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How much does our environment affect us?

The recent release of a Government “happiness report” got me thinking about the effects of the environment in which we live and work — coming as I do from the West Midlands, which scored badly on the happiness index. I know that I’m at my most content when in my garden dealing with tasks such as weeding, and probably at my most stressed when at work fielding numerous questions simultaneously.

There’s also been evidence to show that patients do better when they can see trees and plants. Unfortunately critical care units tend to be somewhat deficient when it comes to plant matter. Nevertheless, being able to glimpse the changing sky through the window gives everyone on the unit a sense of the passage of time and enhances our well-being.

I then pondered further on the effect the environment might have on people’s prescribing. This took me back to the first prescribing error I remember making. I was trying to write the drug chart for a patient at the same time that two of the junior doctors were discussing this patient’s treatment plan. I would write one item and then the chart would be taken by one of the doctors. I’d get it back again and write another item, only to lose the drug chart again. And so it went on. All throughout this there was the ongoing distraction of their conversation. I checked the new chart against the old, yet I was faced with the problem of seeing what I expected to see rather than what was actually there. I failed to see the missing dose. Fortunately, a colleague of mine spotted it immediately and the mistake was rectified.

I took away from this incident several learning points. One of these was always to try to create myself a calm environment when I prescribe. It’s not always easy, since everyone always seems to want a piece of your time. So I now use the “no” word a lot more.

I also remember this incident when I want to talk to other clinicians. If a prescriber is in the middle of writing a chart, I’ll wait until he or she is finished. Similarly, the other day one of the nurses was in the middle of administering a medicine and, although she appeared happy to talk to me, I waited until she had finished what she was doing. Too often though we don’t give our colleagues the space they need to finish the immediate task at hand, and then we wonder why mistakes get made. Teaching my junior colleagues not to distract a prescriber in action is yet another challenge.

I may not be able to spend all my time in the garden, but I do now try to put myself into that frame of mind when undertaking prescribing tasks. It might not make me happier, but it will surely make me safer!

Citation: Clinical Pharmacist URI: 11107698

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