“Myers! Wake up. We have casualties coming in. We need you.” A gruff nudge jerked me awake from a brief two hours of sleep. I rolled off my cot, fumbled for my boots and stumbled bleary-eyed from the canvas tent I called home for six months while in Afghanistan. When I arrived in the ED, I sought out the team leader to receive my assignment. As I gathered my supplies, I glanced over each of the other trauma bays. Team members were taking their positions. There was an attitude of gravid anticipation as we prepared for a scene that had become hauntingly familiar. Some were quiet; others tried to lighten the atmosphere with jokes or superficial comments about yesterday’s meal.
As the injured arrived in the ambulance bay, the room became suddenly silent, soon replaced with the cries of the wounded as they entered. Each team member worked with intention and somber purpose. Soon, patients were stabilized, and the department became quiet again. I headed off to my bunk to catch a few moments of rest before the inevitable nudge came again.
This scene is likely familiar to many of you—if not the exact circumstances, certainly the overall sensations. The above experience occurred while I was a trauma nurse in the U.S. Navy prior to starting medical school and pursuing a career as an emergency medicine (EM) physician. I had the unique opportunity to view medicine from a different perspective. Through this journey, I witnessed a variety of leadership styles and approaches to managing patient care. From these observations, I learned valuable lessons that I now aim to translate into my role as a physician.
One important lesson impacting my daily work life is the role of individual members as integral components to an effective team. Few of us would thrive in EM if we did not have some sense of the value of teamwork. The memory I have just recounted stood out as a representation of this notion. Each member of the team—whether physician, nurse, technician, or housekeeper—is essential to its optimal functioning. When individuals sense the value of their role, the team succeeds. As physicians, we can further build the sense of community by expressing gratitude and consideration to our co-workers. This can be promoted by actions as simple as remembering someone’s name or a personal fact shared.
While valuing the individual might be an obvious principle to some, we often forget to value our own role. Female providers in particular might be at risk of experiencing feelings of inadequacy or underappreciation. Just as we recognize the value of our team members, we must intentionally value ourselves. When we step into our roles with confidence and self-respect, those around us will return that respect. Notably, this is not the same as exhibiting bravado or arrogance. Rather, I am referring to a genuine embrace of belonging and importance to the team. Personally, the providers for whom I have the greatest respect are those who have been strong enough to understand their shortcomings and strengths, learn from them, and lead with resolute confidence.
Lastly, our environment in EM relies on clear and effective communication—often when stakes are highest. In Afghanistan, I worked with many military EM physicians—most of them men—who commanded their traumas much like an admiral would address his troops. However, there was one quiet, petite female physician who greatly impacted me. With her small five-foot frame, she rarely—if ever—raised her voice, but when she spoke, the room would quickly quiet and listen. From this one physician, I learned that effective communication is not confined by boundaries associated with gender. Books, blogs, and mentors have suggested that women should try to emulate traditionally “masculine” characteristics when leading (e.g. volume, cadence, tone, etc.). As I develop my own leadership style, I have given a lot of thought as to how, as a female physician, I can most effectively express myself. For me, I disagree with this “masculinization” effort. Some of the most effective communicators with whom I have worked were soft-spoken women. I have also worked with more traditionally masculine men who were just as effective. It is flawed logic to universally espouse that only one type of communication style is received positively and/or effectively. As physicians, our goal is communicating in a way in which staff and patients understand clearly. This is a skill one should develop with a personal style, not in an inauthentic, copycat fashion.
In my transition from nurse to physician, these principles hold true. The more I recognize my own value and continue to find its unique expression, the more fulfilled I become. My hope is that as we begin to embrace our distinctive contribution in the workplace, we will see less burn out, frustration, and dissatisfaction. This takes deliberate practice and requires an intentional training of our internal monologue. Just as you strive for excellence in your clinical skills, I encourage you to authentically work to embrace your uniqueness and value to your team.