I also find it reassuring to see how attendings really want to be informed about the new developments of what occurred to the patient even if it is at the wee hours in the morning. This shows that they are on top of things and it not only the housestaff and interns running the show. It shocked me to realize that once an attending sent a resident to perform his first colonostomy alone, claiming he will come back but never returning. It is terrifying to realize that resident was left to perform surgery on a patient without being sure what he was doing and was left to ask the nurses technical questions about the procedure like how big should the incision be and how much bowel should he exteriorize. Even though for this case the resident performed the procedure well, the next time complications may occur because he may have made a mistake due to inexperience and the nurses may not be as helpful to guide him through the procedure.
While human subjects are good for learning how to practice medicine on, I believe that it should not be okay to make any mistake. I understand that at first the housestaff is scared of making a mistake, which might be an extra stress on them when they evaluate a patient. I believe that the feeling regarding committing a mistake should be similar to this fear throughout their medical career. Bosk points out that without these mistakes, housestaff may not learn how to fix these mistakes in the future. He mentions that making a mistake on one person may help all the others in the future. This is sound logic, however, considering I may be the patient in the future that may will have to pay for the consequences of the mistake done by the housestaff I wish that one time mistakes are not seen as okay but still feared to caution them against reckless mistakes.
I agree with Cece that its interesting having both a doctor’s and a sociologist’s view point on these issues. As someone that inspires to be a doctor in the future, it is especially helpful to see both takes on the health industry. In a profession such as medicine, it is hard to be sympathetic for a learning curve that would be accepted in any other profession. Since there are people’s lives at stake every time a doctor or resident works on a patient, every step that can be taken to ensure the success of the procedure should be taken. I understand, though, that it is hard to account for this since it is hard to simulate real medical experience and everyone has to have a first time working on an actual patient. Since this is the case, it is hard to decide if there is an actual way to avoid such problems.
ReplyDeleteI agree, is it very unfortunate to have to be the patient that suffers from an intern's mistake. However, I think it is unarguably necessary for growth and learning. Of course, it is unfair if one patient gets the surgical resident, while another gets the seasoned attending but I think that attending would not be as experienced nor seasoned without his residential training. Therefore, it is in my opinion that this cycle of mistakes, which leads to experience and skill cannot be attained without actual hands-on, supervised exposure, which is achieved via a grueling 5-7 year surgical residency. To touch on Amit's comment, I do not think there is any way of avoiding such problems, in fact, I believe this is the best way to teach a surgeon. This is not to say, I think a first-year should be performing a solo coronary bypass surgery but they should start with simple procedures and they should always be supervised, to avoid mistakes.
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