Saying that a good shift is a choice needs clarification. We must expect that there will be bumps along the way. If we always come to work with the attitude that we will have a good shift only if A, B, and C occur (“A” being perfect lab performance, “B” being perfect radiology performance, and “C” being perfect EMR performance), then we will always be frustrated and never have a good shift.

However, if we start with the attitude that we will have a good shift no matter what happens and that we will do the best we can with the resources we have today, our outlook can become more realistic and less frustrating. Of course, we should not lower our expectations and we should certainly continue to work through processes that will enhance our practice; however, during the middle of the shift, it will not improve our situation to become mentally frustrated with a process that is not working correctly on that day.

Three specific suggestions to consider:

1. Please avoid using vulgarity when you get frustrated. Vulgarity just adds stress and tension to those around you and really doesn’t serve to resolve problems any more quickly or completely.
2. The ED is a loud department. When nurses, physicians, PAs, NPs and staff are laughing and speaking loudly, it just promotes angst and leads to a more difficult work environment. Try to minimize noise.
3. The hallmark of ED practice is teamwork. Anger toward our nurse colleagues does not solve problems and may actually hinder their resolution. ED nurses want to do a good job, and they want the physicians, PAs and NPs to do a good job. They care most about the patients, but also about the practice and the ED in general. When a negative situation occurs, try not to be reactionary; instead, think through the situation slowly and be patient.

The bottom line is that after decades of practice and coming to work in the ED, I know for a fact that not everything will go smoothly on every shift. We can prepare by working on our own wellness, bringing our “A” game to every shift, and leaving all distracting baggage outside the work environment. We have to be able to let things roll off our back and move forward. When we are working, we need to understand it is not all about “me”; rather, it is all about “we.” Everyone in the ED and elsewhere in the hospital must function together to ensure not only patient safety, but also a high level of patient and staff satisfaction.

Expect that your shift won’t be perfect, but have the mental outlook that you will move forward and do the best you can every day in spite of what may happen. This attitude will go a long way toward making your shift better, more rewarding, and less frustrating. Remember that “a good shift is a choice.”