Was I unprofessional?
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Was I unprofessional?
Discuss non-medical topics
The Scene, The pre-operative anaesthesia assessment visit. The Patient. A man in his 50s, for intermediate orthopaedic surgery. He is obese (BMI 36), has hypertension and epilepsy controlled on
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Re: Was I unprofessional?
posted at 23/7/2012 5:56 PM BST
on bmj.com
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Posts: 1286
First: 9/12/2011 Last: 23/5/2013 |
John, you were Professional, and Nice, sometimes honesty causes people to become animals. As a Police officer I once shot a Pit Bull who was attacking a persons son, the Dog inflicted some bad, but survivable wounds on the kid, and get this, the Mother was furious that I got blood from the Pit bull on the Porch of her house! Of course she could not sue, but the thought of her being mad, I got blood on the porch, after I removed a Dangerous animal from her sons Leg! WOW, stupidity cannot be cured, no vaccine exists. DuaneF |
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Re: Was I unprofessional?
posted at 23/7/2012 5:56 PM BST
on bmj.com
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Posts: 1286
First: 9/12/2011 Last: 23/5/2013 |
John, you were Professional, and Nice, sometimes honesty causes people to become animals. As a Police officer I once shot a Pit Bull who was attacking a persons son, the Dog inflicted some bad, but survivable wounds on the kid, and get this, the Mother was furious that I got blood from the Pit bull on the Porch of her house! Of course she could not sue, but the thought of her being mad, I got blood on the porch, after I removed a Dangerous animal from her sons Leg! WOW, stupidity cannot be cured, no vaccine exists. DuaneF |
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Re: Was I unprofessional?
posted at 23/7/2012 6:50 PM BST
on bmj.com
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Posts: 959
First: 15/7/2011 Last: 21/5/2013 |
In Response to Re: Was I unprofessional?: Thnak you for your reassurances. I' confident that a suit for tooth damage could be defended - it was my response to the wife, that clearly upset her, even if the husband gave no sign of concern. You can't sue for being upset (can you kirked??) but I don't want to affect anyone so much that they storm out of the hsopital. I conclude that I was professional, but 'not a nice doctor'! Anyone else care to offer a reflection? A 'meditation' on a part of our pratice, or a case. It's part of our UK revalidation process now. John Posted by John D John, no-one can sue because they are upset. Sometimes people get upset because they get the wrong end of the stick, even if you had been rude to her or the patient, even that is not grounds for suing you. She was upset, thats a shame, but life goes on and you cannot cater for everyones emotional responses. My only comment is that it is my understanding that patients going under GA normally consent to the procedure and it is recorded. Particularly possible problems associated with anaethesia/intubation. Did this happen here John?. I must be honest that I thought that elective patients consent not just to the operation but also the anaesthetic. |
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Re: Was I unprofessional?
posted at 23/7/2012 9:12 PM BST
on bmj.com
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Posts: 2059
First: 12/3/2010 Last: 23/5/2013 |
Kirked, I thought we had a 'consent ' thread before? As you well know, patients must give consent. else anyone even touching them is guilty of assault, let alone cutting them open from giblets to breakfast. And the essence of consent is that they are informed. That they consent verbally, by signing something or by swearing an oath to Lister and John Snow is irrelevant. The consent that patient signs is supposed to show that they have been informed, by someone capable of doing the surgery (not a houseman), but it's not worth the paper it's written on unless the information has been given. That deals with the surgery. Anaesthetists have given it a bit more thought. We don't bother with a signature, because it's not worth .... etc etc. We record the conversation that we have had with the patient, outlining the technique(s) we will use, and the risks they incur, on the anaesthesia record form, usually at the end of the Pre-Anaesth Assessment section. This not only indicates that the pt gave verbal consent, but on what terms, and outlines the pts. co-morbidities that influence those risks, all at the same time. Cunning, eh? John, Professor of Cunning, Cunnington U. |
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Re: Was I unprofessional?
