Happy New Year everyone from all of us at CEMBooks. As we updated the website we’re looking to increase the output with meaningful posts. This post is from Dr Stuart Nuttall an Emergency Consultant in Leeds and a member of the CEMBooks team. Here he describes some reflections that he has had following shifts in his ED over the new year period. In what has been a challenging time for all of us nationally in emergency care.
Decision fatigue is real and well recognised in the Emergency department. The number of decisions is great – no wonder we feel stressed, anxious and overwhelmed at the end of a shift.
We try to treat these symptoms with even more distractions when we get home by drinking, over eating, binge watching and doom scrolling. Maybe it would be better to address decision fatigue at the point of impact and reduce the number of decisions we burden ourselves with when we leave a shift. This would create some separation and distance from these decisions. This can be done by simply writing them down. Do you keep a journal at home, or ever heard of the Bullet Journal method?
“Each decision until it has been made and acted upon is simply a thought. Holding on to thoughts is like trying to catch fish with your bare hands; they easily slip from your grasp and disappear back into the murky depths of your mind”. Writing things down allows us to capture our thoughts and examine them in the light of day. By externalising our thoughts we declutter our minds. Entry by entry we’re making an inventory of all the choices consuming our attention – the decision we make running the department throughout the day. It’s the first step to taking back control of all the thoughts and interruptions running through our heads. Here is where you can begin to filter out the symptoms from the noise.
CEMBooks can help with this in 2 ways – write down and log through the day the decisions you and the Nurse in Charge or operational manager make when running the shift. Just add comments to a SitRep or log as you go through the day. It means you won’t go home with them running through your head – they are clear and visible and justifiable. This is exactly what I’ve been doing in the last couple of weeks when the “business” of managing the overcrowded under oxygenated ED has been at it’s worst. It means I can leave it behind knowing that my thought processes around the actions we’ve taken and the people we’ve worked with to try and get through the shift safely are all clearly documented and visible. As I write them down it gives me a chance to think – is this the right thing to do and is there anything further I should be doing. Once done – onto the next.
Can you make some of those decisions easier – yes – pre-planned escalations with specific triggers – you don’t have to create the recipe on the fly, you just follow the pre-written one that has been agreed and risk assessed, build them into CEMBooks and you’ll get a prompt whenever you complete a SitRep about what you need to do.
Does journaling work for you, have you used CEMBooks at work to gather your thoughts and summarise the shift, would having access to a Personal log on CEMBooks to record challenges or gratitude be useful to you – let us know in the comments below.
Ref The Bullet Journal Method. Ryder Carroll