“I wanted to ask for help but I didn’t want to bother my partners.” This was the response I received from a new attending as I assisted her with a difficult case in Labor and Delivery. After further discussion of the case, the new attending felt too embarrassed to ask. I was called in by the nurses to help. This wasn’t a request from the attending. It’s an awkward situation that could have been avoided with previous discussion or just asking the nurses to call for help. Our nursing staff is constantly told to call for help if they need assistance. In one evening during a hospital call, the emergency bell was pressed by the nurses 10 times cumulatively for various reasons ranging from help with medication doses to needing help with a delivery.
They are even encouraged to stop a surgical case if they do not feel comfortable or supported enough. We hope and expect physicians out of training to ask for help. Lately, I’ve noticed residents and newly graduated physicians are afraid to ask for help. As if asking for assistance is a sign of professional weakness or lack of intelligence. But do we encourage and reward this culture of isolation? If we work for health care corporations, do they provide backup in case we need help?
In the medical field, where lives are often at stake, it's crucial to seek assistance rather than make uninformed decisions. Sometimes I need to bounce different thought processes off my colleagues. Some things I know, remember, or forget from residency, especially our “Zebras.” There can be a culture within medicine that stigmatizes asking for help, especially among residents and newly graduated physicians. This can be due to fear of appearing incompetent, the pressure to be self-reliant, or a belief that they should know everything after their years of training.
I encounter situations with residents in which they are unsure of how to interpret a fetal heart strip. Textbook definitions are sometimes inadequate in the face of real-time clinical situations. Only you know the total clinical picture and the small details that led up to this fetal heart strip appearing suspicious. Is it reassuring by definition? Who should I ask? I can’t have the nursing staff think I’m incompetent. My attending/colleagues will think less of me. I should know this. This is what I am here for. This is what I do.
Most of the time, if you are asking or unsure, your gut is sending out alarms. I always tell residents, and both new and well-seasoned physicians, to follow their gut in these cases. It never hurts you — maybe your ego — to ask, and it only facilitates care of the patient. Your alarm bells are going off for a reason. However, achieving this type of “intuition” takes time, cultivation, years of study, and multiple levels of collaboration with your peers.
You may have to deal with questioning glances from staff and colleagues when you ask for help, but to counter this, it's important to foster a culture that encourages seeking help and views it as a strength rather than a weakness. I understand this is difficult in light of the many tasks and hard work days we see on a consistent basis. But future generations of physicians benefit greatly from the experiences of other physicians. Pairing less-experienced doctors with senior physicians can provide a safe space for them to seek advice and learn. Constructive feedback can help younger physicians understand that making mistakes and asking for help is part of the learning process. We as physicians should not expect medical schools and residencies to do all the teaching.
We need to recognize the stress and pressure that comes with the job and provide resources for managing these pressures. This could include mental health resources or stress management workshops. I fully encourage sessions in medical education that emphasize the importance of collaboration and seeking help when necessary.
I know well-seasoned colleagues get frustrated with the questions. We are used to an “on-the-job” training mentality when it comes to certain situations. I remember a young physician asking for help to repair a certain type of laceration after a vaginal birth. She actually wanted someone to do it for her because “I haven't done too many repairs like this.” She was several years past residency. The difficulty in her request was that many of us had not encountered this type of laceration because we try to avoid this complication. However, we are trained to repair it when it occurs.
We can’t assume that information should be known by that resident and/or colleagues. We expect that the person will just take that knowledge and “dive in.” The ultimate goal is to provide the best patient care possible, and sometimes that means reaching out to others for their expertise and support. In addition, we as clinicians have to be receptive to the person asking for help.
Changing the culture is a gradual process, but by consistently promoting these values, we can ensure a healthier, more collaborative environment for all health care professionals.
So, ask for help. There may be some “pushback” in the form of words or facial expressions, but keep asking. Don’t be afraid to say, “I need help.”
When have you had to ask for help? Share in the comments.
Dr. Rohana Motley White is an obstetrician/gynecologist in Orlando. She enjoys traveling, reading, and hanging out with her daughter. Dr. Motley White is a 2023–2024 Doximity Op-Med Fellow.
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