Introverts and EM

[pillowsnice]

Stumbled across this video by Dr. Nathalie Coeller, who speaks about her experience as an introverted EM physician. I feel like EM often caters to those who are extroverted, and often times inadvertently pushes the introverts to the side (something I have struggled with myself). But, this talk shows that there IS a place for introverts in EM, and if we are passionate for this field, we shouldn't shy away.

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[Birdstrike]

Stumbled across this video by Dr. Nathalie Coeller, who speaks about her experience as an introverted EM physician. I feel like EM often caters to those who are extroverted, and often times inadvertently pushes the introverts to the side (something I have struggled with myself). But, this talk shows that there IS a place for introverts in EM, and if we are passionate for this field, we shouldn't shy away.

There's already a thread on this. But you're right. Any personality can go into EM. Do what you think suits you, not what you think someone else thinks suits you.

 

[EctopicFetus]

I consider myself an introvert. no issues. I think regardless of your personality we should all strive to become better versions of ourselves.

 

[NicksMD]

Yeah EM can be unforgiving to introverts. As a Med student I had an attending write on my eval to work on communication because I hated small talk. MSPE and SLOEs all said quiet student. Thank god I matched a program that had a lot of introverts and accepted me for who I was. Many times, EM equates introvert / quiet with inability to lead and it’s quite pathetic.

 

[bky3c]

Many times, EM equates introvert / quiet with inability to lead and it’s quite pathetic.

I've had this experience SO many times. Someone louder has often tried to take over, assuming I was unsure because I wasn't yelling. Or nurses think I don't know what I'm doing because I'm not constantly thinking out loud during a code or trauma. Or people don't even know that the ER doc has arrived at the code in a floor/ICU room because I don't walk in screaming questions and orders.

On the other hand, there was a time when two nearly identically severely injured (but conscious and very aware) patients arrived at the same time, and another attending and I each took one of them in adjoining rooms. The other attending, an excellent EM physician, happened to be the extremely loud and active type. We each did pretty much the same thing with each patient, and afterward, the nurses commented (in my favor) on the drastic difference between the vibes in the two rooms. My patient was calm, had a quiet moment to call a family member before intubation, etc. The other patient received appropriate treatment, but the stress level in the room was palpably higher.

I appreciate the fact that different physicians have different styles, but I would love it if people would not assume that someone who isn't yelling is incompetent. That said, I certainly don't think it's a reason to avoid EM as a career. Just something to be aware of.

 

[Zebra Hunter]

I've had this experience SO many times. Someone louder has often tried to take over, assuming I was unsure because I wasn't yelling. Or nurses think I don't know what I'm doing because I'm not constantly thinking out loud during a code or trauma. Or people don't even know that the ER doc has arrived at the code in a floor/ICU room because I don't walk in screaming questions and orders.

On the other hand, there was a time when two nearly identically severely injured (but conscious and very aware) patients arrived at the same time, and another attending and I each took one of them in adjoining rooms. The other attending, an excellent EM physician, happened to be the extremely loud and active type. We each did pretty much the same thing with each patient, and afterward, the nurses commented (in my favor) on the drastic difference between the vibes in the two rooms. My patient was calm, had a quiet moment to call a family member before intubation, etc. The other patient received appropriate treatment, but the stress level in the room was palpably higher.

I appreciate the fact that different physicians have different styles, but I would love it if people would not assume that someone who isn't yelling is incompetent. That said, I certainly don't think it's a reason to avoid EM as a career. Just something to be aware of.

While obviously there are merits to what you’re saying, I do find issue in you saying that the floor/ICU codes don’t even realize you’re there. Being an introvert in EM is perfectly fine, but you still need to make your presence known in codes. How are these individuals who don’t know you supposed to recognize who the code leader is if you just stand by the bed quietly?

Edit: Also probably important to ask questions and give orders loud enough for everyone in the room to hear as the code leader.

 

[DeadCactus]

I'm an introvert. I would guess a lot of people who spend time on internet forums are introverted. There is nothing wrong with being an introvert or an extrovert. In either case, you need to be aware of how your tendencies help you and how they hurt you and then make accommodations for them.

 

[Splenda88]

Yeah EM can be unforgiving to introverts. As a Med student I had an attending write on my eval to work on communication because I hated small talk. MSPE and SLOEs all said quiet student. Thank god I matched a program that had a lot of introverts and accepted me for who I was. Many times, EM equates introvert / quiet with inability to lead and it’s quite pathetic.

It's not only EM... It's medicine in general.

 

[Birdstrike]

A lot of patients like having a doctor who comes across as serious and focused on them and their problems. Introverts often do that very well.

 

[NicksMD]

It's not only EM... It's medicine in general.

Life in general**

 

[wamcp]

I've had this experience SO many times. Someone louder has often tried to take over, assuming I was unsure because I wasn't yelling. Or nurses think I don't know what I'm doing because I'm not constantly thinking out loud during a code or trauma. Or people don't even know that the ER doc has arrived at the code in a floor/ICU room because I don't walk in screaming questions and orders.

On the other hand, there was a time when two nearly identically severely injured (but conscious and very aware) patients arrived at the same time, and another attending and I each took one of them in adjoining rooms. The other attending, an excellent EM physician, happened to be the extremely loud and active type. We each did pretty much the same thing with each patient, and afterward, the nurses commented (in my favor) on the drastic difference between the vibes in the two rooms. My patient was calm, had a quiet moment to call a family member before intubation, etc. The other patient received appropriate treatment, but the stress level in the room was palpably higher.

I appreciate the fact that different physicians have different styles, but I would love it if people would not assume that someone who isn't yelling is incompetent. That said, I certainly don't think it's a reason to avoid EM as a career. Just something to be aware of.

i’m introverted And awkward as heck in real life. Yet i have never had problems leading codes. Nobody ever mistakes me for anything but the code leader

Give orders. be LOUD with orders or literally anything you say.

For me with tiny lungs and scrawny frame, yes I am practically yelling. Don’t be shrill, frantic, or panicky like I have seen some do because that makes your team panic.

 

[namethatsmell]

Personality-type aside, when I'm walking into a chaotic code, the easiest way I've found to run things is to ask for silence.

I say something like (loudly if need be) "let's have a quiet room please with any questions or suggestions one at a time." After that nobody needs to raise their voice. As things play out, keep talking to your team and recap what's going on and what the next steps will be. I've found this gives people actually doing things in the code an idea of their goal/next step and gives people just observing a way to stay engaged.

If the patient comes back then great. Give team small pat on the back and tips for keeping pt alive and getting them packaged for transfer or admission. Once the patient is actually out of the dept then give more generous props and debrief.

If the patient isn't coming back despite all reasonable efforts, then recap the situation to the room and ask if anybody has any other ideas/suggestions and briefly make direct eye contact with everyone present to acknowledge their value.

Doing the above usually makes for a smooth code and primes staff on what to expect from me in future codes so hopefully they're even smoother.

There are plenty of ways to run a successful code, and I encourage students/residents to not feel boxed in by perceived personality types.

 

[Angry Birds]

Come to work on time, do a good job, don't piss people off, be a decent person, you'll be fine. Nobody cares if you go sky diving or not.