Kenneth V Iserson
Emergency physicians repeatedly encounter problems that clinical expertise alone cannot resolve, such as a patient with decision-making capacity leaving against advice, a consultant declining to come in, admitted patients boarding for hours, or a family asking for continued resuscitation after the team concludes that it cannot succeed. Residency prepares us well for what we can control but offers little guidance about the rest. Some of these encounters produce moral distress; others are frustrating limitations. This Educator's Blueprint presents six tips to face such situations adapted from Stoicism, Buddhism, and Taoism. Stoicism helps distinguish what can be changed from what cannot. Buddhism helps separate a difficult outcome from professional identity. Taoism helps direct the remaining effort toward action the circumstances can absorb. The tips are designed for use in conferences and reflection groups that many programs already conduct. The article also explains why these traditions were selected and acknowledges important criticisms of their use.