How do you deal with stress related to patient complications?
Click Here to Manage Email Alerts
Click here to read the Cover Story, "Ophthalmologists aware of need to protect mental, physical health."
Visualization, decompression, support
Fortunately, I am a surgeon who has not had a high rate of complications, but nobody’s rate is zero. I have vivid memories of the moment when I ruptured the posterior capsule for the first time.
I still remember the patient’s name and how stressful it was to counsel her afterward and talk with her family. Your first complication out of training really leaves an impression on you. As time went on and I gained more experience as a surgeon, the stress of the regular operating day diminished quite a lot. However, I am now in my sixth year of practice and still feel drained at the end of an operating day. I have learned some ways to decompress a little bit before I get home. I listen to music while I am driving and sit in the driveway for a few minutes before I get out of the car, just to shift into home mode. When something stressful happens, I seek help and talk with a mentor or my husband to get it out and verbalize it. Having somebody who can help you bear the burden of the stress that you are feeling is of great support.
Back to my first capsule rupture: I had an experienced scrub tech who afterward commented that I seemed so calm she could not believe that I was so stressed and panicked. I did in fact manage to stay focused and do my anterior vitrectomy and everything else neatly and precisely.
There are a few things that helped then and continue to help me now, and one of them is to watch a lot of surgical videos. I like Dr. Uday Devgan’s cataractcoach.com and watched a lot of his videos in my first years of practice. So, when the rupture happened, I knew exactly what I needed to do. I had thought through the appropriate management steps, and despite how panicked, nervous and stressed I felt, I knew exactly what I was doing. Even now, every so often I watch those videos and think through the different steps of what to do if I have a case that I anticipate being challenging. I believe in planning out your steps ahead of time, visualizing what you are going to do and going through the various if-then scenarios. That visualization technique is something that I would do going back to my teenage years as an athlete, and I have it carried through to my surgical career as well.
For more information:
Alison D. Early, MD, is with Cincinnati Eye Institute.
Preparation, trust, continuous learning
As surgeons, we are not immune to complications. If you have had the privilege of performing surgery long enough, eventually a complication will arise, and you must be able to handle it in the utmost care for the sake of the patient. Dealing with the stress that comes from such complications requires a multifaceted approach, grounded in preparation, trust and continuous learning.
In-depth preparation: I strive to stay committed to preparation such as engaging in regular simulations and case studies to anticipate potential challenges. This rigorous preparation creates a mental road map for various scenarios, enabling me to approach complications with a problem-solving mindset. Dedicating time to study videos of various surgical techniques and complications allows for a collective sharpening of skills and approaches.
Trusting my training and instincts: I have had the privilege to train at one of the top ophthalmology residency programs in the country, and one of the greatest skill sets I have learned is the ability to integrate my knowledge with my instincts to make the best decisions under pressure. It is also about self-compassion, acknowledging that while perfection is unattainable, striving for excellence is always within reach. This mindset helps mitigate stress by framing challenges as opportunities to apply my skills to their fullest.
Reflective learning and emotional support: After confronting a complication, I dedicate time to introspection and discussion with mentors and peers. Surgery itself is a high stress activity, and any complication will add to the flurry of emotions a human being feels in such a situation. Recognizing the role of emotions in decision-making helps me refine my approach to patient care. Having access to a supportive community within the medical field provides a safety net of collective wisdom and empathy, essential for resilience and growth.
Holistic self-care: This probably comes from my background as an osteopathic physician. I prioritize activities that foster mental and physical health, such as mindfulness, exercise and hobbies that allow me to continue to be my authentic self. This holistic approach to self-care ensures that I can return to my duties refreshed and focused.
Managing stress from patient complications is an ongoing process of professional development and personal growth. By deeply investing in preparation, cultivating trust in my abilities, embracing learning from every outcome and prioritizing my well-being, I try to navigate these challenges with a balanced perspective and a resilient spirit.
For more information:
Shehzad Batliwala, DO, is with Lasik Plus in Little Rock, Arkansas.
Editor's note: This article was updated on April 19, 2024, to include Shehzad Batliwala, DO.
Collapse
Read more about
Click Here to Manage Email Alerts