Do you wish that you could finish charting faster, maybe you’re bringing charts home, doing them in the weekends in the evenings. And it’s just exhausting. I want to invite you to join me for a 10 day email challenge, designed to help you finish charting faster, so that you can get home sooner for what matters most to you. So if that’s you, I want you to head over to www.mededwell.com/efficiencyguide and get enrolled today. Can’t wait.
Welcome to the MedEdWell podcast, empowering physicians to get work done at work, then be able to reflect and choose what is important for both their life and medical practice. I’m your host, Dr. Ryan Stegink, general pediatrician and life coach for physicians. Hello, everyone. And welcome to another episode of the MedEdWell podcast where physicians and other medical professionals come to be encouraged on their wellness journey of how to be a good doctor, how to be person who’s able to show up for themselves, and able to take that next step toward whatever you see as wellness for you.
Thank you so much for listening to these episodes for sharing. And if you haven’t taken the time to leave a review, if you really like this podcast, if you can go to Apple podcasts or wherever your podcast player and leave a review, it really helps others find out about this podcast that otherwise didn’t even know it existed. So I’d encourage you to do that. But as we get into today’s show, I am just so thankful that you’re here joining me and we’ve talked about goals about where you are and where you want to go. And really, we’re going to kind of build on what we talked about last week, talking about goals, feelings, buffering, that supposedly is going to help us feel better, at least in the short term.
And we’re going to bring that all together today around charting.
But first, a little backstory. Hi, this week, I have been able to spend a lot of good family time, spend time with family and friends. We had a birthday party in this house, and there was a lot of pink and a lot of unicorns. And it was great. But I was able to do that and to be fully present because I was already done with my charting. So that gets into my big why of what’s the purpose behind getting a whole of my charting done. And it was great.
But that wasn’t always my story. I was straight out of residency into my clinic. And I was bringing charts home. I was doing them in the evenings and on weekends. And it was really starting to add up. It was really stressful.
I was trying to be a good doctor, a good husband, and it was difficult.
I felt the stress. I just started to internalize that and wonder am I really still a good doctor if I can’t get all these things done in a timely manner. It was just a weight that as I was trying to get up to speed as a new attending, figuring out my workflows, how I’d counsel patients about particular things that I intellectually I knew about, I pass my boards by this point, but it was still really hard. My notes would just go by the wayside. I’d do a little bit. But then I’d have three, four or five other patients waiting for me in the building and I just had to keep going.
And that was when it happened.
I did a stretch of 10 days in a row when I was doing some of my call requirements and I was exhausted.
I sat down with my wife one night and less than a year out of residency.
She said to me, something has to change.
And she was right.
And I was so thankful that I was able to make a change. I had supportive leadership. I was able to subsequently figure out some things with my charting. And I’m now in a much better place, I still have struggles, from time to time, things that I’m reminded of ways of communicating with patients with my staff, the importance of summarizing things at the end of the visit, so that I don’t have to go back in and clarify something else later.
But it’s about continuing to examine those workflows and to grow.
So, this week, we’re going to use last week’s questions about goals, and apply them specifically to charting so that you can see yourself in this and be able to examine your own workflows, and what you may be doing well, and what you may want to ultimately make some changes on.
So the three questions were about where do you want to go? Who are you now? Who are you in this situation? And so where are you?
And then, who do you want to become?
Where do you want to go?
And what are you going to have to feel to get there?
The first, where do you want to go?
I want you to think about with your charting where you want to go. It’s maybe it’s charting done all at the end of the day, could be that you’re home at a particular time, that you’re able to leave when you want to, not when you feel like you have to.
Because things just kept running behind. And there may always be some variability in when you get done if emergencies come up. But when there’s routine days, can you get out within a certain window of time, maybe you really want to do all of this. And still feel like you can provide the level of patient care that you want. You want to feel like a good doctor a good and be a good nurse.
These things matter.
And so I want you to take a moment, this is one of those episodes where you may need to pause, and or just come back to it and really take that moment to reflect on where are you?
And where do you want to go. Just envision that future state of AI, six months from now, three months from now a year from now.
I get my notes done, by the end of the day.
I know you’re gonna have to fill in the blank. But this is really important that you take the time to see where you want to go. And when you’re there. What does that look like? How does it feel?
And how does that enable you to be present for what matters most to you?
So it’s important to have that ideal future state where you’re going to have that in mind. But then I want you to then take a moment and think about where are you now?
Where are you now? What’s holding you back?
Are your charts all getting done? In real time, or shortly after your last patient leaves?
And what’s maybe holding you back from getting your charts done faster.
For me, initially, it was a lot of feelings, feelings of discomfort, of the discomfort of being behind the discomfort of not of not wanting to take that extra moment. Maybe it’s just two minutes. My orders are all in and I’m talking to the patient while I’m trying to finish things up. Or even though I tell them hey, I’m gonna finish up your chart here for just a minute. I don’t have to bring it home and pediatrics. Talk to the kids. Do you want more homework? They look at me with a funny look and say no. And I say neither to the doctors. One
more homework either.
I also run up against feelings of obligation that, well, this patient’s been waiting for me for 1015 minutes, or often, significantly more. And I just need to go to that next room.
And it’s just a feeling. And I can choose to allow that feeling. Because maybe the circumstance that’s contributing to being behind is that there was an emergency or there was additional patient complexity, or that I get 15 minutes for a primary care appointment. And maybe there should be more.
