There is really only one problem – distraction. And therefore only one solution – mindfulness. -Dzongsar Khyentse Rinpoche

Normally we do not so much look at things as overlook them. –Alan Watts

Introduction

In an age when multi-tasking is lauded as a prized gift, it can become easy to lose sight of the value of being fully present in the moment, something referred to as “mindfulness”. While we know that being mindful during patient encounters allows us to listen fully to our patients, make more accurate diagnoses, and develop more effective treatment plans, preventing ourselves from becoming distracted can be a challenge.

With this in mind, taking time to step back and reflect upon experiences in which your being distracted while caring for patients impacted the care you delivered is the key first step towards coping better when distracted and becoming more mindful in the future.

Assignment

Reflect on a moment during your core clerkships in which your being distracted had an impact on the care you delivered to your patient. The distraction might be work-related (such as another clinical responsibility, a due assignment, being distracted by a physical impairment of your patient or their family member, etc.) or might be unrelated to your work (such as stressors related to personal or family relationships, among others). In your writing:

1. Describe the situation. Set the stage and be specific to help the reader more fully appreciate the context in which you became distracted. As well, describe the source of your distraction, giving enough background information so that the reader can understand what was distracting you.
2. Examine why you were distracted in the situation described. What were the competing interests with which you were dealing? Were you surprised that you were distracted? In considering situations in which you have been distracted from patient care, also consider whether there have been situations in which your patient care has distracted you from other responsibilities (family, friends, etc.). Do you find that the sources of your distraction in these two situations are similar or different?
3. Analyze the impact your being distracted had on your interaction with and care for your patient. Did it also impact your interactions with other members of the healthcare team (including support staff, nurses, interns, residents, and faculty providers)? If so, how?
4. Describe the insights you gained about yourself through reflecting on this experience. In thinking about that, also consider how your being aware of your own distractions affects how you react to patients who are distracted when you interact with them, especially in light of your knowledge that some of our patients have illnesses that cause them to be distracted such as TBI, PTSD, depression, etc.? When a patient is distracted while you are talking with them, might this be a diagnostic clue to an underlying diagnosis you are missing?
5. How do you think your reflections on the topic of distraction will impact your practice of medicine in the future? What strategies do you anticipate employing?