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{
    "pk": 13010,
    "title": "“Breaking” the Emergency Department: Does the Culture of Emergency Medicine Present a Barrier to Self-Care?",
    "subtitle": null,
    "abstract": "Introduction: \nOur goal was to critically examine emergency physician’s (EP) beliefs about taking breaks for self-care on shift. Our operational definition of a break for self-care included time not engaging in direct patient care, eating, drinking, using the bathroom, or leaving a clinical area for a mental break. Using focus groups, the study aimed to accomplish the following: 1) identify barriers to why residents and faculty at our academic center may not take breaks in the emergency department; 2) generate hypotheses for empirical testing; and 3) generate solutions to include in a departmental breaks initiative.\nMethods:\n We convened eight focus groups comprised separately of resident and faculty physicians. Group discussion was guided by eight questions representing a priori themes. The groups were recorded for transcription and subjected to a “cut-and-sort” process. Six themes were identified by consensus after independent review by three of the co-authors, which were confirmed by participant validation.\nResults:\n We identified six themes that represented the pooled outcomes of both resident and faculty focus groups: 1) Physiological needs affect clinical performance, 2) EPs share beliefs around taking breaks that center on productivity, patient safety and the dichotomy of strength/weakness, 3) when taking breaks EPs fear worst-case scenarios, 4) breaking is a learned skill, 5) culture change is needed to allow EPs to engage in self-care; and 6) a flexible, individualized approach to breaking is necessary. Our central finding was that productivity and patient safety are of key importance to EPs when considering whether to take a break for self-care. We identified a dichotomy with the concept of strength related to productivity/patient safety, and the concept of weakness related to self-care.\nConclusion:\n The current practice culture of emergency medicine and the organization of our unique work environment may present barriers to physicians attempting to engage in self-care.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Self-care in working Emergency Medicine Physicians"
        }
    ],
    "section": "Emergency Department Operations",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/3kp2c57x",
    "frozenauthors": [
        {
            "first_name": "James",
            "middle_name": "",
            "last_name": "O'Shea",
            "name_suffix": "",
            "institution": "Emory University, Department of Emergency Medicine, Atlanta, Georgia",
            "department": "None"
        },
        {
            "first_name": "Salwar",
            "middle_name": "",
            "last_name": "Vu",
            "name_suffix": "",
            "institution": "Emory University, Department of Emergency Medicine, Atlanta, Georgia",
            "department": "None"
        },
        {
            "first_name": "Jeffrey",
            "middle_name": "",
            "last_name": "Siegelman",
            "name_suffix": "",
            "institution": "Emory University, Department of Emergency Medicine, Atlanta, Georgia",
            "department": "None"
        },
        {
            "first_name": "Sheryl",
            "middle_name": "",
            "last_name": "Heron",
            "name_suffix": "",
            "institution": "Emory University, Department of Emergency Medicine, Atlanta, Georgia",
            "department": "None"
        },
        {
            "first_name": "Michelle",
            "middle_name": "",
            "last_name": "Lall",
            "name_suffix": "",
            "institution": "Emory University, Department of Emergency Medicine, Atlanta, Georgia",
            "department": "None"
        }
    ],
    "date_submitted": "2019-07-18T21:25:20Z",
    "date_accepted": "2019-07-18T21:25:20Z",
    "date_published": "2020-02-21T20:38:58Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/13010/galley/6817/download/"
        }
    ]
}