A is for Abracadabra – Staying Current in the Real World

In a perfect world, by virtue of some unique magic, everyone would know what they need to know to do their best work. Every source of knowledge and learning would be consistent. Every piece of information would align with every other piece of information, without contradiction.

But we don’t live in a perfect world… And the constant stream of practice changes sometimes presents a challenge.

This is a complicated topic. Try as we might, these questions don’t have black/white, yes/no, clear-cut answers.  

1. How do I stay up to date about practice changes?

There is no perfect solution with regard to keeping up to date with practice changes. No health authority or government agency has fully cracked this. Dissemination always takes time to reach front-line providers. Always. We have to be comfortable with never feeling quite up to date since practice shifts so quickly. (See below).

2. What do I do if there are points of divergence between what I learned in class, my provincial practice protocols, and Odyssey protocols?

This question is more complicated. Within the context of Odyssey protocols, the most current versions are posted on Odyssey’s intranet (and if there are any substantive changes, the given version will be flagged as “updated”). And, many of you know where to find your provincial protocols, which we also strive to keep up with and endorse.

If anyone is still using a paramedic or nursing textbook to guide practice in the field, you might consider a shift to using that text as a background resource going forward. The purpose of a clinical textbook is somewhat different than clinical practice guidelines (and it outdates almost as soon as it goes to print). Most provinces have apps or downloadable treatment guidelines if you are referencing a regional or provincial service. 

Growing Your Knowledge Base

Everyone has their own strategies. Based on my experiences working with strong, smart, capable health care professionals, this is how the magic happens:

  1. Share and absorb knowledge. Make opportunities to learn and to share clinical wisdom when you are working with a team. Absorbing clinical wisdom is a great professional habit to develop and hang on to. A “stance of curiosity” and openness makes it easy to absorb knowledge and experiences from others.
  2. Go outside of what you know. Take courses during your downtime as a great way to stay current.
  3. Focus your attention and go for it. For specific practice changes such as new medications (e.g., methoxyfluane), the expectation is that you won’t use the medication unless/until you have undertaken the background learning required. If you want to use a particular protocol, reach out and find the resources you need.
  4. Know what you know. No action should be undertaken by a provider if that provider has not yet obtained the appropriate knowledge, skill and experience to undertake a given action. If you already have the knowledge, skill and experience to give a particular medication and only the dose has changed, you simply need to learn the new dose (and be more alert for potential side effects if there was a dose increase).

One Final Thought

For the greatest degree of comfort, you might consider that the easiest and safest solution is to learn one set of protocols thoroughly and then practice to that standard. The challenge of taking some practice tips from one set of protocols and other things from another set of protocols is that this might cause confusion when you are in a critical situation and may be difficult to defend. You have lots of relevant clinical experience and I am certain that you have a degree of comfort with both Odyssey and your provincial/base hospital protocols. Pick the set that is easiest to use. If there is something that falls outside of the set of protocols you are using (e.g., Nova Scotia is not using methoxyflurane/green whistle), you can always look it up in real time, on an as needed basis.

So, it’s not really magic, just a commitment to remaining curious and open to learning and growing your clinical knowledge base.

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