Mental LoadJun 14, 2019
What is your goal and why?
One of my goals is that I want my consult notes completed before I move on to the next patient.
The Why? I take my mental load from 10/10 to 0/10 regarding that encounter.
What is this mental load?
Mental load is the mental energy you are using. You already have a large mental load. Think about everything on your to-do list for today.
I have to think of something for supper, get my child out of bed and drop to school, figure out when I will do my results, round on my inpatients, manage phone calls from pharmacists, patients and the nursing home. See patients, chart patient encounters, refer patients, fill in forms. Home to cook supper, do laundry, pay bills and other household tasks. ETC, ETC.
My mental load is already heavy. Now to this you want to add: trying to remember the intricate details of every patient encounter today and who you promised to refer them to or what imaging you were arranging for them.
You spent 30 minutes with them but that was perhaps about their complex condition and you forget that you were to arrange their mammogram which was less than one minute of that consultation! You wake up in a cold sweat and add it back to your mental to-do list for tomorrow or you get up and onto the EMR so you won't forget and stay there for another hour checking results and charting.
That is mental load and part of what is contributing to burnout!
Now back to my goal: If I chart after every encounter every time then I don't have to remember to refer them, I don't have to remember the fine details of their situation specifics. Write it down and move on.
Mental load 0 for that encounter! Or perhaps 0-2 if it was an emotional encounter or a new bad diagnosis. Either way - it is not a 10!
Will you achieve your goal on day 1 - Of course not!!!
You will have the urge to leave it until later. You will even tell yourself reasons that sound lovely:
"I'm running behind and don't want to leave Mrs X waiting"
"I can catch up at lunch time"
"It's not that important to do it now"....
You will be UNCOMFORTABLE making yourself sit down to complete the chart. It is unfamiliar and feels like you are letting someone down as the next patient is waiting for you. You will resist this goal.
This is NORMAL!!!!
Also, even though you have this goal and this determination you will still fail MANY MANY times and this is also NORMAL!!! You have to allow the urge to not complete your notes and feel that emotion all the way through as you sit to write your notes.
You have to fail at least 100 times before you know that you will be OK and that you can handle these urges even on days when you seem to be interrupted from every direction and running so far behind.
As I step into that future self: A family physician who completes her notes after each consultation, I then evaluate the end of the consultation differently.
"This is my space, the time I have created for myself to reduce my mental load and be prepared and present and engaged with my next patient. I will not be rushed but I will work efficiently and an on task"
I will arrive home with no encounters to have to recall. They are completed and I am ready for my family.
This is a future that you can create for yourself.
Impossible goals are the most fun and most challenging!
Make the impossible your possible!
xx Sarah, the Charting Coach
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