Working the rounds
i am painfully, embarrassingly, frustratingly, annoyingly shy. pick your favourite shade of fuschia or red and you’ve just about guessed the colour i turn when (on purpose or by accident) i am made the centre of attention. as soon as i was old enough to get my hands on a hairbrush, i frizzed out my blonde natural curls into a messy halo so strangers wouldn’t stop my parents and scoot down to my level to tell me how cute i was. in high school, people used to think i was a snob when i was actually just too introverted to talk to anyone other than my close friends most of the time.
add to that the fact that i have spent hours and days and months training my brain to work in the multiple-choice USMLE question format, and i have a bit of a conundrum when put on the spot with medical questions on rounds…
i just can’t get the words from my brain to my mouth fast enough.
over the years, i have developed an adequate number of coping mechanisms to deal with my annoying shyness. this website is probably one of them. writing for you guys every (other) day is much different than standing up and speaking in front of you all.
but i have 72 weeks of clinical rotations and “pimping” to get through on rounds. and i can’t answer those questions via Twitter. i might know more than the guy next to me, but it really doesn’t matter if i can’t get the information down from my brain. i am so painfully aware (self-consious, imagine that!) of my deficit that i am genuinely considering joining some sort of Toastmasters club to work on my public speaking when i get back to North America. while still here on Nevis, i am attending every clinical opportunity available to us MED 5s because i figure practice can only help.
which brings me to the reason for this post… i don’t often solicit advice from you guys, but i’d like to put you all on the spot. i need some ideas for how i can work on this and improve my demeanor both on rounds and with patients in the future. most of the people that know me in real life understand that i’m not shy in EVERY aspect of personal contact and conversation. and some will probably be surprised to read my lifelong claim of introversion. there are more than a few things that come naturally and easily for me, but answering questions on the spot even from an information bank that i know backwards and forwards cold is not one of them.
so, should i start talking to myself in the mirror? should i figure out if i am nervous about being wrong and just get over it? or do i simply need to study more so i OWN the material and am more confident?
how can i improve? what did you do to improve?
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photo: from a “365 days” project on Flickr that i participated in to improve my self-awareness, creativity and confidence.
February 20th, 2009 at 9:09 am
Hi Jen
I can totally relate to what you say. I suppose you have come across the Myers-Briggs personality inventory; from what I understand of it you are describing yourself as a total introvert by their standards.
I run into the same kinds of problems being a teacher. About the only way I’ve learned to cope at all is to consider teaching as “theatre” and improvisational theatre at that. When I walk in the door I’m on…until I leave. I have to find some down time during the day, even if it means doing dishes in the staffroom so I don’t have to talk to anyone or think too hard. When I leave work, I don’t want to talk to ANYBODY. As I get older, I find it almost frightening how much I like to be alone- with the doggies.
This isn’t the advice you seek, I know, but it is my response to what you have written. Good luck!
February 20th, 2009 at 10:18 am
Everyone gets nervous about something, even the most accomplished public performers. Everyone makes speaking mistakes too.
Trust your training and knowledge and treat patients like respected friends. Accept that you can’t be right all the time and most people will understand that – they’ll probably be more forgiving of you than you are of yourself.
Perhaps you could try building confidence by speaking to random people in the street, or by having a go at an open-mike poetry or comedy night.
February 20th, 2009 at 11:34 am
As a fellow shy person, I think what you need is practice. And not in a mirror, but practice as you go through your rotations. The more you do it, the more comfortable you’ll become with the scenario because eventually it will become your routine. Really, any new scenario that is not part of our day-to-day can make us nervous – but give it a few weeks and I bet you’ll overcome those butterflies and get more confidence to speak up.
And girl, I know you will own that material (*snaps fingers in Z formation*).
