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Using Emotional Regulation for Effective De-Escalation

For many physicians and other healthcare professionals, the threat of workplace violence is something that they feel underprepared to manage. Statistics consistently show that there is an epidemic of violence in hospital and healthcare settings. In fact, if you use the metric of nonfatal illnesses and injuries, healthcare is the most dangerous profession there is.…
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Reducing Risk of Violence with Situational Awareness

Back in 2016, the New England Journal of Medicine published an article referring to violence in healthcare settings as “ubiquitous” (Phillips, 2016). In 2018, healthcare workers accounted for 73% of all nonfatal workplace injuries and illnesses due to violence, more than prison staff, police officers, and other occupations that may typically be considered more “dangerous”…
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The Weight of Error

Suicide risk for physicians is elevated when facing a malpractice case or licensure restriction, or dealing with other career concerns. These are obviously significant stressors, and they deserve attention and intervention. But what about the distress associated with making a mistake, even if that mistake doesn’t lead to external consequences? The weight of error can…
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Suicidality and Hope for Physicians

September is Suicide Prevention Awareness Month and September 17th is National Physician Suicide Awareness Day. Every suicide is an unspeakable tragedy, a loss that ripples outward in waves of pain and grief. The Council of Residency Directors in Emergency Medicine estimates that up to 400 physicians take their own lives every year. While estimates of…
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Grief Myths That Impede Healing

Dealing with grief is a natural, but difficult, part of life. Unfortunately, there are some widespread myths that can make the process even more difficult. We explore a couple of these below: Myth #1: You will progress through stages of grief in a linear fashion. Reality: You may be familiar with the stages of grief…
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Disenfranchised Grief

Have you ever felt guilty for feeling grief? We’ve talked before about ways to cope with loss and access appropriate social support in difficult times. But what happens when you don’t think you have the right to feel the way you do? Disenfranchised grief refers to grief that is unacknowledged or invalidated by others or…
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The Hidden Curriculum: The Lessons of Microaggressions

“He didn’t mean anything by it when he did that.” “She only said it because she doesn’t know any better.” “Don’t take it personally. They didn’t mean it that way.” Microaggressions refer to everyday, subtle, intentional, or unintentional interactions and behaviors that communicate some sort of bias toward historically marginalized groups. The term is not…
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Techniques to Improve Focus

It is an ugly reality that sometimes our learning environments are incompatible with learning. Sleep deprivation and stress can both lead to impaired cognitive performance. Low self-efficacy can reduce motivation and perseverance. Internal and external distractions can hinder concentration. Fortunately, there are evidence-based techniques to improve your focus and performance even in difficult circumstances. Keep…
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Mind Body Experiences of Residency

Let me tell you a story from my early doctor days to bring to life the mind body interactions that can occur when our inner mindsets, beliefs and assumptions, face circumstances that activate our ancestral stress-response survival systems. When I was a chief resident, I was given the opportunity for the first time to present…
