Jennifer Spicer, MD, MPHVarmennettu tili

2/ To me, “Being Available” means ensuring that my team feels that I am their safety net Nothing is beneath me. I’m here to help. WE, as a team, are responsible for our patients. A failure of one, is a failure of all. Yet, an accomplishment of one should be celebrated by all.pic.twitter.com/WnVaGRVZLs

3/ In my mind, the concept of “Being Available” has two components: Approachability (i.e. are people comfortable asking for help?) Proximity (i.e. are you physically & mentally “there” for your team?)pic.twitter.com/PUmdqI7uZ1

4/ Approachability has two inter-related aspects: Creating a safe learning climate Setting clear expectationspic.twitter.com/2SBTMj2FxO

5/ A safe learning climate means that team members are comfortable being vulnerable. Imposter syndrome is prevalent in medicine: https://link.springer.com/article/10.1007/s11606-019-05364-1 … We should encourage team members to ask questions. ...And answer those questions. Saying "look it up" is not always helpfulpic.twitter.com/jYzguBhHW3

6/ Setting clear expectations regarding availability is helpful As a trainee, I found myself worrying about “bothering” people when I called. As attendings/fellows/residents, we should set the expectation that needing help is normal & reiterate that people should call if neededpic.twitter.com/YJdEsEv8Di

7/ Go beyond saying “call if needed” & be explicit. I tell trainees they can contact me anytime when I’m awake (5:00 am – 9:00 pm), & ANYTIME for the following: If a patient decompensates If a patient tries to leave AMA If a time-sensitive decision needs to be madepic.twitter.com/5z06lzBcvD

9/ First, especially as an attending, try to be “mentally present” for your team by blocking off your schedule. Avoid scheduling research meetings, other educational obligations, etc Cancel as many non-essential recurring meetings as possiblepic.twitter.com/eMes2zhdEt

10/ Then, during rounds, pay attention. Use active learning techniques Use positive, open body language Avoid glancing at your phone Avoid looking at the patient's chart And, if presentations are too long, then provide feedback instead of tuning out!pic.twitter.com/iC2RYEtQ7i

11/ Physical proximity lowers the barrier to ask questions, which has pros & cons. Being present makes it easier for others to ask you questions. This can be good. But significant learning also occurs when learners are on their own (eg. nightfloat) Appropriate balance is keypic.twitter.com/iF4sWhhTkz

12/ So what’s the ideal physical proximity? It probably depends who you are on the team: Attending: stay during rounds, then let team do work Fellow: stay until residents done with notes Residents: stay until the team’s work is donepic.twitter.com/hXAQBKLIxG

13/ Staying until the work is done helps: Fellows Residents will write better consult notes b/c they are more likely to ask detail-oriented questions Residents Interns will appreciate you helping them with work; plus, you will know more about their workflow & efficiencypic.twitter.com/cL1f8C0VzN

14/ And as an intern, being available to medical students is important & rewarding. You have lots to teach. And you can help the students shine on rounds. Just set clear expectations with students to maximize learning & patient care (more on this next week from @GStetsonMD!)pic.twitter.com/rRFR0q2CTe

15/ So, in summary, be your team’s safety net using these concepts: Approachability: Create a safe learning climate Set clear expectations regarding availability Proximity: Be physically close (while allowing autonomy) Be mentally present to the teampic.twitter.com/AkAOj77hbk