Was I unprofessional?
False
General
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
2
Cat:OffDutyForum:General
Cat:OffDutyForum:GeneralDiscussion:dc383215-a559-449c-9512-f7d231aee677
|
Re: Was I unprofessional?
posted at 24/7/2012 8:00 PM BST
on bmj.com
|
Posts: 154
First: 29/11/2010 Last: 19/5/2013 |
In Response to Re: Was I unprofessional?: @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. Posted by MRH I appreciate your effort, this was an informative reply.Cheers!
|
|
|
Re: Was I unprofessional?
posted at 24/7/2012 8:33 PM BST
on bmj.com
|
Posts: 1
First: 24/7/2012 Last: 24/7/2012 |
Your reaction might have been a little extreme given that she quickly followed her remark with the statement that she was only joking and that they were nervous. you could have said that you understood her nerves but that you were obliged to discuss risks as they might be unavoidable however good the quality of care. You were not unprofessional but, for all of us, it is worth trying to be kind as well. |
|
Re: Was I unprofessional?
posted at 25/7/2012 1:11 AM BST
on bmj.com
|
|
Posts: 3
First: 11/2/2011 Last: 25/7/2012 |
In response to "Was I unprofessional?": 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 drugs, smokes 10-15/day (allegedly) and has bad teeth. He also has a partner/wife with him who interjects all the time. The Scenario. I tell the man how I intend to anaesthetise him (GA, TCI, LA for post op, analgesia). I also say that I will do my best to avoid damage to his teeth, in the course of maintaining his airway. The wife cuts in, "Then we'll sue you!" I glare. "Ha-ha! Only joking! We're a bit nervous" I say that I am not joking, I take my job very seriously, and that I hope that they will too. I give a short lecture on the risks of anaesthesia with special reference to the airway. I conclude my visit, having obtained the man's verbal consent (all that we do in the UK). He arrives in theatre, calm, and his anaesthetic and operation go smoothly. But In theatre and later on the ward, the staff all ask me, "What DID you say to that woman?!?" Apparently, she stormed out just after I had gone, very clearly very angry. Reflection. She had already irritated me by her constant prodding and correcting of her husbands replies to my questions. I have been threatened before with being sued for tooth damage. Then and now, I warn the patient and document it, but no one likes being sued. She may have been worried, for her husband, and I should have made allowance. The patient was not straightforward, and I wasn't expecting to enjoy his case. so another reason for being snappy. But was I unprofessional? Should I have ignored her remark as being irrelevant to the patient's care? John
Posted by John D |
|
|
Re: Was I unprofessional?
posted at 25/7/2012 7:16 AM BST
on bmj.com
|
|
Posts: 1
First: 25/7/2012 Last: 25/7/2012 |
IGOOD .KEEP IT UP. YOU SHOULD SUE HER FOR INDECENT BEHAVIOUR,THREATENING AND CAUSING UNNECESSARY STRESS TO THE DOCTOR FOR SOMETHING WHICH MAY BE BEYOND HIS CONTROL.n Response to Was I unprofessional?: 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 drugs, smokes 10-15/day (allegedly) and has bad teeth. He also has a partner/wife with him who interjects all the time. The Scenario. I tell the man how I intend to anaesthetise him (GA, TCI, LA for post op, analgesia). I also say that I will do my best to avoid damage to his teeth, in the course of maintaining his airway. The wife cuts in, "Then we'll sue you!" I glare. "Ha-ha! Only joking! We're a bit nervous" I say that I am not joking, I take my job very seriously, and that I hope that they will too. I give a short lecture on the risks of anaesthesia with special reference to the airway. I conclude my visit, having obtained the man's verbal consent (all that we do in the UK). He arrives in theatre, calm, and his anaesthetic and operation go smoothly. But In theatre and later on the ward, the staff all ask me, "What DID you say to that woman?!?" Apparently, she stormed out just after I had gone, very clearly very angry. Reflection. She had already irritated me by her constant prodding and correcting of her husbands replies to my questions. I have been threatened before with being sued for tooth damage. Then and now, I warn the patient and document it, but no one likes being sued. She may have been worried, for her husband, and I should have made allowance. The patient was not straightforward, and I wasn't expecting to enjoy his case. so another reason for being snappy. But was I unprofessional? Should I have ignored her remark as being irrelevant to the patient's care? John Posted by John D |
|
|
Re: Was I unprofessional?
