As a first year medical student, I was asked to make a few remarks about a video on medical errors. If you have 5 minutes, I highly recommend http://www.ahrq.gov/video/teamsteppstools/ts_Sue_Sheridan/Sue_Sheridan-400-300.html
Afterwards, they asked us to comment on medical errors and their frequency as preparation for a mandatory training they had set up the following week called Interpersonal Team Training. We took a survey that asked us our opinions in the fluffiest of ways of how we perceived our colleagues in the hospital setting ranging from nurses to PA's to other physicians. I personally believe many of the questions were designed to accuse the physician (or physician in training) of being overly haughty and egotistic. First of all, that's insulting. Are there physicians who think they're the center of the universe, yes. Should some physicians get off their high horse, yes. Do physicians have years of specific training that make them much more capable of handling specific situations, yes. Do nurses and other healthcare providers have years of specific training that make them much more capable of handling specific situations, yes. OBVIOUSLY. Shame on any person in healthcare who doesn't realize this facet of medicine. Maybe I just don't want to go to training...
Now, I don't mind giving up a few hours to do some training where they'll tell me to respect one another and to get closer to my feelings and to see others as human beings as if I saw everyone else as a slave until you miraculously opened my eyes... BUT I took this opportunity to tell "them" about a program I do want to see - hospital management and I mean REAL hospital management. After watching the video, it's obvious. The wrong people are doing it. Here's my review of the movie which turned out to be a scathing review of a hospital I briefly had the opportunity to work in:
It seems as if talk of medical errors is forbidden and cliche in the modern medical setting. What Sheridan has gone through shows how even a single medical error, a single mis-communication can mean pain and suffering for a lifetime. It's this idea that because the establishment of healthcare is present to do good and that the intentions of all of the practitioners are for the betterment of the sick that healthcare should be immune to criticism, immune to change. People should not be dying because we can't get our paperwork in order. Patients shouldn't have to change their teenagers diapers because we waited to act and hushed a "new mother" of her concerns. That is NOT what medicine is about. Even as a student, I have seen GROSS inefficiencies in the hospital system with my limited exposure and I have watched my supervisors and seniors simply throw up their arms without making any real change. It is not because they don't want to change how healthcare is carried out, on the contrary, there is nothing more they yearn for than efficiency, to make their lives and the lives of the patients better. The real question is WHO do we turn to to make these changes? Seriously, think about it. At HOSPITAL X (won't publicly badmouth a hospital), I shadowed a 3rd year medical student on his rotations and his attending. Just getting a simple form was the biggest chore in the world. The attending asked the 3rd year to go to the nurse's station to get the form. At the nurse's station, the 3rd year had to wait for the head nurse to show up from caring for a patient because none of the other 3 nurses there knew how to get the form. When she returned 10 minutes later, we found out that the sheet wasn't available on the computers in this floor (for god knows why) and they had to call the nurses station a few floors up. After 2 tries on the phone a few minutes apart the nurses from the upper floors told them they were sending the form down through the tubes. About 7 minutes later, a tube containing the form arrived via the air pressurized mailing ducts that flow through the hospital and was transferred to the 3rd year. Total loss by the hospital, about 22 minutes TO PRINT 1 FORM. How many people got sick waiting for this form? How many surgeries could this 3rd year and attending been focused on? Why weren't the forms available electronically on the computers immediately? Why is there is only 1 person on the ENTIRE floor who knows how to get forms and that too from another floor? Where could this process have broken down and someone not gotten something signed off fast enough? Most importantly, WHO IS RESPONSIBLE FOR RUNNING THE HOSPITAL EFFICIENTLY? I am all for interpersonal conduct, I get it, teamwork is important and is the hallmark of wonderful care for the patient and respect between colleagues. What I don't see, however, is anyone walking around the wards asking questions about how to make the hospital more efficient. Where are they? I have never seen a single person listening to a nurse, a PA, a doctor, a medical student and trying to make their lives easier. Why? Fire them. I understand that respect for one another's roles in the hospital is important and is the basis for this whole mandatory meeting but in my opinion, if a physician is rude to a nurse (just an example) it's because he's an ass of a human being who has an ego problem. One thing we need to discuss is how to actively work together to report changes we need in the hospital system and problems that are present and know WHO is in charge of those changes and WHY it's taking them so long to fix the most basic problems of the hospital. I don't care if it's complicated, medicine is hard, taking care of patients is hard, filing is NOT HARD.
