How To Focus Doing Clinical Work

Most of the time I spend at work is in the outpatient setting. There is usually a set number of patients scheduled for the day. Once in a while, there may be a patient I decide to add on last minute. Outpatient patient care is usually well-structured. Sometimes I spend more time with a patient based on the clinical situation. For me, patient care in the clinic setting has been quite routine. I am usually done for the day by 5 pm, after seeing 20-27 patients.

Inpatient care is quite different for me. Although my practice limits outpatient care to be consultation work only, we do follow most patients throughout their hospital stay. Inpatient service is unpredictable. Patients in general are more ill. Any attending physician from any specialty may request hematology or medical oncology consultation at any time. There are days I get 2-3 consults, and there are days I get 10 consults with 20 other patients to follow up on. Not to mention phone calls from other clinicians, infusion unit, calls related to outpatient issues, etc.

This can be easily overwhelming. When you are overwhelmed, it is difficult to focus and decide what the next immediate step is. You may end up spending more time to process what is going on or arguing with what is going on. You may think the day should be going a different way. You may think this is too much for you to handle.

The patients still need to be seen. The work still has to be done. How do you bring yourself back to do what you set out to do at work?

First, accept your current situation. Do not argue with reality. You cannot change the fact that your service is requested in 8 different directions. Accept it and get ready to handle your day.

Tell yourself that you can handle it. You have done many hard things. You have had years of training. You will figure it out along the way. The day will eventually end.

Inpatient care is different from outpatient care in that the former does not have a fixed time schedule for when to see each patient. If you happen to get three consults at about the same time, identify which patient should be seen first. Patients in the ICU are generally more urgent to be seen than those on the regular floors. It is helpful to talk to the referring doctor directly – this will save you time on figuring out why the patient is here, why the consult is requested and what guidance they are looking for. I had an experience when the message about a consult was to evaluate for anemia when the actual consult was for something far more serious - pancreatic cancer.

Eliminate distractions – concentrate on one thing at a time. Put your attention to one patient at a time. If you find your mind wandering in other directions, bring it back. Do not attempt to multitask. Good quality work and efficiency result from doing one thing at a time. When you are in the patient’s chart, further decrease distractions by only paying attention to the pertinent information rather than studying the entire chart. Constantly be the watcher of your brain and nudge it to do only one thing at a time.

I cannot emphasize more the importance of exercise regularly and getting enough sleep. Exercise and sleep help you clear your mind and focus better in general. When you are mentally exhausted, it is difficult to focus.

Taking a short break at work actually helps you complete your tasks faster than if you work straight through without any pause. The break time gives your mind and body a little rest, so it is easier to refocus on what you are doing.

Remember what your goal is for the day. Take me for an example. My goal for the day is usually to take great care of my patients and to go home on time, so that I can spend meaningful time with my family. What is your goal for the day? Remind yourself throughout the day. With that in mind, it is easier to focus on what you are doing to achieve your goal.

If you can improve your focus at work, you improve your efficiency. You will also have a lesser chance of making mistakes. Keep things simple, prioritize what you are doing and tackle one thing at a time.