posted at 25/7/2012 8:07 PM BST
on bmj.com
|
Posts: 963
First: 15/7/2011 Last: 24/5/2013 |
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 Hi John, I only mentiomed Consent because of your comments " say that I am not joking, I take my job very seriously, and that I hope that they will too. I give a short lecture on the risks of anaesthesia with special reference to the airway. I conclude my visit, having obtained the man's verbal consent (all that we do in the UK).". I just thought that consent for an anaesthetic case written consent was obtained. Am I wrong? |
|
|
Re: Was I unprofessional?
posted at 26/7/2012 9:54 AM BST
on bmj.com
|
Posts: 2060
First: 12/3/2010 Last: 24/5/2013 |
In Response to Re: Was I unprofessional?: In Response to Re: Was I unprofessional? : Hi John, I only mentiomed Consent because of your comments " say that I am not joking, I take my job very seriously, and that I hope that they will too. I give a short lecture on the risks of anaesthesia with special reference to the airway. I conclude my visit, having obtained the man's verbal consent (all that we do in the UK).". I just thought that consent for an anaesthetic case written consent was obtained. Am I wrong? Posted by kirked Yes, KIrked, As I outlined, anaesthetists take verbal consent, but record the conversation that established that consent. In other words, the informing bit. That's what the work at Cunnington established. I continue to be grateful for everyone's support. And criticism! And yes, I do think I should have played duck and let it wash off my back without comment. I wasn't really concerned about being sued - in the circumstances I would have an invulnerable case, althouhg a TRust might pay-off such a claimant because that would be cheaper than Court. It was the affrontery, the level of demanding entitlement and passive aggression that shocked me. John |
|
|
Re: Was I unprofessional?
posted at 26/7/2012 11:50 AM BST
on bmj.com
|
|
Posts: 1
First: 26/7/2012 Last: 26/7/2012 |
In Response to Was I unprofessional?: 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 drugs, smokes 10-15/day (allegedly) and has bad teeth. He also has a partner/wife with him who interjects all the time. The Scenario. I tell the man how I intend to anaesthetise him (GA, TCI, LA for post op, analgesia). I also say that I will do my best to avoid damage to his teeth, in the course of maintaining his airway. The wife cuts in, "Then we'll sue you!" I glare. "Ha-ha! Only joking! We're a bit nervous" I say that I am not joking, I take my job very seriously, and that I hope that they will too. I give a short lecture on the risks of anaesthesia with special reference to the airway. I conclude my visit, having obtained the man's verbal consent (all that we do in the UK). He arrives in theatre, calm, and his anaesthetic and operation go smoothly. But In theatre and later on the ward, the staff all ask me, "What DID you say to that woman?!?" Apparently, she stormed out just after I had gone, very clearly very angry. Reflection. She had already irritated me by her constant prodding and correcting of her husbands replies to my questions. I have been threatened before with being sued for tooth damage. Then and now, I warn the patient and document it, but no one likes being sued. She may have been worried, for her husband, and I should have made allowance. The patient was not straightforward, and I wasn't expecting to enjoy his case. so another reason for being snappy. But was I unprofessional? Should I have ignored her remark as being irrelevant to the patient's care? John Posted by John D It would been better if the anaestheist would have discussed the details of risks and possible complications of anaesthesia in the presence of a clinical staff e.g. a nurse or a junior doctor rather than patient's spouse, but as he did not, he should have ignored her as she was more of a hinderance than help |
