When Everything Feels Like It Is Going Wrong: A Lesson in Self-Compassion for Physicians

Our hospital system just changed the electronic medical record system. Months were spent talking about it and preparing for it. We physicians attended all the required meetings, workshops and modules to prepare for the new EMR go live. As much as I prepared, I did not feel prepared at all.

I spent a day preparing for the patient notes and order their labs, thinking that I would be all ready for the first day of seeing patients with the new EMR system. Many of you know that when a new EMR system is introduced, a lot of things can go unexpectedly, usually not in a good way. For me, it was my lab orders. We always draw labs during the visit. Somehow, my orders could not be released by the nurses.

EMR tech support was there. Several people tried to help me and troubleshoot. At first, no one could figure out what was wrong, because everyone could see my lab orders but somehow they could not be activated. Different people tried different things. Not working. Reordered the labs – not working. Then, finally, we found out that the labs had to be ordered a certain way. In the meantime, a patient was waiting for more than an hour and a half – which was unheard of for me.

I felt helpless and frustrated, because I did my best to prepare for the unknown, yet I gave myself more work to do, more wait time for patients, and I was holding up nurses because of those orders. I cried.

At that moment, I let myself feel my feelings. I also allowed myself to gather my thoughts. Instead of thinking that “everything” was not going well, I named what was wrong – it was the lab ordering method. I vented, perhaps even “ugly-cried”.

Then I took a moment to pause and settle down. I was mindful to be kind to myself. I did the best that I could. As for most EMRs, unless you are using it in real life, the tutorials or the learning modules do not prepare you enough for the real world.

Asking for help was the best thing I did. There was no way to figure it out on my own – it took several EMR experts to solve the problem.

Through this incident, I was reminded of a few things. When things do not go as expected, it is easy to believe that everything is going wrong. Instead of thinking that, label the main issue. Understand why you are feeling what you are feeling. Allow yourself to experience your emotions rather than bottle them up. Take a moment to process your feelings.

Be kind to yourself. You are doing the best you can, given the circumstances. It is always a learning and growing opportunity, no matter where we are and what we do. Be grateful for what you have. In the midst of chaos, what is going well? I am grateful for the support we have.  It is also important to have hope. The hope that things will be better. In this new EMR incident, I believe that things will get better and better. The more I use it, the more familiar I am with the program, the more efficient I will get – this applies to any program we use. Then, explore what you can do differently next time. For example, before the official EMR goes live, maybe it is helpful to have a longer period of “soft go-live”, so more clinicians can have real-life practice. It is important to focus on what is going well and what positive things to look forward to.