fifteen years. Describing the job, he says: “You’re constantly handling problems.
You don’t have much time, and you never stop moving. In one hour, you’re
making perhaps one hundred or two hundred decisions:
which tests to order,
where to send a patient, and what interventions are needed. You’re on different
shifts, sometimes morning, sometimes night. A twelve-hour shift can turn into
fourteen hours if something bad happens with one of your patients.” And Rakesh
confirms that the job is emotionally draining as well as mentally and physically
challenging. “It’s very hard when you get an outcome you don’t want or expect.
Initially I used to say ‘Nobody’s going to die on my watch,’ but that’s not
realistic.”
So Rakesh takes a calculated approach to keeping on what he calls his “game
face” throughout a long shift. For example, he uses music to shape and shift his
mental state. “You know you’re going to walk into a full waiting room, and as
soon as you walk in you’re going to need to spring into action. So I need to
pump up my energy levels on the drive into work, and I pick music that I know
will do that for me, like some Linkin Park. Once I arrive, I switch to reggae, and
we have it playing in the background for everyone. It’s
sort of happy but also
relaxed, which is how I need to feel to perform at my best under pressure.”
Rakesh also knows when the highs and lows of the shift are going to happen,
and plans accordingly. “You’ve got to be aware of your own biorhythms to get
through something as tiring as ER work,” he says. “For example, I always know
that my highest energy levels are going to be in the first two to three hours of
each shift. My brain’s working fast, I feel alert. So I don’t waste that time. I want
to capitalize on that and see as many patients as I can in that time.” Then, when
he’s flagging, Rakesh says: “I make sure to keep the conversations going with
staff and with patients. I like asking patients
to tell me about their lives,
especially the older ones. The other day I found out that someone I was treating
had been a B-52 tail gunner. You can have a meaningful conversation in just a
few minutes, and it helps the patient as well as improving my alertness.”
It doesn’t take a lot to become as self-aware as Rakesh—it’s just a matter of
paying more attention to our personal patterns. If we know what’s likely to feel
especially draining, and we know the most reliable way to pick ourselves up
again, we can be far more proactive in managing our mood and productivity
throughout a long day. Here’s what you can do to build that self-awareness:
Draw a timeline from morning to night. Plot some of the peaks and troughs
you’ve experienced in recent days (or weeks)—the moments when you’re full
of energy, and moments when you feel depleted.
Notice the patterns in your highs and lows. What
reliably lifts or depresses
your energy level? Here are some categories to consider:
• Mental: analysis, creative thinking, planning, reading
• Physical: exercise, travel, manual labor
• Social: specific individuals, types of people, being in a group vs. alone
• Surroundings: music and sounds, workspace, natural environment
• Time of day: circadian rhythms, family or personal routines
• Themes from this chapter’s list of seven energizers: gratitude, generosity,
curiosity, achievement,
connection, purpose, and humor (assuming that
funny things make you smile).
Then decide how to apply your most reliable energy boosts to smooth out the
troughs. In particular:
• On days that promise to be tiring, or at times of day when your energy
regularly dips, manufacture a peak or two: for example,
plan a
conversation with a friend or tackle a task you always enjoy.
• See if you can attack your more energy-sapping tasks while surrounding
yourself with things that boost you—perhaps an uplifting location,
energizing people, or some upbeat music.
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