Afterwards, they asked us to comment on medical errors and their frequency as preparation for a mandatory training they had set up the following week called Interpersonal Team Training. We took a survey that asked us our opinions in the fluffiest of ways of how we perceived our colleagues in the hospital setting ranging from nurses to PA's to other physicians. I personally believe many of the questions were designed to accuse the physician (or physician in training) of being overly haughty and egotistic. First of all, that's insulting. Are there physicians who think they're the center of the universe, yes. Should some physicians get off their high horse, yes. Do physicians have years of specific training that make them much more capable of handling specific situations, yes. Do nurses and other healthcare providers have years of specific training that make them much more capable of handling specific situations, yes. OBVIOUSLY. Shame on any person in healthcare who doesn't realize this facet of medicine. Maybe I just don't want to go to training...
Now, I don't mind giving up a few hours to do some training where they'll tell me to respect one another and to get closer to my feelings and to see others as human beings as if I saw everyone else as a slave until you miraculously opened my eyes... BUT I took this opportunity to tell "them" about a program I do want to see - hospital management and I mean REAL hospital management. After watching the video, it's obvious. The wrong people are doing it. Here's my review of the movie which turned out to be a scathing review of a hospital I briefly had the opportunity to work in:
It seems as if talk of medical errors is forbidden and cliche in the modern medical setting. What Sheridan has gone through shows how even a single medical error, a single mis-communication can mean pain and suffering for a lifetime. It's this idea that because the establishment of healthcare is present to do good and that the intentions of all of the practitioners are for the betterment of the sick that healthcare should be immune to criticism, immune to change. People should not be dying because we can't get our paperwork in order. Patients shouldn't have to change their teenagers diapers because we waited to act and hushed a "new mother" of her concerns. That is NOT what medicine is about. Even as a student, I have seen GROSS inefficiencies in the hospital system with my limited exposure and I have watched my supervisors and seniors simply throw up their arms without making any real change. It is not because they don't want to change how healthcare is carried out, on the contrary, there is nothing more they yearn for than efficiency, to make their lives and the lives of the patients better. The real question is WHO do we turn to to make these changes? Seriously, think about it. At HOSPITAL X (won't publicly badmouth a hospital), I shadowed a 3rd year medical student on his rotations and his attending. Just getting a simple form was the biggest chore in the world. The attending asked the 3rd year to go to the nurse's station to get the form. At the nurse's station, the 3rd year had to wait for the head nurse to show up from caring for a patient because none of the other 3 nurses there knew how to get the form. When she returned 10 minutes later, we found out that the sheet wasn't available on the computers in this floor (for god knows why) and they had to call the nurses station a few floors up. After 2 tries on the phone a few minutes apart the nurses from the upper floors told them they were sending the form down through the tubes. About 7 minutes later, a tube containing the form arrived via the air pressurized mailing ducts that flow through the hospital and was transferred to the 3rd year. Total loss by the hospital, about 22 minutes TO PRINT 1 FORM. How many people got sick waiting for this form? How many surgeries could this 3rd year and attending been focused on? Why weren't the forms available electronically on the computers immediately? Why is there is only 1 person on the ENTIRE floor who knows how to get forms and that too from another floor? Where could this process have broken down and someone not gotten something signed off fast enough? Most importantly, WHO IS RESPONSIBLE FOR RUNNING THE HOSPITAL EFFICIENTLY? I am all for interpersonal conduct, I get it, teamwork is important and is the hallmark of wonderful care for the patient and respect between colleagues. What I don't see, however, is anyone walking around the wards asking questions about how to make the hospital more efficient. Where are they? I have never seen a single person listening to a nurse, a PA, a doctor, a medical student and trying to make their lives easier. Why? Fire them. I understand that respect for one another's roles in the hospital is important and is the basis for this whole mandatory meeting but in my opinion, if a physician is rude to a nurse (just an example) it's because he's an ass of a human being who has an ego problem. One thing we need to discuss is how to actively work together to report changes we need in the hospital system and problems that are present and know WHO is in charge of those changes and WHY it's taking them so long to fix the most basic problems of the hospital. I don't care if it's complicated, medicine is hard, taking care of patients is hard, filing is NOT HARD.
