From Chaos to Clarity: How Physicians Can Reclaim Focus from Distractions

As I was stepping out of exam room 3, my mind was focused on marching the few steps to exam room 4 and starting to see the next patient. Not quite. Between me and the exam room door stood two nurses, looking at me. They could not possibly be waiting to talk to me. I was already thirty minutes behind schedule. The first nurse asked me to review a blood count and decide if that patient needed an injection. The second nurse informed me that the patient in the treatment room area wanted to speak to me but was not sure what it was about. The first one was straight forward. The second request took a while and it turned out that the patient had a question about the dosage of her medication, which I listed in the chart.

Finally I got to see the next patient. In the middle of our conversation, my cell phone rang. That was probably work related, I thought. I took my cell phone out of my white coat pocket to check. It was a spam call. When I went back to my room to chart, there was this audio alert about a new email message.

My day was constantly interrupted. It was hard to focus and concentrate for an extended period of time because of those distractions. It was quite frustrating.

That was about four years ago.

Clinical medicine is unpredictable always. Your day may be very hectic if you do not plan for interruptions or surprises. Although distractions are part of any clinical day, there are strategies to tackle them to maintain focus and efficiency.

It is important to be mindful of any distractions. Be on the lookout for anything that is disrupting your workflow. Instead of being annoyed that they even exist, accept their presence and focus on how to handle them.

There are several common distractions in the clinical setting. First, alarms and alerts. If there is an infusion unit in your office, or if you administer any intravenous treatment, that beeping sound is a common recurring offender. This is more so in the inpatient setting. When you first hear the beep, it is natural for your mind to wonder what it is about – is the patient’s elbow bent or is there another problem? This may not be something you can control, although you can ask your nursing staff to address the situation as soon as they hear the alert. Email notification is another common one. By turning off the notification, it minimizes the temptation of thinking about what the notification is about.

The other type of alert is from phone calls and texts. Or pagers if you still use one. If possible, separate your personal phone from your work phone so you can silence your personal phone while at work. Nursing staff, front desk, other physicians or patients may disrupt your day at any time. While you cannot predict when or who will contact you, it is possible to minimize some of the distractions with the help of your staff. Set clear protocols on when it is appropriate to interrupt you during patient care. Are there messages that can be handled by a nurse instead of you? The more you can delegate in advance, the less distractions you will have.

What about the interruptions from your staff? This happens more frequently with new staff members, but this does not have to be the case. If they are working within their scope of expertise and if they have clear instructions on what to do in certain specific scenarios, then you will leave with the interruptions which are appropriate. By setting clear instructions and protocols will allow your staff to be more independent too.

Are you causing your own distractions? It is important to manage your own mind. An undisciplined mind tends to wander. Before you know it, while you are ordering labs for a patient, you may be thinking about what to eat for lunch, or what the next patient has to share with you, or how much you want to go home by 5 pm. It is more difficult to concentrate when you are sleep deprived or emotionally stressed. It is important to take care of yourself physically and mentally so that you can focus better and manage distractions better.

Multitasking is a distraction? Yes! You may think that attempting to do multiple things simultaneously will save you time. On the contrary. When you try to do more than one thing at a time, you are actually switching from one task to another. It takes seconds to minutes for your brain to switch from one thing to the next. When you do this back and forth multiple times, it takes you longer to complete those few things compared to when you do them one by one. Avoid the temptation of multitasking. Set your mind to focus on completing one thing at a time.

Is your environment a source of distraction? For example, the noise from a nearby construction site. Or conversations from others close by. A messy desk may also be a source of distraction. If you cannot find something, you will spend extra time looking for that thing.

Since that time, we have trained our staff better. The phone calls are better screened so many of them can be handled by the nurses. The staff also has a clearer protocol to follow, so that the daily interruptions are minimized. Communication is crucial. Things change all the time. There is always something to improve. When I see a nurse standing at the door waiting for me, I know it is about something only I can handle.

As long as you work in clinical medicine, you will always encounter some form of distractions. It is important to be mindful of them and set a plan to tackle them. Beware of both the external and internal distractions. By minimizing distractions, you will have better workflow, better efficiency and better patient care.