But I can’t always change some of those circumstances, but the thoughts that I have about them, and those feelings that come up, there’s a lot of automatic feelings or automatic thoughts, that generate these feelings, that as I bring that to awareness, then I can examine, what do I want to do with that? And is there an intentional thought, that really helps me put getting ahead of myself, and we’ll get back to some of that in just a couple minutes.
The other feelings and urges that come up, or just, yeah, have to keep going, I have to go to the next room, I have to check my work email, I have to talk to my colleagues when really, there’s a time for everything. And in the midst of busy clinic day or busy shift at the hospital, it may be that right now I need to sit down and to do my work. It may be that I intentionally choose to pause and to be present with someone else to say how was your day? How was your weekend? And to really listen.
But the key here is the intentionality. Is that what you intended to do? Or is that something that I did as a means of buffering of getting away from this other tasks that I was trying to prioritize?
And this is something that I see even doing productive things, I can say, well, I don’t want to finish my chart. So I’ll go and do my paperwork, or I’ll go and check my labs. And going back and forth between these different things. If it’s more of a means of avoiding feeling the discomfort of just getting another chart done.
That is what’s called buffering, where we’re trying to avoid something. And so that ultimately leads us to a net negative feeling of I didn’t get as much done, as I knew that I could, if I was going for it.
So how are you feeling right now, this a little bit weighty and kind of a downer.
I want you to pause with this new awareness of maybe how some of these automatic thoughts are showing up for you as you go through your day in medicine.
I want you to pause with this new awareness and just have some self compassion to say I’m here for you.
Because these things are part of the human experience.
And particularly a part of the experience of being a physician of being another medical professional in the field of medicine these days, providing care in the medical system.
And only as you have that self compassion are you able to say well, this is where I want to go and this is where I am now.
But sometimes it’s about giving yourself grace for those.
Those times when it doesn’t seem to be moving forward in the timeframe you thought if there’s been other setbacks or challenges
and to just say, I can do this and it’s okay.
It’s okay to feel these negative emotions because is both positive and negative emotions are part of the human experience. And there’s a lot of challenges and hard things in life.
And it’s okay to sit and to acknowledge that.
But as you have that self compassion and holding that new self awareness, I want you to then think about, who do you want to become? And what are you going to have to feel in the context of charting, there’s going to be a lot of feelings that I have to allow, and that you’re going to have to allow,
and hope you’ve seen this. But these are things that I’ve worked on, and that I’ve made a lot of progress on. But by no means, Am I perfect in this. And I still struggle with many of these things, and how to allow into how to be able to, to move forward, as I have those intentional thoughts on the heels of sitting with that discomfort.
So in thinking about which of these feelings that we’re going to have to allow, and the intentional thoughts,
one of them will be discomfort. And it’ll be how do I chart in the room more. And even, I commit to if as much as possible to finish my note before going on to the next patient.
Now, there’s a number of tools, the templates, the preference lists, some of the bundles of orders, order sets, order panels, things that can help with this.
And it’s an iterative process, it’s over time. But those things ultimately start by allowing that discomfort to say,
Yes, I hear that urge. I hear that urge to go on to the next room, but I can sit here and do it. I can sit here and move forward even amidst that feeling.
That feeling of guilt of being behind and reframing that to say, I am a good doctor, I give my patients my full attention when I’m with them. And I thank them for their patients, even as I may not be on the same timeframe that I had initially intended, when I started out my afternoon,
sometimes doing the same thing over and over, whether it’s paperwork, or completing a typical note,
that may be something that I have an urge to go do something else. And instead of doing my paperwork, I go talk to my colleague about one of their patients, when maybe that could wait and talk to them about a couple patients, or I do it at the end of the day.
Instead of taking that temptation to buffer by doing something else, I can hold on to the thought, I finish what I intend to, and then have time for what matters most to me, not just whatever feels less uncomfortable in the situation.
And lastly, feelings of shame and the blaming that goes on as a result of having that feeling.
Just holding on to thoughts of I am a good doctor, I can learn, I can grow.
And I can have self compassion.
So as we wrap up today, I want you to take some time today and consider where you are and where you want to go.
And what you’re going to have to feel to get there
in the in the context of your charting and your clinical workflows. Because what matters most to you is really impacted by how you’re able to deal with these things about how you’re able to process these uncomfortable, negative emotions that ultimately are able to help you move forward.
Because who you are, is not defined by What you do, it’s deeper than that, your priorities and who you are. And your value is separate from what you do. But I want hue, to be able to see, to feel and to experience that in a deeper way as you work through these things, and examine what’s already there, and how you can take your next step.
Thanks so much for joining me on another episode of the MedEdWell podcast. If this has been helpful to you, I would love it if you would share this episode with another physician with another friend with someone who would benefit from hearing this message.
If you’ve enjoyed it, and you haven’t left a review yet, I would love if you’d go to your podcast player and leave a review
And I’d also encourage you to just take the time,
take the time to examine your own thoughts and where you want to go.
And to have that self compassion when your journey isn’t like you expected or it isn’t on the same timeframe that you’re hoping for.
Again, thank you so much for all that you do. And have a great day.
And now for our important disclaimer.
Dr. Ryan Stegink is a practicing general pediatrician. But the MedEdWell podcast does not reflect the views, opinions or beliefs of his employer, nor is affiliated University.
Additionally, the MedEdWell podcast is for educational and entertainment purposes only and should not be considered advice regarding financial, legal student loan, medical or any other specific topic.
In such a case, you should seek consultation with certified professional in that particular area.
Again, thanks for joining us on the MedEdWell podcast. Have a great day.