I recently completed my night senior rotation—it’s one of the few times in pediatric residency where residents can function fully autonomously, without a full team, attending, and all the resources that are present during the day. While adjusting to a fully nocturnal schedule for several weeks can be difficult, there is a lot of personal growth that happens during those few weeks. Being alone in the hospital overnight is an interesting experience—it is less insulated, and the “system” as a whole becomes more obvious. I wouldn’t say that errors tend to occur more overnight, but being the primary person responsible for my team made me question things more. I approached each problem that arose with a higher level of scrutiny—wondering how it happened, if I missed something, and if it could have been avoided. I dealt with many patient safety issues —from patients being escalated in support shortly after being admitted, to medication administration errors, to patients being inappropriately admitted to the floor service.
Though I was able to address each problem on an individual patient level, I wanted to be able to approach it from a more holistic viewpoint, that would truly address the root cause. There are many “why” questions that we often don’t get a chance to reflect on in our day-to-day work. Many practices and protocols are simply accepted, though they may not be the best for patient care. As I enter into my last year of residency, I know my role in patient care will evolve, and there will be more expected of me—by both my patients and team. I believe the Telluride Experience will prepare me to take on a more active leadership role, advocate my patients, and allow me to identify flaws and inefficiencies in how we provide healthcare to our patients, and offer solutions.
I have a particular interest in provider documentation and how it affects patients’ transitions of care both within and outside the hospital, and patients’ understanding of their own illness. I often think we as healthcare providers overestimate our effectiveness in explaining to patients their hospital course, medications, and discharge instructions. I am excited to gain a new skill-set and framework at the Telluride Experience to help me in my current research pursuits.