I can only say what I have found that helps me on the harder days. Whether that's wisdom or not, I leave up to others to decide.
Conversations? Simple and succinct, whether with patients or anyone else. "Less is more" is true. Takes less effort at some point.
It's a job like we keep saying, not a marriage -- though a unique one. The cool stuff about it is for another thread.
Energy is finite. Protect it. Know when to not go down the rabbit hole of bull**** (drug seekers, "I didn't get what I want so I'm gonna whine", abusive psych/substance patients who can't channel their emotions properly, etc). Chart to your tastes, done, next, rinse, repeat. Nothing to get hung up about.
The actual awesome moments? I found seeing them for the awesome that they are helped me realize what isn't worth giving a **** about.
"Customer service" in medicine: about as enjoyable a term as "provider." Nope. There's this fine line between reading the room/knowing your audience and pandering. On one side, it's art and science. On the other, it's schmuckiness. Schmuckiness takes energy, at least for me. Energy is finite, remember? Ain't nobody got time for that.
The old surgery adage of "slow is smooth, smooth is fast" applies to EM in a stoicism sort of way. Always be getting the core things done to protect your mental workload. Corollary: the bull**** or extraneous stuff becomes more obvious and easier to push to the side. I found this reduced my post-shift stays.
I'm not here to pick fights with people, win Pyrrhic victories over debatable z-paks, pursue nonemergent issues beyond due diligence and standard of care, or make everyone else's life easier at my own expense.
Today will end just like all the rest of the days that will follow it. Do a legitimately good job, go home, and remember all the good this, and the blood/sweat/tears spent to get here, allows.
EM makes it easy for us to focus on the **** and lose sight of the good.
Don't let it. Seeing the good for what it is, and the not good for what it is, and what we actually are here to do, makes it easier to identify where no ****s are to be given, at least for me.
