Day 1 Reflection

The story of Lewis Blackman was very effective in showing how important communication is. As a peds resident, I watched the whole video looking at all the errors made from the resident perspective, but when listening to others comments, I heard nurses looking at it just from the nursing view and you realize in any medical error, each profession looks at what they could have done better and it seems that we are always hardest on ourselves in the situation. That ties into Jack Gentry’s story, that admitting your fault helps deal with our own turmoil we experience after the situation. So many times the hospital wants to protect their financial responsibility but in the end, things can go a lot smoother when you are upfront with the patient and their family. Listening to Jack Gentry’s story, I thought if that was my family member I would have been so… Continue reading

Day 1 Reflection

As a first year medical student, I was always taught to not “chase the zebras.” As we were trained to think of broad differential diagnoses, we were also taught to not get locked down on a rare disease. However, today during the Lewis Blackman video, one piece of advice they gave was to always ask yourself, “what’s the worst it could be?” It is part of what it means to have mindfulness – the ability to reevaluate your prior diagnosis and double-check or second-guess yourself. I agree that asking what the worst possible outcome for the patient might be will more likely ensure higher quality care for the patient, but what if the worst possible outcome is the zebra? Am I supposed to be a physician that always assumes the patient has the super rare disease, or to go with the most likely disease? As I reflect today, I… Continue reading

Day 4: Good-bye

Farewells are always hard for me, to the point that I avoid them as much as possible. As we wrap up Telluride Napa 2018, I reflect on the lessons we have all been exposed to over the last four days and what I will bring back to my home institution. Some talks were so powerful that I feel that I cannot forget how they inspired me. I am glad to have made a new family, with whom I will be bonded and always be able to reach when I have issues undertaking the overwhelming obstacle of changing the healthcare culture. I also will not forget the happy moments and laughs we shared both within and outside of the classroom. This experience was incredible and I will recommend it to my junior residents when I return home.

Dance, Dance

I had many conversations with my fellow med students about what going home would look like for us. We saw the ideas the residents had for their QI projects and what improvements they would like to make at their institutions, but our conversations looked different than the resident’s. Although fascinated with what we had learned, we just weren’t sure where to go from here. Something Dave said in our final reflection really helped solidify the whole week for me. He said something along the lines of “Medstar didn’t do this overnight. You aren’t expected to either. Do what you can today.”

It can feel overwhelming when you are bombarded with so much information all at once. You see success, and you want to share it, but it can be near impossible to implement all the programs etc all at once. Culture changes are not instantaneous and trying to do it… Continue reading

Meraki: Heart + Medicine

 

“meraki [may-rah-kee] (adjective) This is a word that modern Greeks often use to describe doing something with soul, creativity, or love — when you put “something of yourself” into what you’re doing, whatever it may be.”

Translating the Untranslatable, NPR—

What does it mean to practice a whole-hearted version of medicine?

Over the four days I spent at Telluride, the idea of full-hearted-ness came to me over and over again. I could see it in the looks of concentration and dedication in the residents, nurses, and medical students. I could hear it in every talk that told an important story or illustrated a new point. More than anything, though, you could feel it—feel the deep, deep importance of what taking care of patients in the best way possible meant for everyone in the room.

This long-lost word popped up: Meraki. To put a “something of yourself” into… Continue reading

Rookie climbing and patient safety

After a week at the patient safety conference, I’ve been given a lot to think about. Throughout the weekend, I reflected on my experience – from human factors to just culture, from care for the caregivers to root cause analysis there has been something that stuck with me though each session. It comes back to the video that we watched at the start the conference with the dancing man and his first follower. One of the things that we didn’t touch on in our discussion was role of both enthusiasm and encouragement in movements.

When watching that video, the dancing man’s energy and moves were breaking the status quo and his follower came in and matched that energy. If the follower had less conviction or started dancing in a mocking way with the shirtless dancing man, I doubt the ‘movement’ would have been successful.  

This weekend, I went and… Continue reading

Reminders

On the final day of orientation, I was given a single sheet of paper. We had spent the week learning about this exciting journey ahead of us, but also about the difficulties we would face. Over the next four years, we would be faced with both external and internal hardships that would put our bodies, minds and spirits to the test.

Instructed to write a letter to myself that would be given on graduation, immediately I knew what I would write to remind me of the reason I took this journey in the first place.

I had just started working in the ED /Urgent Care as a scribe. That particular night I had been working with a nurse practitioner maybe 2 weeks into starting this new job. At the time, I had no interest in the medical field. Yeah, the stuff we saw was interesting, but having been pushed by… Continue reading

Monkeys (Day 2)

I wanted to take a moment to think about our conversation on the central line removal case. We’ve spent time talking about how systems are perfectly designed to give the results they produce. So when we consider the central line case, a systems based approach would say that not having standardized protocols would be one of the primary factors in the outcome that resulted. Going off of that, I appreciated that our discussion was based on identifying the faults we found in the system rather than asking what the intern did or did not do leading up to the events. Saying “this error occurred in part because the documentation on heparin had not been added to the chart yet” is vastly different than saying “this error occurred because X person had not added it to the chart yet,” and I appreciated that the first phrasing was used by most people… Continue reading

Can a conversation change an outcome?

Can a conversation change an outcome? Can it save a life?

It’s been two days- two days worth of raw emotion, in depth conversation, and self reflection. The last two days with my fellow academy members and faculty have been nothing short of eye opening. I’ve found myself overwhelmed by a number of emotions including anger, empathy, pride, and sympathy. I’ve found myself reflecting on my own nursing practice and life experiences, and it’s been a very moving thus far.

Today, we discussed the importance of informed consent and shared decision making. After seeing the Michael Scolnik film, I began thinking about a time that my own life was affected by informed consent. When I was 2, my younger sister Danielle was born. My parents told my brother and I that she suffered a “broken heart.” Shortly after her birth she was diagnosed with transposition of the great vessels, and… Continue reading

Day 3: INSPIRE

I was asked to reflect and understand why I came to Telluride. This experience, while a great honor, took a lot of planning. Hearing opinions from prior alumni, composing a personal statement, obtaining leave from residency duties, planning the trip… Of course the opportunity to be exposed to such great lectures, experiences, and atmosphere speaks for itself and I am so grateful to be a part of this conference. But I also realize that the why I wanted to come here is the what I wanted to bring back.
I teach many of the patient safety education series to my emergency medicine residency program. Not only have I witnessed my fellow residents tune out, answer text messages or close their eyes, but they have also bluntly told me that the lecture was a ‘waste of time’ or ‘boring.’ While I hope this doesn’t reflect my teaching and engagement skills, I… Continue reading