Interruptions

As an Emergency Room doctor I’m quite used to the completely chaotic, barely-organized environment, and while it’s not a really comforting place for me to be I handle it was well as any other (I think). However, the high-speed, get-things-done-now pace sometimes can lead to some bad habits, and one of them has recently risen to the level of Formal Irritant: interruptions while speaking.

We all need to communicate, and we all need to get things done quickly for any type of efficiency to happen. I truly get that, and operate that way myself. But, because you want to have a question answered in the shortest amount of time doesn’t mean you get to interrupt me while I’m trying to communicate with someone else. That’s called Being Rude, and well mannered people don’t do it.

Yes, please interrupt me to tell me the patient in bed 6 is coding, thanks! But, don’t interrupt me in the middle of a sentence with anyone else to ask “Is this patient’s admission full or obs?” “Can bed 3 have a box lunch?” I realize I talk a little too much, but my time is as valuable as yours, and when interrupted I have to start over, thereby taking more time (and it’s less efficient, and we’re back to the rude thing, again).

I see this throughout my ED, certainly not just with me. It’s ubiquitous. I probably interrupt people, too, but since it’s been annoying me I’m making an effort to not interrupt without real cause (like the lady in bed 6). I don’t expect anyone to wait through the Gettysburg address, but there are natural pauses in conversations when questions aren’t completely disruptive, can we all try to wait for that?

There, I feel better now.


Comments

  1. Nice rant. I read a study somewhere years ago about the level of multitasking and interruptions that ER docs must perform and endure and it was off the charts compared to other professions.

    How about the interruption of the interruption of the original task or conversation?? That occurs about 20 times a shift.

  2. This isn’t just a problem in the ED, but a problem more generally felt as good manners seem to be falling by the wayside on a much larger scale. In the medical context, it seems impossible these days to simply make a trip to the doctor’s office without at least three interruptions during the visit in the exam room, and that’s after having waited your turn for over an hour in the waiting room. Great rant. I’ve added mine.

  3. I recall a statistic that the average ER doc gets interrupted something like 20 times an hour. From my experience in the pit, I’d say that’s accurate. Our nurses are actually pretty polite on this front, though — I have to give them credit.

    Though I should point out, for reference, that the Gettysburg address is two paragraphs long and takes about three minutes to read, so I don’t think it would be *too* unreasonable to ask someone to wait that long. Though why you’d be giving a war memorial speech in your ER, I can’t fathom.

  4. Great minds think alike. Most of the nurses I work with know that there are times that you should have the “sterile cockpit”. Talking to consultants, listening to dictations or talking with patients. Interruption at that point should only be for serious problems. The more you are interrupted the greater the risk for a mistake. The next time I am inappropriately interrupted I will refer them to your rant.

  5. Point well taken. Definitely mea culpa…I never even realized this until I read this post. Thanks! And I bet the doctors I work with will thank you, too! : )

  6. There’s an analogous, related problem: talking to someone who keeps getting interrupted and allows it to happen. The worst are people who, of course, never shut off their cell phones, and feel compelled to answer them. I’ve had patients in the office interrupt my visit with them to answer their cell phone, with something like, “Hello. Honey, I’m busy right now, I’m at the doctor’s. No, I can’t come straight home right now, I’ve got some errands to do after this. Is your sister there? Put her on the phone. Kim, try to keep Melissa busy for a while, cause I’m at the doctor’s. Yes, I remember about your practice tonight. Well, I’m not sure what we’ll have for supper tonight…” (snip)

  7. I used to wait tables in a restaurant where during service the custom was to say “Chef, may I speak?” when you needed a question answered. Some servers found this to be demeaning but it worked quite well as a system. The chef acknowleged that you had a question and he was able to finish calling out food orders before he answered it. Otherwise there would have been total chaos.