Help! I Need Somebody


asking for help..

It's not so easy - how do you ask neurosurgery at 4 in the morning to see your patient with subdural hematoma? Or when you have a really sick patient that you don't know what to do with, or a difficult airway but you're the most experienced person in the room?

Why is asking for help so hard?

  • We don't think we will get help

  • We think asking for help makes us weak

  • We fear rejection

Fears seem valid, but are they legitimate? According to Dr. Grant, no.

Bring on the Psychology - Cognitive Biases

  1. Illusion of Transparency - Tendency for people to overestimate the degree to which their personal mental state is known by others

  2. Egocentric Bias - We weigh our own perspective much too heavily when trying to consider another individuals perspective

  3. Bystander Effect - phenomenon when no one helps in a code/similar situation because they all think someone else is going to do it; partially due to illusion of transparency

  4. Diffusion of Responsibility - the more people around when you need help the less likely you will gt help

Poor Ways to Ask for Help

  1. Apologizing Excessively "I'm so sorry, but can you see this patient? I'm so sorry."

    • Partially due to illusion of transparency

    • No sense of fulfillment - people are wired to help people naturally

  2. Offering a Reward - "Can you see this patient for me? I'll buy you coffee."

    • Feels like completing a transaction - not like helping a friend

  3. Making them feel manipulated - "Hey, can you do me a favor??" ... "Can you take me to the airport?"

    • Not good for friends or colleagues you want to have good relationship with

    • Forces someone to help

  4. Stopping short of the ask - "Hey, we have a patient with a distended abdomen and low pressure."

  5. Controlling Help - "can you write this next podcast? Be funny, but not too funny. Make it short."

    • Want some direction, but don't be too controlling

    • Can be a beautiful thing -> new perspectives from people doing things differently

  6. Not telling them how it went

    • Robbing them of feel good vibes afterward

How to ask for help

  1. Get over your initial fear of asking for help

  2. Be aware of the cognitive biases and be specific, direct with your need

  3. Avoid the mistakes above; let person know how their help was valuable

How can you make team more helpful when it isn't already?

Lead by example - takes someone on the team to make the change to shift the culture, snowball effect


  • Asking for help isn't easy but be aware of our cognitive biases

  • Medicine is a team sport - must act like a team

  • Some of the busiest shifts can be the best with a good team, some of the easiest shifts can be the worst with a bad team



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