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ER Goddess

ER Goddess

EM New Year's Resolutions You Can Actually Keep

Simons, Sandra Scott MD

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doi: 10.1097/01.EEM.0000552794.64950.66
    new year's resolutions
    new year's resolutions:
    new year's resolutions

    This New Year's I'm doing something different. I refuse to participate in the tradition of starting a new year by heaping more pressure on myself. I will not make the same worn-out resolutions just to break them (again).

    It seems January is the season to give the self-critical voice in our heads a megaphone. This time, we need to custom-tailor something for overachieving physicians. Most of us have been bombarded throughout our careers with incessant messages to be better, to the point that this message becomes part of our inner dialogue.

    We face conflicting pressures from so many groups that to make one happy is to let another down. To please patients by getting to them quickly and spending time listening, we frustrate medical coders with anemic charts. To please administrators and coders by staying late to chart, we let down loved ones waiting for us at home. Living with the constant nagging feeling that we need to do better by someone, including ourselves, means physicians have an ever-ready list of possible resolutions. We make them each new year as if January has magical ability to accomplish what we couldn't the rest of the year.

    It's no surprise that most resolutions fail because we make them with the odds stacked against us. We make them arbitrarily because the calendar says Jan. 1, not because our circumstances are amenable to change. We make resolutions whose success is at the mercy of things we can't control. We make resolutions for ourselves to change as individuals even though institutions aren't changing. I can resolve to work faster, but there is only so much I can do without the appropriate infrastructure, ancillary services, and EMR. We make overly ambitious resolutions that try to change our habits too radically, forgetting that we have limited willpower. We make resolutions based on myths, like work-life balance, that may not even be attainable.

    I'm not saying we shouldn't strive for improvement, but we need to choose goals realistically for change to occur. Even the loftiest ambitions are achieved one step at a time. The best resolutions are simple and small. Instead of resolving to lose 40 pounds, how about resolving to schedule three runs and three sessions of strength training per week? Manageable aspirations are key.

    Real change also requires inspiration. We need circumstances compelling enough to snap us out of bad habits. If I were to become so fluffy that I couldn't button my pants and it was either trim down or buy all new clothes, that might motivate me to lose weight. If I were to fall asleep behind the wheel, that might motivate me to pursue better sleep hygiene. But the day changing from Dec. 31 to Jan. 1? I can't say that compels me to do much besides pop a bottle of champagne.

    Why force it? Meaningful change will happen because I'm ready. This year I'm not setting myself up for stress and failure again. Instead, I'm stacking the deck in my favor and choosing targets I can hit. And I'm using one of EPs' favorite strategies for dealing with stress—humor. Who's with me?

    Here are my EP New Year's resolutions:

    • I will not steal pens, not even accidentally.
    • I will try to figure out why I really need pens in every single pocket of my white coat plus every single pocket of my scrubs. I will remove said pens from said pockets before they explode in my washer or dryer.
    • I will not stand like a fool in the exam room expecting the paper towel dispenser to feed me its goods. Nothing instills patient confidence like flailing my hand repeatedly under the sensor and getting zilch. Foam it is in 2019.
    • If I am ever lucky enough to get a paper towel from the dispenser, I will not miss when I shoot it into the trash can.
    • I will stop letting ECGs from my entire shift and the shift before pile up on my desk so I have to hunt for my keyboard.
    • I will think of a better Epic password than “password.”
    • I will put the peppermint oil on the mask, not on my upper lip. (I learned that the hard way.)
    • I would resolve to give up eating cupcakes when they show up in the break room, but who am I kidding? I will not eat the whole cupcake but will stop at half. Maybe two-thirds. And I will not get frosting on my nose.
    • I will stop sneaking into the graham cracker cupboard.
    • I will make it to the bathroom at least once a shift to enjoy an empty bladder and 30 seconds of me time.
    • I will rescue the chair from whatever corner of the exam room it's trapped in and park my butt on it while I talk to patients.
    • I will actually say, “I don't know” when I don't know. Or at least, “I'm not sure. Let me check.”
    • I will appreciate the opinions of other people, no matter how boneheaded they seem. After all, mine seem just as boneheaded to them.
    • I will try to be more realistic about the more-than-gently-used condition of my countenance. Every little crease and furrow is a crisis avoided or a critical patient saved. Besides, getting old and wrinkled is better than the alternative.
    • I will, above all, be kinder to myself.

    I wish you all a great 2019. Happy New Year, everyone!

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