Cast & Curious

Tag: Medicine

  • Gratitude: The Art of Savoring.

    I was stressed this past past few weeks I finally figured in a sports injury which was supposed to be a way to de-stress my body. The many roles I acquired during the pandemic finally took its toll after almost all required physical presence and face to face activities.

    Face to face tasks demand full attention and physical presence. You cannot attend two conferences at the same time anymore or listen to two lectures on two different gadgets. It seems that, the technology enabled “always present, always available” does not hold true anymore post pandemic. It came to a frustrating point that I decided to give up one of the “roles” I took on during the pandemic. The reason? I couldn’t handle that many roles anymore, not in this post pandemic, physical presence demanding work environment. I just want to go back see and treat patients, nothing else.

    One mentor I consulted said “instead of lingering on the many difficulties this pandemic brought us, try savoring on the ones you survived- the small wins. You may have downplayed many of these wins because of the negative experience we had in this pandemic!” “You journal right? I’m sure there is a lot you can write on the gratitude corner”. He was absolutely right!

    Gratitude! I can certainly count many but why is it easier to linger on a negative experience? Medical professionals are often taught to spot uncomfortable experiences like pain, decrease range of motion or difficulty breathing. When was the last time you asked a patient “Did you have a good night sleep?” Somehow we relegated that gratitude to that small corner of our planner. We lost that art of savoring the small wins.

    “Savoring” said Daniela Ramirez Duran, is “intentionally placing our attention on positive events and prolonging the positive feelings that arise”. Duran further enumerated the many benefits of increasing savoring ability. I first encountered the word “savoring” in Christopher Peterson’s Pursuing the Good Life: 100 Reflections on Positive Psychology. Savoring: A New Model of Positive Experience by Fred B. Bryant and Joseph Veroff dug deeper into this “art” and gave practical tips applying it on our daily life. Dr. Hayley Lewis enumerated some of these tips in a sketch note below.

    I’m asking my fellow healthcare providers about the art of savoring in their daily life and how they practice gratitude in spite of the challenging grinds of the medical life. This will be the topic of our #HealthXPh chat this Saturday July 1, 2023 9PM Manila time. Here are the guide questions:

    [su_box title=”Art of Savoring among Healthcare Professionals”]
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    • T1. What are the benefits of savoring/ gratitude?
    • T2. How do you practice savoring/ gratitude?
    • T3. Do you recommend/ prescribe gratitude exercise? [/su_list] [/su_box]

      See you all this Saturday 9PM for the #HealthXPh Tweetchat!

      Image by partystock on Freepik

  • Leading Change When “Change” Isn’t the Norm

    Leading Change When “Change” Isn’t the Norm

    “If there is one thing that will definitely change about our complex healthcare system, practices and behaviors aren’t one of these”

    One comment I get whenever I talk about “learning organization” as a way for healthcare institutions to adapt to the new normal is this- “I really like the change concepts your saying, but what else can I do if many in my organization doesn’t embrace that change philosophy?”

    Rina is a new resident physician assisting more senior residents attending and treating fractures at one healthcare institution. Yet to learn the finer details of cast application and monitoring, her team leader instructed her to apply cast on a young patient who had recently incurred a forearm fracture after a fall from a height. The senior resident added that she “read about techniques of applying and monitoring cast” from the recommended textbook. When an emergent call from ER summoned her senior to attend to another patient, Rina eagerly went on applying the cast to the patient’s forearm alone and unsupervised, with only her recently “acquired” cast application techniques, and a single experience of seeing one senior resident applying a cast in their last team duty. She sent home the patient after advising the parent about cast monitoring she learned from the book she read.

    Less than two hours after, the patient was brought back to the ER in pain and crying. “My arm hurts! like it is being squeezed and twisted! ” complained the patient. Suspecting that the cast its too tight, Rina instinctively cut the cast in half (bivalved) using a cast cutter. Patient immediately reported relief, but Rina was shaken by the experience. She felt she did what is the right for the patient and still ended up with a potential complication.

    Rina brought her experience in one group mentoring discussion with an attending consultant. “Is there a certain level of competency which a resident possess to be able to apply cast and prevent this complication from happening?” she asked. “If you are referring to how many times did the resident applied cast to the same extremity in a number of patients in the past, there’s no ballpark figure” said the consultant. “The incidence of that complication is less than a percent. What we know is that you have to have some high index of suspicion to catch the prelude to a complication” the consultant added.

    Rina then talked to several ward nurses and patient companions about their knowledge of cast monitoring and what they actually do in the wards and at home. “We write on the monitoring sheet what our clinical inspection would tell us, but I’m not quite sure about what’s the exact results do we refer to the residents on duty” said one nurse. One parent told her that although pain and tightness in the casted extremity is a danger sign, “we’re leaving”we live far away from the hospital it is usually too late when we arrive back in the hospital.

