Documented mistakes

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hzma

hzma

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Does your program document your mistakes?
For example, if you forget to ink a specimen, will they document that and make you sign a paper acknowledging that you made that mistake? Not in all specimens, but every now and then?
 
I think perhaps big screwups get documented in some sort of informal manner, at least, but I have never heard of anyone being made to sign a statement about it. Then again, I imagine stuff like that would be kept pretty quiet and not passed around.

Speaking of mistakes, though, most mistakes happen out of ignorance or inattention (either deliberate or not - a lot of ignorance is far from deliberate!). The biggest mistake I see residents making is not asking for help, either they think the attending will think less of them or they waited until it was too late to tackle a major specimen and everyone went home, or whatever. I also see many senior residents avoiding giving help, which is unfortunate also.

My biggest lesson to incoming residents: ASK QUESTIONS. I can't think of any attending here who wouldn't offer to go over a difficult specimen (or your first of any specimen) if you ask. They may tell you to ask a senior resident if they are too busy, but no one will ever leave you hanging if you ask.
 
yaah said:
My biggest lesson to incoming residents: ASK QUESTIONS.
Click to expand...

This cannot be stressed enough, IMO. It is better to look like a complete fool and ask a stupid question than to make a mistake that can't be undone. The key, I suppose, is to be aware of what will be an irreversible mistake that harms a patient. Ask, ask, ask. Leave your pride at the door. Being a first year resident is a humbling experience for everyone and trying to fight it will only make it worse. Just go ahead and ask if you are not absolutely sure. Attendings will understand, especially at the beginning.

Another good thing for new residents to remember is: never let yourself feel rushed. Take the time you need to get it right. People will try to rush you and make you feel rushed... just ignore them and do what you need to do, even if it means being there really late. Don't worry, you'll get faster later in the year.
 
2121115, are you a PD? I wish I matched to your program.:laugh:
 
I didn't think so. So why are they doing that at my program. Some sort of sick scare tactic? I don't know, but its making us residents so nervous- we're like afraid if we screw up it'll go in our file. How are you supposed to learn in an enviroment like that? Sheesh.
 
hzma said:
I didn't think so. So why are they doing that at my program. Some sort of sick scare tactic? I don't know, but its making us residents so nervous- we're like afraid if we screw up it'll go in our file. How are you supposed to learn in an enviroment like that? Sheesh.
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Maybe there have been a lot of mistakes and they are trying to "prove" they are doing something about it? Programs have to answer to various entities about their residents' progress and capabilities. I dunno, maybe there is somebody old fashioned in charge who thinks the only way for people to learn is through intimidation.
 
hzma said:
I didn't think so. So why are they doing that at my program. Some sort of sick scare tactic? I don't know, but its making us residents so nervous- we're like afraid if we screw up it'll go in our file. How are you supposed to learn in an enviroment like that? Sheesh.
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hzma -

for the benefit of those applying for the 2008 match, will you please reveal what program you're at, as what you're saying is something i think is important to know?
 
mlw03 said:
hzma -

for the benefit of those applying for the 2008 match, will you please reveal what program you're at, as what you're saying is something i think is important to know?
Click to expand...

Good luck with that. People don't typically want to divulge where they are at even if they are elated with their experience, little lone if they are contemplating a change of venue.
 
yaah said:
I think perhaps big screwups get documented in some sort of informal manner, at least, but I have never heard of anyone being made to sign a statement about it. Then again, I imagine stuff like that would be kept pretty quiet and not passed around.

Speaking of mistakes, though, most mistakes happen out of ignorance or inattention (either deliberate or not - a lot of ignorance is far from deliberate!). The biggest mistake I see residents making is not asking for help, either they think the attending will think less of them or they waited until it was too late to tackle a major specimen and everyone went home, or whatever. I also see many senior residents avoiding giving help, which is unfortunate also.

My biggest lesson to incoming residents: ASK QUESTIONS. I can't think of any attending here who wouldn't offer to go over a difficult specimen (or your first of any specimen) if you ask. They may tell you to ask a senior resident if they are too busy, but no one will ever leave you hanging if you ask.
Click to expand...

I agree with you yaah about asking questions, but this can only apply to things you KNOW you don't know. There is an entire category of things you don't know that you don't know. And this is where it gets tricky. It hurts to be criticized for something that you had no idea you were supposed to do. I think good training programs do what they can to minimize this category, but there are some training programs that are very unclear regarding responsibilities, protocol, and standard procedure.
 
cjw0918 said:
I agree with you yaah about asking questions, but this can only apply to things you KNOW you don't know. There is an entire category of things you don't know that you don't know. And this is where it gets tricky. It hurts to be criticized for something that you had no idea you were supposed to do. I think good training programs do what they can to minimize this category, but there are some training programs that are very unclear regarding responsibilities, protocol, and standard procedure.
Click to expand...

Well, that's very true also. Here we sometimes have problems when new residents start surg path rotations for the first time, and they don't know about all the templates, or where to pick up slides, or how to dictate, or things like that that become obvious as you go on. Chief residents need to help this out better, IMHO, and senior residents should also help. But it still lies on the resident who is actually responsible to make sure they know what they are doing. Like I said, almost always if it is an honest mistake, or a newbie mistake, people will understand.
 
I think it can't be said enough, how extremely easy it is to be overwhelmed as a first-time surg path resident.

Our only defence is common sense.

On a previous rotation there was some question about who formalinized a bowel perf specimen which turned out the next day to have PTLD because hell, it was a bowel perf and it was 4:30pm on a busy grossing day and no pertinent history had been provided on the requisition.

You learn your lessons, and move on.
 
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