February 20th, 2009 at 2:03 pm
oh honey, trust me when i say that i definitely know this one and you likely never would have guessed that meeting me, even my close friends have a hard time believing it and yet, i can tell you stories of bright red ears and shaky hands and uh um well voice doesn’t work. it was the reason i minored in drama in uni ~ to try and get over it …
but .. here is what works for me, for example when i am working as a photgrapher, it is so not about me. its about the people i am shooting and making them comfortable and ensuring beautiful photos of them and a good experience for them :) when i reframe it that way, it becomes easy …
… same with your rotations really, its so not about you, its about the knowledge that you have for the patient, its about making them comfortable … i think that as soon as you take the focus off of you then you will be fine and no longer self conscious or shy …
sounds simple because it is … deep relaxing intentional breath through your noise, calming you inside, grounding you with the knowledge that you are following your dream and you are wonderful and amazing and fully capable of this. just be yourself.
xox
cheering you on over here
February 20th, 2009 at 2:18 pm
I don’t think the seconds it takes for the words to get from brain to mouth are as long to everyone else as they are to you…and as much as patients might put god-like expectations on healthcare professionals, I’m sure they appreciate a more thoughtful than regurgitated answer. If you find it helpful, talk to yourself in the mirror, or to friendly animals…then work up to people who can talk back. Try to relax and be your wonderful self, and you will improve with time & practice :)
February 20th, 2009 at 3:14 pm
I read so much of myself in your comments (snob? oh I’ve *so* been there!), so I’ll share the biggest thing that helped me, in the hopes it helps you too. My shyness also came with a hefty dose of self-consciousness and insecurity, which is where this is coming from.
I worked with a personal coach who opened me up to the fact that “not everyone will like you/believe you/agree with you/understand you, no matter what. So you might as well just be *you* – because wouldn’t it be so much more satisfying if the people who did like you/believe you/agree with you/understand you were interacting with the *real you*?”
And her challenge was to just go out and “be me”. So I did. And it was hard, but became easier very quickly.
So yes, just do it. And you’ll realize that it’s okay to be wrong or disliked, and it doesn’t bother you nearly as much as you might think it would because it’s so much more often that you are right, and loved!
February 20th, 2009 at 4:02 pm
I think the only real way to deal with that is by practice. My biggest fear ever was oral presentations, so much so that all through university, I would read the course syllabus before enrolling in a class just to make sure there were no presentations. When I started the program I’m in now, I was forced to do multiple oral presentations. My first one was a 20 minute group thing. I spent about two weeks before, worrying, practicing, being scared, etc. I was a total wreck the day of, and then kinda fumbled my way through the thing cause I was so nervous. The next few were much the same. This year I had to do 4 presentations…and by the 4th one, I was still nervous for sure, but only an hour or so before the presentation (not 2 weeks before), and my nerves didn’t stop me from doing a good job once I was up there. It also helps me to realize that i’m not the only one feeling anxious in certain situations.
February 20th, 2009 at 4:20 pm
‘cuse me while I give sarah an oral presentation. *smooch* ;-)
February 20th, 2009 at 4:33 pm
Toastmasters is actually a great idea — I’m pretty much the *opposite* of shy, so my goal in toastmasters was to improve my “off the cuff” speaking, as I tend to … have no idea what to say and end up saying a bunch of nonsense instead (hah) but most of the people in my group were the shy ones who needed a “safe” outlet to get used to public speaking.
My group was all coworkers, which made it easier — not necessarily all people I knew (large office, couldn’t keep track of anyone outside my area), but at least we had the commonality of the job.
You could always start a Nevis chapter. :)
February 20th, 2009 at 4:56 pm
practice practice practice.
and waiting a few extra seconds before engaging your mouth doesn’t hurt either.
i hated having difficult conversations with clients when i first started working for myself. i still do, but time and repetition has made it much easier to have those conversations.
i don’t think you need toastmasters or any sort of coaching. it’ll come with time.
hugs,
c
February 20th, 2009 at 5:00 pm
I got over my shyness once I realised that it was actually going to stop me from getting everything that I wanted from life. It’s like a bitter pill, you swallow it and get on with your life. So I came out of adolescence not shy at all. I accepted the fact that the people whose opinion and judgement I was fearing were in the vast majority less intelligent and more boring than I was, and the ones who weren’t were actually intrigued by what I had to say. It’s that simple.