    Rina is currently doing a research on a better protocol for cast monitoring and preventing such devastating complication before it happens. Since the incidence of such devastating complication is low (as we all believe it to be based on foreign literature) and local literature about this complication is scarce, she lamented that her experience and research will just be buried in anecdotes again. I smiled. “Just keep on doing what you are doing” I said to Rina . “Maybe your research results will change behaviors, practices. Maybe it won’t, but at least you will have made things better for you, your patients, and then some”.

    “Do what Rina did” is my reply to the comment -“I really like the change concepts your saying, but what else can I do if many in my organization doesn’t embrace that change philosophy?” Start small, talk to like minded people, research, recommend a change policy, do it, even if others won’t. Maybe your new policy will change behaviors, practices. Maybe it won’t, but at least you will have made things better for you, your patients, and then some”.

    So what would a healthcare professional do when you want to change behaviors and practices in your organization yet many doesn’t espouse the change philosophy? This will be the topic of our #HealthXPh chat this Saturday May 27, 2023 9PM Manila time. Here are some guide questions:

    [su_box title=”change behaviors and practices in healthcare industry”]
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    • T1. Do you have any experience in the past urging you to change practices and behaviors in your healthcare organization?
    • T2. What healthcare change initiative did you do and what were the results?
    • T3. What advice would you give a colleague or health advocate when it comes to changing behaviors and practices in healthcare? [/su_list] [/su_box]

      Please join #HealthXPh chat Saturday May 27, 2023 9-10 PM manila time. Reply to the guide question above via twitter and append #HealthXPh to all your tweets! See you there!

      (Image by wavebreakmedia_micro on Freepik)

  • How Change is Ushered in Healthcare

    Pre pandemic, it is said that among service industries, change is predictably most difficult in the healthcare profession. There are several reason for this, but because processes in healthcare are already often complex, and sometimes ambiguous, embedding a new culture happen at a very slow pace. Take the pre pandemic research to standards of care policy change and implementation. It usually takes a decade for new promising research result to become standards of care in clinical medicine. This is even longer in the field of surgery.

    Interestingly, it took us a pandemic to change some of our long held beliefs and practices. Vaccine development and approval for public use for example, took a lightning speed compared to pre pandemic process development and implementation. The use of telemedicine as an adjunct to clinical care also took a “boost” during the pandemic. There’s a saying that necessity is the mother of all inventions, but I guess we cannot wait for another pandemic like scenario to usher change in healthcare. Thus, whatever ushered the lightning speed changes to the healthcare industry during this pandemic, is worth reflecting and replicating. This will be the topic of our tweet chat this Saturday Feb 25, 2023 9:00PM Manila time.

    [su_box title=”Ushering change in the healthcare industry”]
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    • T1. What ushered the rapid behaviour changes observed among healthcare professionals during the pandemic?
    • T2. What ushered the rapid process change observed in the healthcare industry during the pandemic?
    • T3. What leadership or management culture that ushered the rapid behavior and process change in the healthcare industry? [/su_list] [/su_box]

      To join the tweet chat, just introduce yourself, answer the above guide questions on prompt and append the hashtag #HealthXPh” to your tweets. See you!

      Image by wavebreakmedia_micro on Freepik

  • Social Media’s Role in Bridging Healthcare’s Generational Gap

    At the height of COVID-19 pandemic, a nurse posted a video of them dancing inside an empty emergency room with a big bold text caption complaining their work isn’t valued. That video went viral and although there were multiple and vastly diverse interpretations, the video posting didn’t go well with the health care organization’s (HCO) leadership and resulted to tumultuous reorganization within.

    One HCO leader complained in one conference that their “younger” HC provider seemingly had a different work ethic, behaviour, loyalty and respect for older peers. She continued that the government should mandate that the diaspora of healthcare workers be stopped immediately as our healthcare system is collapsing because of worker shortages.

    T1: Is there a generational gap in the healthcare workforce?

    The Gap.

    There’s no denying that the workforce now mostly consist of the younger generation of healthcare workers- the millennials. These young healthcare workers are adept at digital technology and would rather work and interact with their peers collaboratively. Contrast that with the existing HCO leadership and structure. Most HCO leaders are Baby Boomers whos used to running a top down, highly structured, regulated and bureaucratic organization. The above mentioned stories exemplifies the “clash” happening if this “gap” isn’t bridged. A gap that is making the shortage in our healthcare workforce- nurses in particular, worse.

    There are myriad of reasons for the continued shrinking of our healthcare workforce. Generational gap though rather correlational than a direct cause, is just one of these factors. The COVID-19 pandemic highlighted the gap even more, pressuring the already volatile and complex healthcare system, widening the generational misunderstanding between HCO’s workforce and its leaders. In the words of one famous motivational keynote speaker, this shift or gap is a “cycle”. The shift is the same as what other older generation experience during their time, when they were rebelling with their predecessor generation. Understanding this shift is key to solving this gap and communication may be the only doable course of action for now.

