Journal of general internal medicine
-
Many approaches to burnout and compassion fatigue in medicine do not focus on the reason most physicians went into practice, namely love. And we do not explicitly think of our daily work in these terms. If we believe our job is to help others in a very task-oriented sense and we are not able to succeed or a patient has a poor outcome, we can miss the fact that often our simply being present is what is needed. Refocusing on our love of others in our work whether they are patients, colleagues, or administrators can reinvigorate our experience and make us happier people in the process.
-
Observational Study
Predicting Outcomes of In-Hospital Cardiac Arrest: Retrospective US Validation of the Good Outcome Following Attempted Resuscitation Score.
Providers should estimate a patient's chance of surviving an in-hospital cardiac arrest with good neurologic outcome when initially admitting a patient, in order to participate in shared decision making with patients about their code status. ⋯ The GO-FAR score can estimate, at time of admission to the hospital, the probability that a patient will survive to discharge with good neurologic outcome after an in-hospital cardiac arrest. This prognostic information can help providers frame discussions with patients on admission regarding whether to attempt cardiopulmonary resuscitation in the event of cardiac arrest.
-
During the initial consultation with a patient to communicate a diagnosis of late-stage cancer, the oncologist may refrain from giving survival statistics, redirecting the conversation from the bad news (incurability) to the practical aspects of the patient's care (treatments, timetables, appointments, and testing to monitor response to treatment). Whether conscious or unconscious, this diversion helps cushion the impact of the disturbing news. ⋯ To remedy this problem, I describe an approach to straight talk about late-stage cancer that can give a patient realistic hopes instead of false hopes that are apt to betray later on. I also propose an enhanced method of displaying and interpreting comparative efficacy data that can facilitate understanding and serve as a basis for shared decision making.