• Rob Orman

8. The Bob Ross School of Trauma

Updated: May 25, 2020

Bob Ross is best known as the mellifluous host of The Joy of Painting, yet there are things he can teach about how to effectively care for trauma patients. In this episode, we cover: how Bob Ross can help invoke calm during crisis, the Chuck Norris mode of trauma resuscitation, why Bob Ross is your trauma room spirit animal, finding your feet, the power of acknowledging mistakes.

We discuss:

Who Bob Ross is and how he can help us remain calm in a crisis [00:24];

  • Bob Ross was the host of  The Joy of Painting which aired on public broadcasting from 1983-1994. He became a caricature of himself with his mellifluous voice and spherical planetoid of bushy hair.

The tendency for trauma team leaders to stay in full-on warrior mode, even when that mode not only is no longer necessary, but also may be deleterious [02:30];

  • The primary survey of a resuscitation, when the airway/breathing/circulation are being assessed, is the time to be a trauma warrior.

  • You need to be quick and methodical, ready for whatever life-saving measures are needed.

  • After the patient is stabilized, you begin the secondary survey. This is when you go head to toe, looking for injuries. 

  • Too often, clinicians remain in trauma warrior mode for the secondary survey -- a little rushed, not paying focused attention on the patient in front of them. 

Bob Ross wasn't in a hurry. He didn't rush, but also didn't linger.

Why Bob Ross (not Chuck Norris or Wonder Woman) should be our spirit animal in the secondary survey [05:00]; 

  • Bob Ross was calm, kind, and methodical. His voice was soothing.

  • He painted his paintings the same way every time.

  • When Bob Ross painted, he had efficiency of movement, continuously communicating and thinking out loud. He told you what he was going to do, and then he talked you through it as it was happening (as demonstrated below).

Specific ways to be more like Bob Ross in the resus bay [05:50];

  • After the primary survey, take a pause. 

  • Does the patient need anything to make them more comfortable, so you can get an accurate exam?

  • Let the patient know exactly what’s going to happen before you start. Verbally walk them through the secondary and tertiary surveys.

  • Create a mental setpoint that is calm, using a tone of voice that is even.

  • Proceed with the rest of the exam, doing it precisely the way you do it every time. 

How “finding your feet” can help you when mistakes are made [07:44];

  • Bob Ross said, “We don’t make mistakes. We have happy accidents.”

  • The stakes are obviously much higher when a mistake is made in the resus bay versus on a painting. 

  • But there are different ways to handle yourself when an error is made.

  • When you’re feeling the apprehension of a mistake, sweating and fretting, try finding your feet. Use the sensation of your feet on the ground as an anchor to bring you back to the present moment.

  • Focusing on your feet will prevent you from projecting in the future to the negative things that might happen, to the patient or to yourself. The spiral of your negative thoughts is not going to help anybody.

  • Then take a few slow, deep breaths, in and out through your nose.

The value of acknowledging a mistake and validating how it makes you feel [09:35];

  • Rob suggests this mental exercise, “I wish things were different and that hadn’t happened. But it did. So let’s deal with it.”

  • This mantra can be a powerful tool for dealing with things that don’t go as you would have liked.

Shownotes by Melissa Orman, MD

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