    T2: What is the role of social media in bridging this healthcare workforce generational gap?

    Health Is Social.

    I wasn’t surprised when our HR reported one of the more effective hiring platform we have right now is social media. Even the previously held “word of mouth” campaigns are now spread on social media. Initial hiring activities and engagements takes place on social media. Most healthcare workers keep tabs of the various HCOs social media pages as a way to scout for potential opportunities.

    The first story above highlights another generational difference often misconstrued by older generations- the young workers need for constant recognition and multiple technologies. Older HCO leaders may take this as counterproductive to work and are often suppressed in the workplace as a bad work ethic or behavior. Many HCO leaders neglect that part that the new generation needs constant feedback and communication and will be valuable assets if their team effort are reinforced and recognized.

    Internally, many millennials prefer to work in a flat organization, engaging in a more collaborative approach rather than a strictly structured system our healthcare system is built. The young healthcare leaders build networks and interact with thru social media. As many HCO leaders now knew, most “unofficial” work related discussions are happening over social media. And we’d rather look at this as a problem rather than an opportunity to engage.

    T3: What social media strategy will you recommend in bridging this healthcare generational gap?

    Strategy for an opportunity.

    Personally, social media role in bridging this gap is to connect or engage the seemingly different generations. Thus, socmed strategy primarily deals with this objective. I knew one baby boomer HCO leader say sorry to a millenial HCW via messenger, initiated a face to face meeting with the team, listened to their concerns and proactively set up a group page within the hospital socmed platform to work collaboratively and find solution to these concerns. Another multinational HCO hired an external social media manager, integrated it into its HR HCW engagement team and increase the younger generation participation in hospital patient and employees initiatives. An even more proactive baby boomer HCO leader trained himself social media tactics and used the various platform to connect and provide feedback to his peers.

    Taking on social media as a tool does have it setbacks though. In healthcare, patient information privacy should be protected. While many social media platforms are free, a deliberate attempt to harness its power needs some serious investments both in human capital and finances.

    The role of socmed in bridging generational gap now is even clearer than before. The COVID-19 pandemic highlighted this and will weigh considerably even in a post pandemic healthcare. Taking advantage of this opportunity will be the topic of this Saturday’s #HealthXPH tweetchat 9PM Manila time. Join us by live tweeting your answers to these guide questions and appending “#HealthXPh” to your tweets.

    [su_box title=”Generational Gap in Healthcare Profession”]
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    • T1. Is there a generational gap in the healthcare?
    • T2. What is the role of social media in bridging this healthcare generational gap?
    • T3. What social media strategy will you recommend in bridging this healthcare generational gap? [/su_list] [/su_box]

      See you all at the #HealthXPh chat!

      Image by Drazen Zigic on Freepik

  • Future of Healthcare Work and Learning

    Future of Healthcare Work and Learning

    It was never easy for healthcare professionals shifting to online learning and hybrid work during the pandemic. I never imagined though, that going back to pre pandemic set up, is equally challenging.

    I am one of those who wish we’d go back to pre pandemic healthcare work and learning once this pandemic is over. Alas, we’re two (2) and a half pandemic years and the end isn’t in the horizon. Something tells me we ain’t going back to where we used to be, no matter how hard we try.

    When our COVID cases went down in one institution for example, we tried face to face conferences again. Our OPD also resumed (albeit slower) seeing patients. Our OR also slowly reverted back to its old routine. Despite all the requisite precautions and vaccinations, some medical staff contracted COVID-19 two weeks into the resumption, prompting us to go back to online learning and hybrid work again.

    Trying to go back to an old routine should be easy, I thought. I’m one of those who once profess adaptability and flexibility as my strongest point. But the two years of traumatic, pandemic struggle probably ingrained an aversion to change in many of us, me included. And I am discovering how hard it is to go back now. Is it the design? Strategy of going back? Perhaps, before we can strategize going back or adapt we need to forecast what part of healthcare work and learning is here to stay, fade away or will be in demand in the future.

    Share your thoughts on the Future of Healthcare Work and Learning by joining the #HealthXPh tweetchat this Saturday July 23, 2022 9:00 PM Manila time. The guide questions are as follow:

    • T1. What will FUTURE healthcare work and learning HAVE that doesn’t exist today?
    • T2. What will FUTURE healthcare work and learning NOT HAVE that is common today?
    • T3 Is there a specific part of healthcare work and learning that will become more common in the future? ( e.g Zoom/ Hybrid learning, conferences, remote guided surgeries?)
    • T4. Where should healthcare look for inspiration in adapting to the future healthcare work and learning?

    (Note: This post is inspired by the #HCLDR chat on Future of Healthcare Facilities)

    Image by Freepik