Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

3 Tips from the ED For All Healthcare Professionals


Sharing appreciations with colleagues and learners is your superpower. Use it. 

A young man was shot in the chest, just a single shot. I looked at the electrocardiogram monitor and saw he was having a heart attack. He looked at me and said, “Please don’t let me die.” I offered reassurance and said we would do everything in our control to prevent it. But he had been shot through a major blood vessel that provides the muscle of the heart. He died in the operating theater, and I had to tell his crying mother the news.  


I’ve told numerous patients that they have lost a baby, or have new cancer, or that it’s time to let go of their loved ones because there is nothing left medically to do. I often reassured angry patients that they haven’t been forgotten or that their care will still be excellent despite the long wait to see me.  


Years ago, I lost an elderly lady to a ruptured aorta. I went to my supervisor and said I couldn’t do this job anymore. This physician of 20 years recounted something just a few days before that he felt he could have done better. I then realized that after 20 years of practice he still felt uncertain and reflected on what he could have done better. He remained a caring physician who hadn’t lost his humanity. I understand how important that is now.  


As an emergency physician, you carry the burden of someone else’s pain. You use the intellect that was divinely given to you to directly try to help a patient, a family, and a community. You study illness scripts of diseases that you never will see in the hope that if a patient comes to you with that rare disease, you can solve the mystery and give someone the care you hope your family would receive. You’re rewarded when you’re sometimes the best part of someone’s worst day. It’s an understated success. You get a letter sometimes from a family member that you put on the fridge. And that is enough for me.

Here are three tips I’ve learned during my career in the ED that I hope may benefit all healthcare professionals: 


1. You can’t take care of your patients to the best of your ability if you’re sleep deprived, unhappy, feeling guilty, or under the influence of a substance. Take the time for breaks and rest. 


2. Bestowing a sincere compliment to/about a learner or colleague to them and their immediate supervisor is your superpower. Use it.


3. Take time to learn a clinical disease to the point of mastery. If you have a patient with that disease, it will fill your sail and renew your job satisfaction. 






This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.