Separation of work from life or combine the two?

The Emergency Care System

Pre-hospital: self care, GPs, Ambulance service and other emergency services (Fire...Police) other primary care/community services (intermediate care...)

EDs.

Other hospital specialists.

Education

Fast track education and training or take your time?

Stress and burnout

Stress has various definitions (my preferred: when demands outstrip resources).

Burn out: Emotional exhaustion, depersonalisation, low sense of personal accomplishment.

Most doctors (everyone?) will experience these.

Complications include poor performance at work and home and probably physical ill health.

What should be done by others? Supervision, psychological support and feedback?

By oneself, when stressed or identifying onset of stress reaction?

Will vary from person to person....

Worthy goals

Being committed (and, maybe passionate).

Being thoughtful.

Being positive.

Systems thinking

Worthy of an essay, but, for now, the thinking about one's impact beyond one's immediate zone of influence, and of course it's impact on you...

The interfaces if you like.

Quality in an Emergency Department

I've found it helpful to separate, at least mentally, service delivery, service quality and service strategy:

1. The main aim of service delivery is to be safe
2. Quality care is STEEEP care (safe, timely, effective, efficient, equitable and patient orientated) supported by strong clinical governance mechanisms and
3. Strategy determines trust and department policies.

The Bigger Picture

Making mind map of the bigger picture...

The reduction.

The epoché...

Postivity

Telling a team to 'have some spirit' fails unfailingly.

Can one generate 'spirit'?

I suspect not directly.

It emerges.

It is a function of leaders and team.