An Adlerian-Based Narrative Inquiry of Temporal Awareness, Resilience, and Patient-Centeredness Among Emergency Physicians-The Gyroscope Model.

Abstract

Although extensive research examined time perceptions among patients in the emergency department (ED), studies on temporal awareness among emergency physicians is scant. Salutogenics is the theoretical anchor. The sample comprised ten emergency resident physicians from an Israeli public tertiary hospital. Narrative interviews were conducted. To determine the theme of the study, Adlerian narrative analysis was performed. To identify categories, semantic and content analyses were performed. Adlerian narrative analysis highlighted temporal awareness as a strong theme across interviews. Semantic and content analyses identified categories within temporal awareness. Analyses revealed a movement among three subcategories: A clinical task in which physicians rapidly shift along seven distinct times, temporal awareness shaping their work experience, and temporal awareness as inhibiting or enabling relationships with patients. Data-analyses identified two groups of physicians, one group driven by the need to control the time to avoid errors, experiencing anxiety and poor wellbeing, and the other, shifting from clinical tasks to patient-centeredness while removing the time factor from their considerations and experiencing resilience through manageability and meaningfulness. We introduce the "gyroscope model" for physicians to illustrate these findings and propose recommendations for practice. Understanding the complexity of the temporal continuum and the influence of shifting from the clinical task to relationships with patients may contribute to resilience of resident physician in the ED and to their self-efficacy, enriching their professional skills and capacity to cope and grow while facing the complexity of the ED.