February 20th, 2009 at 6:43 pm
Hi, I used to be exactly as you describe yourself. Now I speak in front of 100′s of people a week. My advice is practice..practice….and more practice (it’s not like you have anything else to do..lol). Honestly I remember thinking “whats the worst that could happen?” and realizing that it was never that bad. Believe me it gets easier the more often you do it.
February 20th, 2009 at 7:20 pm
I think you are amazng at the hospital and on rotations. I love going with you because you always say the one thing that I could not come up with. I always just blurt out the answers BECAUSE I am nervous…. it helps me to realize the stuff that I really have no idea about. You will work it out, I think you have a wonderful start going…
February 21st, 2009 at 12:06 am
practice is good, definitely. im grateful for the 72 weeks of rotations to work on my bedside manner and presentation skills. but even now, i still get anxiety talking to patients, and presenting to my colleagues and my attendings.
and i take propranolol when i have to present in front of the residency during noon conferences. hehe.
February 21st, 2009 at 2:31 am
oh jammie, you just set me back a few years in my progress…i’m all flustered again
February 21st, 2009 at 10:11 pm
…they’re all naked…
February 22nd, 2009 at 2:01 pm
Dear Jen,
I recognized myself in your post! I am super shy too! When I have to say my name at the beginning of a yoga class or a work meeting, I get all stressed while every person is doing it because of the anticipation, and when its my turn, I blush and speak so low that nobody hears me and I have to repeat!
However, I also think that parctice makes perfect. If I had to do it everyday, I now eventually I would get a lot less shy. In your case, the best thing you can do is going on rounds. I am sure that a couple of months after starting your everyday clinical rotations, you will read this post and realize that your shyness will be a lot less pronounced in those situations.
It would be funny if you reposted on the subject in 6 months, just to see what happened with the shy you on rotations!
Take care my dear!
February 23rd, 2009 at 6:17 am
Okay, so I’m in the UK and things are different here, i know, but have you mentioned your shyness to anyone “in authority”? I ask because it’s not uncommon for the local university to put people onto my training courses when they suffer from the symptoms you describe. (Hey, I’m happy to be flown to the States to help! :) )
Practice will helps, for sure, but only once you’ve got to the necessary level – if you try it and fail you’ll only reinforce your sense of there being a problem! My suggestion would be that even before Toastmasters, you get yourself some professional training (yes, obviously I’m biased!) because simply being thrown in at the deep end is often counter-productive.
If you can’t face a course, there’s even some good online advice and some decent books (some of which are even mine! :) ) but face-to-face training is more effective.
S
February 23rd, 2009 at 8:26 pm
It’s strange, because I am not normally shy. I’m usually a very outgoing person, and will walk up to a stranger with no problem. However, if you put me in front of a large group of people, or a bunch of very smart doctors, and ask me to “present” I will literally get so nervous that I shake!
However, I will reiterate what others have said. PRACTICE baby, practice. The more I do it, the less nervous I have become. By now, it’s practically no big deal to present to a physician. (I’m still working on speaking in front of a large group of people, however.)
But I promise, with time, it will become like second nature. :)
February 24th, 2009 at 8:37 pm
Hi Jennifer,
I can totally relate to you. I have the same problem and I am so glad that you brought this up. I freeze when I am put on the spot and it seems impossible for me to think sensibly at that moment. I am actually trying to figure out how to deal with this problem. My first goal is to learn my material well and see if that makes a difference. I hope it does…..but to be honest I don’t know why this happens to me. I am also trying to go to as many rotations in Med 5 so I can practice and learn to answer questions without freezing….
February 25th, 2009 at 7:09 pm
Aren’t you supposed to have a god complex by now? I know having a massive ego has always helped me feel comfortable speaking in front of a crowd. I just assume everyone always wants to hear what I have to say.
Is there a kid’s ward at the hospital where you could volunteer to read stories out loud? Reading someone else’s words removes the pressure to find something to say, giving your body time to accustom itself to the adrenaline rush of public speaking, plus sick kids are less likely to boo and throw things. Once you’re past the pure fear stuff, you can work on confidence and content.