What Then Is Time? An Exploration of Time Perception in Emergency Medicine.
نویسنده
چکیده
Moving from the resuscitation room, where the preceding 45 minutes of the shift seems to disappear in a blur of CPR, drug administration, defibrillation attempts, and invasive procedures, into the “urgent” care section of the emergency department (ED) where a young mother has been waiting, worrying for 3 hours with her febrile child, it is too easy to forget about the relativity of time. Newton believed in and described an “absolute, true, and mathematical time, of itself, and from its own nature, (that) flows equably without relation to anything external.” His successor in the quest to understand and describe the reality we experience, Einstein, was less grandiose in his attributed explanation of how he saw time: “When you sit with a nice girl for two hours you think it’s only a minute, but when you sit on a hot stove for a minute you think it’s two hours. That’s relativity.” At first glance, it can seem obvious, what time is: it is the ticking of the clock, the rise and setting of the sun, the changing of the seasons. But really these are just physical manifestations of the passing of time. Time is a universal ingredient of everyday life, science and academic thought, yet its true nature and essence escape definitive description. In medicine, and especially in emergency medicine, we often cling to a Newtonian appreciation of time. What is the current wait time for level 3 patients? How long did your pain last? How long since the last dose of epinephrine? Yet for the patient, experiential or relative time contributes more to their memory of their visit to the ED than the actual ticking of the clock. Intense experiences such as pain, anxiety, or inactivity can alter the appreciation of the flow of time. The frustration of waiting can magnify the actual wait time. Have you ever had to correct a patient complaining about their ED wait, to tell them that they underestimated the duration? What do we, as emergency care providers, have to offer our patients? Our knowledge, our skills, our compassion, and our time. For emergency care providers working in a busy ED, our time is “full” of activity, interruptions, interactions, tasks, and responsibilities. For many of our patients, their time in the ED is “empty.” They wait to be triaged, then wait again while the nurse completes the record. They wait to register. They wait to be called into a consultation room, where again they wait to be seen. Then, for a brief minute or two, their time is filled as a nurse or physician enters their room, asks some questions, briefly examines them, and disappears again, only for them to wait again. Perhaps some tests are performed. Perhaps some treatment is administered. Then, more time. Perhaps the test needs to be repeated. Then, more time. What is happening? Have I been forgotten? How long will I be here? Do I really need to stay? The doctor did not seem to be worried. The relative experience of time for patients and staff in the ED is vastly different. Yet, there is much we do that exaggerates this “full” and “empty” time contrast. The necessity to access and complete medical records, to deal with phone calls, and to complete reports can significantly detract from the amount of
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عنوان ژورنال:
- CJEM
دوره 18 4 شماره
صفحات -
تاریخ انتشار 2016