Too Fatigued to Care?

MMiz

I put the M in EMTLife
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I always feel bad for those I interact with at the end of my workday. I'm tired, hungry, and not quite as empathetic. I do my job, yes, but it's not the same quality of work I put out earlier in the day.

In EMS I always cared, but the calls at the end of a 12 hour shift were the worst. I was simply tired, hungry... you know the rest.

What do you think? What's the solution?
 
Normal I wouldn't worry too much about it. Just try to always be caring and hope it shows
 
Stay another 72 hours and the first 12 don't seem too bad anymore.
And lots of caffeine.
 
I don't think there is a "solution", at least at the provider level. Humans wear out. At the system level, the solution is a manageable workload, shorter shifts, and making sure providers can take care of their needs.

But I've noticed this too, especially because my social skills are just about the first thing to go when I'm fatigued, hungry, or under sustained cognitive load.
Some people (Ian Miller from theNursePath) advocate mindfulness for this problem and being more efficient and less error-prone overall, but I haven't really done much of that. What I think has helped is, first of all, arranging things (sleep, snacks, partners that don't suck, etc.) so I can stave off that point as long as possible. More helpfully, I'm trying to raise my interpersonal baseline. The more I consciously work on developing rapport, managing the encounter, and appearing empathetic, professional, etc, the more these things become an automatic part of my practice the way most of the technical skills are, the less they degrade under stress, and the less I have to rely on my actual feelings about the patient and call to generate them. I hope.
 
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