedures), or just intrinsic qualities of the problem (super-complex patient, psychosocial issues, and the like). i've mentioned that i've felt sort of 'over' residency -- but things that are challenging should really just be reminders that there is so much more to learn, and this is my chance.

part of what makes these situations difficult is that it's uncomfortable to feel like you don't know how to handle things. but i need to remember that i don't suck, and having weaknesses in certain areas is normal and okay. we DON'T get tons of experience with lacerations or traumas -- why should i think that i'm a failure if i need some help dealing with them?

i want to work on accepting this -- and just diving in and doing my best with these tougher things. maybe getting rid of the panic/dread factor might actually make them easier? we'll see . . .

restaurant review: thursday night getaway
i had yesterday off! my schedule is pretty decent right now in that the night shifts are in strings of 3-4 -- enough to get in a groove, but with time to recharge. josh's aunt and uncle were in the general area visiting family, and we headed out on a little mini-weeknight-adventure to meet up with them in neighboring winston-salem (about 70 minutes away).

we met them for dinner at river birch lodge. disclaimer: this restaurant is owned by josh's step-cousin! i've never been to a restaurant owned by someone i knew before, so this was really cool.

we had been hearing about the lodge-themed restaurant for years and had always wanted to try it. it completely lived up to our expectations -- and then some! even if we weren't quasi-related to the owners, i would recommend it wholeheartedly and would go back. it would be especially convenient en route to charlotte, so i'm sure that we eventually will.

the outside was impressive! a fully-realized lodge hanging out by a little strip mall in NC . . . not a common site.


the inside was even more dramatic. every detail was in place, from these awesome-looking chandeliers to the woodpaneled walls and cozy fireplaces.


the menu was different and fun -- there were delicious looking salads, sandwiches, and burgers (elk + bison!), along with more traditional entrées -- many featuring different game meats and fish. i started with a glass of sonoma pinot . . .


and enjoyed a crusty roll. the bread tasted straight-out-of-the-oven and i liked the unique shape.


for my entrée, i chose the smoked salmon salad -- and i chose well, if i do say so myself, for the warm summer-like evening we were having. the dressing was bright and lemony and the bed of arugula was crisp and laced with pine nuts and red onion. loved it -- both for the flavors and the fact that it was made up of fresh, whole foods!


josh had trout wrapped in bacon. i had a bite and it's true -- everything is better with bacon. in moderation, of course.


we split this coconut creme brulee for dessert -- a perfectly smooth and sweet ending.


the conversation flowed nicely and it was fun having a family gathering at the restaurant! then, thanks to my night-owl ways this week, the drive home was no problem. another plus to these evening shifts.

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4.1.10

workout: since yesterday was my 'weekend', i did a longer run. 10 miles out in the 78 degree heat -- RealFeel of 90! this definitely dropped my pace -- average 9:14/mi, and i'm actually surprised it wasn't slower. i took an extended water break midway through, too.

reading: 15 PREP questions. i'm happy to welcome studying/learning back into my life! i feel so much better about myself when i do the things i know i should be doing for my job.

6 comments:

inmytummy said...Best Blogger Tips[Reply to comment]Best Blogger Templates

Sounds like a good book. I'll have to check it out.

I like your course of action for the ED. Go into it with a positive outlook, but even if it doesn't end up going as smoothly as you wish, it's not a reflection on you. I think that your experience is a learning one and you are always going to be learning to be a better doctor no matter how much practice you've had.

Once again, I am leaving comments that don't make much sense.

runsarah said...Best Blogger Tips[Reply to comment]Best Blogger Templates

Not a big fan of those parts of the ED myself. I generally hate procedures and try to tell myself I am a bad at them but realized that it is setting myself up for failure. I recently finished my anesthesia rotation and am feeling a bit more competent - still need to work on peds IVs when the patient is awake though, it's infinitely MORE challenging! Sighs.

marathonmaiden said...Best Blogger Tips[Reply to comment]Best Blogger Templates

i love your mindfulness on how to tackle the ED. i think those two focuses (foci?) are hard no matter what they're being applied to!

feetinmotion said...Best Blogger Tips[Reply to comment]Best Blogger Templates

you're so adorable and I definitely plan on checking out that book!!

Anonymous said...Best Blogger Tips[Reply to comment]Best Blogger Templates

I'd love to hear how you apply the happiness project ideas to your own life.

it sounds like you have a "sense of urgency", which is a wonderful awareness to have, because I think we all acknowledge that life could change in an instant (i am sure you see it all the time in your line of work), and therfore it's almost a DUTY to live life in the moment and to the fullest, while we can.

Ada said...Best Blogger Tips[Reply to comment]Best Blogger Templates

As someone who hopes to become an emergency room doctor, it's really interesting to hear your take on the various cases and your likes and dislikes about working in such a chaotic environment.

Your meal at the restaurant looks great, I'm glad you had a nice evening and I hope you have a nice weekend:)

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