CEO: Use effective listening, observational and communication techniques in all professional interactions.
There are many words that become a part of your vocabulary as you journey through medicine. Words such as disposition, SNF and consult become so common place we don’t often reflect on what they mean.
One word that I have often reflected on throughout medical school is the word Team.
Who are the members of the team? What are their roles? What does it mean to be on a team?
With each new rotation I have endeavored to discover what it means to be a helpful member of the team. During my 3rd year psychiatry rotation I tried to determine the anatomy of a good team. First, who are the members of the team. During my inpatient psychiatry rotation this included the attending, resident physician, nurse practitioner, social worker, medical student and patient. Before starting the rotation I thought the most important team member would be attending, being the most senior in knowledge, the “teacher”, and the arbiter of grades. However, as the rotation progressed, I learned that the most important member is the one that everyone forms the team around, and that is the patient. The patient is the greatest asset to the team because they provide the information for history upon which a diagnosis is built and for me the patient did the most teaching. From the patients I learned about the symptoms of psychiatric conditions and side effects of psychotropic medications. Additionally patients taught me about the human condition and how psychiatric conditions affect every aspect of persons life. My psychiatry rotation helped me to appreciate the value of interdisciplinary teams and to consider what I can learn from all the professionals on the team.
Below is my evaluation from my month on inpatient psychiatry.
Determining the role of the team members, and particularly your role as a student is the bane of clinical rotations. During my EM rotation of 4th year this rang more true than ever. With every shift I had to outline my Attending, the PA/NP and the nurses that would form my team. Once the team was determined I had to learn everyone’s role and then asked to be assigned my own. During my EM rotation my role focused on collecting a good history and physical on patients and then following-up on my patients until they were discharged or admitted. During my first few shifts I had not yet learned my role. I often found myself waiting to be assigned a patient or to engage in a trauma. Being able to receive feedback at the end of each shift really allowed me to improve and to own my role as the month continued. With each shift I learned to ask for tasks to be assigned to be such as completing pelvic exams, putting in IV lines or venipuncture. My taking initiative and then properly completing assigned tasks I was able to be entrusted with more tasks that were within my areas of interest (i.e. women’s health and psychiatry). As I have reflected on this rotation there were so many lessons that are applicable for me as I transition to being a resident, specifically being aggressive about outlining my role and taking on responsibility during every rotation.
During my EM rotation I also had the privilege to work briefly with another type of team. I spent a day working with the EMS as part of a medic ride along. This team experience highlighted to me what is means to be on a team. My day with the EMS of Station 7 was filled with adventure, camaraderie and learning to appreciate the scope and depth of the work done by these officers. I was excited to work with the medics and learn how to manage urgent and emergent medical conditions. However, I was worried I would not be of much help to my team outside of shadowing. My day fortunately surpassed my expectations. One thing I enjoyed about my day and learned from the EMS was the importance of community and treating everyone with respect. Throughout the day I felt comfortable asking questions, offering my help and also engaging with the patients. I was able to help with getting a POC glucose on every patient we saw and also transporting the patients into the hospital. This was a great experience and the highlight of my EM rotation. As someone going into FM I felt that many lesson were learned that can be applied to ambulatory medicine, primarily what it means to be a part of a team and how to treat your other team members with respect.
Below are some photos from my ride along (all EMS officers agreed to be in the photos):
My goal as a resident is to be a reliable and amiable member of every team that I work on. I aim to keep the patient as the central focus while also considering how each player (whether physician or other professional) plays into that team running smoothly. And finally I hope to keep the camaraderie and respect that I saw the EMS officers show as central to my interaction with all people.