Real-time peer coaching from a colleague by Patricia Capone
You’re working a shift in a place with double coverage, has residents, and a cardiac arrest comes in. Nursing, RTs, everyone shows up. As the attending you’re job is to organize the chaos and all of a sudden out of the corner of your eye, you see the other attending (your double coverage) come in and stand in the corner quietly.
How do you feel?
- Reassuring? as a junior physician, having a back up is nice.
- Easy to fall back into old habits if you are working with someone who used to train you – they may even overstep and that has to be addressed.
- If done well it’s good, helpful and sometimes you can even get good feedback from the other attending.
What do you do if someone comes in and they are getting in the way while you’re trying to run a code?
- Try to set boundaries at the beginning of the resus if possible: If you give them a job they will know how they can be helpful to you. If they step outside that role it will have to be handled case by case. A really good job to give the other attending is overseeing procedures because when you are supervising or doing a procedure you get tunnel vision and like we said an attending’s job during a resus is to see the big picture and organize the chaos
- Depending on the resus you may or may not need the second set of hands
- Give them busy work (go find the family and get them settled, grab EMS for more history, find the chaplain, go get towels, xyz) if they are getting in the way, later on, have the conversation that they can’t come in and start giving orders because it’s confusing for the team. It’s great if they want to help, but they have to defer to you.
How do you go about it?
- Be clear and direct
- Ask them why they entered the room/situation? I didn’t ask you to be there
- Remind them that it’s not good for the team and therefore not good for the patient because the team gets confused.
- Tell them if they feel they need to give you reel time feedback they can get your attention and pull you aside or if it’s not urgent they can tell you after.
Residents do it to each other too sometimes – address the situation professionally after
Goal by the end of the training:
- Be able to receive feedback in an appropriate way.
- Build good relationships with the people you work with so that you feel empowered to pull someone aside either in the moment or more likely after to give them feedback.
- We need to normalize peer coaching and make it a positive productive and not a negative and daunting thing.
Live Grand rounds for St.Joe’s Residency program with Andy Drew Swami and Miguel
Some Resources worth looking at: