Mindfulness in the ED: a winning approach

Medical students are easily impressionable in ED. Students watch intently, and they will listen and learn everything they can from clinical staff and attendings. Each shift brings with it new patients, new staff, new experiences, and so much more to learn and gain.

As well as positive learning, there are also judgments to be formed. Arguably, impressionable and receptive are two of the most important qualities for medical students to possess. However, students should be mindful of the impressions that are being left upon them. Something rarely discussed in medical school is mindfulness, a technique and skill that students should try to leverage.

Mindfulness means being aware of your constantly moving emotions and thoughts, as well as what’s going on around you, without judgment. It is about not judging another person or yourself as you notice the situation around you, causing certain feelings or biases, you must manage to refrain. Through mindfulness, you are able to notice the temporary thoughts and feelings you have. It also lets you bring clarity to your biases, responsibilities, emotional state, and roles.

Mindfulness is important because it brings with it many benefits. Research has shown that those benefits include:

• Increased flexibility of response
• Decreased reactivity
• Better focus and attention
• Improved ability to maintain and/or establish interpersonal relationships

Mindfulness also enhances one’s ability to handle stress, cope better, and results in lower depression and anxiety rates.

In 2020, a report was compiled highlighting physician suicide and burnout. It reported that 43% of EM physicians felt burned out. The blame is most likely to be placed on the overcrowded ED. Caused by unnecessary patient visits, surgical scheduling, uninsured and poor patients, and seasonal illnesses, health care is heavily burdened. The overcrowding and non-emergent visits continually contribute to longer wait times, medical mistakes, and ultimately, doctor burnout.

A study showed frequent users of the ED is only around 5% of patients. The Annals of Emergency Medicine concluded that these frequent patients tend to get sick more often and have an admission rate of about 51% across a 5-year term. With mindfulness practices, we can challenge the biases and our emotional replies that come up when we treat patients like the man who attends frequently. Accounting for around 85% of medical mistakes, the most frequent diagnostic error in the ED is a delayed diagnosis. Being aware of the elements that affect your current state of being and your experience allows you to perform better patient assessments, gain clear clinical judgment, make faster diagnoses, and become a better emergency physician.

Becoming the best clinician for your future patients is what all medical students strive for. It is essential to be self-aware. To be aware of your thoughts and feelings, and biases but also to be considerate of the impressions that people leave upon you—using mindfulness while working with patients and beyond will allow for a more effective and compassionate future clinician.