posted at 24/7/2012 8:38 AM BST
on bmj.com
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Posts: 959
First: 15/7/2011 Last: 21/5/2013 |
In Response to Re: Was I unprofessional?: Kirked, I thought we had a 'consent ' thread before? As you well know, patients must give consent. else anyone even touching them is guilty of assault, let alone cutting them open from giblets to breakfast. And the essence of consent is that they are informed. That they consent verbally, by signing something or by swearing an oath to Lister and John Snow is irrelevant. The consent that patient signs is supposed to show that they have been informed, by someone capable of doing the surgery (not a houseman), but it's not worth the paper it's written on unless the information has been given. That deals with the surgery. Anaesthetists have given it a bit more thought. We don't bother with a signature, because it's not worth .... etc etc. We record the conversation that we have had with the patient, outlining the technique(s) we will use, and the risks they incur, on the anaesthesia record form, usually at the end of the Pre-Anaesth Assessment section. This not only indicates that the pt gave verbal consent, but on what terms, and outlines the pts. co-morbidities that influence those risks, all at the same time. Cunning, eh? John, Professor of Cunning, Cunnington U. Posted by John D I concur with my learned friend - I am now clear |
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Re: Was I unprofessional?
posted at 24/7/2012 4:48 PM BST
on bmj.com
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Posts: 15
First: 24/9/2009 Last: 24/1/2013 |
In psychiatry we consider jokes as expressions of an idea or feeling that is otherwise outside of the individual's conscious awareness. So it is appropriate professional conduct to consider seriously every comment make by a patient or family member. Reviewing carefully the importance of maintaining the airway with someone who has just threatened to sue you if in the course of keeping her loved one alive you damage his tooth, is spot on! |
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Re: Was I unprofessional?
posted at 24/7/2012 5:23 PM BST
on bmj.com
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Posts: 23
First: 21/10/2010 Last: 6/12/2012 |
I'm only currently a medical student but I'm also a mum and have managed people and clients in a previous career. While there is no harm in you questionning abd reviewing your actions and motivations, it's also important to remember that sometimes, it's the situation that's the problem not you or how you act. It may well be the case that the wife was very scared and nervous about the situation and handled it oddly/badly and absolutely nothing you could have done would have changed her reaction to it. Always work hard to see what you can do to improve but also accept that sometimes, it's really just completely out of your control. Cheers Vicky
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Re: Was I unprofessional?
posted at 24/7/2012 5:43 PM BST
on bmj.com
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Posts: 3
First: 24/7/2012 Last: 28/8/2012 |
I wasn't there so I can't be sure. But here's my impression: you may have been a bit irritated with the wife, and therefore on the snappy side. But unprofessional? No. You gave all the facts and made sure they were understood. Don't lose any sleep over it. |
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Re: Was I unprofessional?
posted at 24/7/2012 6:00 PM BST
on bmj.com
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Posts: 68
First: 29/8/2010 Last: 21/5/2013 |
I have often wished that I had the nerve to say to a patient who threatened to sue in the event of a recognised complication, that if they were unable to accept that risk, then I was sorry, but I was unable to care for them. John, It sounds as though you were entirely in order. The woman, after all, was not your patient, her husband was. You would have been entirely within you rights to ask her to leave the consultation if she was unable to stop interfering with it. Too bad more of us don't. Being polite and correct is not being rude. Perhaps we should point out to patients and their relatives that being threatened with being sued, to us, is extremely stressful, no joke, and by causing us stress and tension, is hardly in the interests of the patient we are looking after, ie them or their relative. @SURB - I have asked our corporate lawyers if there is scope for counter-suing for vexatious complaint under UK law - apparently there is not. There should be. It might deter the no win, no fee lawyers if theirs were the pockets hit, and need not deter those with a genuine claim for negligence against our colleagues. Currently, it is well worth any patient suing for any damages up to around £12K, I have been told, since it will cost the Health Authority more than that to take the case to court, and it will be settled out of court, regardless of the effect on the doctor's reputation. One effect of Crown Indemnity for hospital doctors, is that the regional risk organisations are not interested in the individual doctor, only the overall financial outlay. Only the defence organisation is looking after the individual doctor's interests.
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