I made a mistake, what repercussions should I expect?

[ipressurexd]

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I
made a mistake today in the hospital. I was catching up a patient on their medical problems when I got a call regarding another patient needing urgent procedure. While the patient was still anxious, I had to run out and get set up. Instead of excusing myself professionally, I answered with with a comment that was unprofessional and made the patient extremely anxious. I later came back to the patients room and another physician was comforting him.

I attempted to apologize to his family and I take full responsibility for my mistake. I will apologize again to him and his family again.

What are the repercussions from a complaint where I am in the wrong? I still can't believe I let this slip.

 

[anonperson]

I
made a mistake today in the hospital. I was catching up a patient on their medical problems when I got a call regarding another patient needing urgent procedure. While the patient was still anxious, I had to run out and get set up. Instead of excusing myself professionally, I answered with with a comment that was unprofessional and made the patient extremely anxious. I later came back to the patients room and another physician was comforting him.

I attempted to apologize to his family and I take full responsibility for my mistake. I will apologize again to him and his family again.

What are the repercussions from a complaint where I am in the wrong? I still can't believe I let this slip.

What exactly did you say?

This is all very vague.

Who was the other physician? An attending? Another resident?

Is the patient making a formal complaint?

 

[ipressurexd]

What exactly did you say?

This is all very vague.

Who was the other physician? An attending? Another resident?

Is the patient making a formal complaint?

I said something along the lines of yeah unfortunately your injuries are severe due to the mechanism and drug use. Then I turned and ran out to prep the procedure. He had not been made aware of the drug use results prior, and I delivered it poorly.

Another attending was comforting him. I am an intern.

I'm not sure if they've made a complaint yet. I'm hoping to apologize and make some type of amends.

 

[GoSpursGo]

Talk to your attending and ask them for feedback.

Chances are, this is just a learning experience for you. We've all had patient interactions that we wish we could do over. Recognizing that you could have done better, and asking for and accepting feedback, will go a long way.

I would not go back and talk further with the patient before talking with your attending. Going back and belaboring your apology, trying to "make amends" whatever that might be, is likely more motivated by wanting to make yourself feel better and is probably not actually going to help the patient feel any better.

 

[comp1]

This is one of the most confusing (and yet somehow intriguing) threads I have seen, but it sounds like you were too direct with a patient while managing multiple other issues? I'm fairly sure the patient was aware of their drug use, although you might have been ahead of them on the stages of change. I do have to wonder what "mechanism" was involved. I would work on trying to scrub the word unprofessional from your own personal usage if you can. It's a vague, horrifically undefined term that's mostly used to punish people, or in your case, yourself. It's not helpful and is often used for racist or sexist purposes to boot. Try to be specific. You might have been impolite or abrupt? You apparently didn't proposition or assault the patient, so I don't think there's going to be anything resembling consequences past this week.

 

[onamission!]

Talk to your attending and ask them for feedback.

Chances are, this is just a learning experience for you. We've all had patient interactions that we wish we could do over. Recognizing that you could have done better, and asking for and accepting feedback, will go a long way.

I would not go back and talk further with the patient before talking with your attending. Going back and belaboring your apology, trying to "make amends" whatever that might be, is likely more motivated by wanting to make yourself feel better and is probably not actually going to help the patient feel any better.

OP: don't take this advice. Say nothing to your attendings. If it is brought up by them then explain yourself and apologize. You are an intern and are clearly handling multiple things at one time and got flustered. What is good here is that you have the insight and recognize your mistake. Don't do it again. If you do and happen to develop a habit of having bad bedside manners, then surely your patient will complain, and your attending will have a word with you. An isolated bad conversation with a patient in October of your intern year is not something that should be taking up a lot of space in your mind. Again, keep your head down, do your work, and do it well, and get through the living hell that is residency in the American ACGME system.

 

[Apollyon]

Academic administrator doctor vs some no name. Hmm, who to trust, who to trust?

 

[HemeOncHopeful19]

Academic administrator doctor vs some no name. Hmm, who to trust, who to trust?

I agree with both to a degree. I would probably not bring it up again and just try to learn from it. No reason to bring it up to YOUR attending either unless it comes up IMO

I still don’t get how a patient on a trauma service with a positive UDS was somehow traumatically harmed psychologically by being told they had a positive UDS

But to actually answer the OP I wouldn’t really expect repercussions at worst I think a 2 minute chat with your attending (or absolute worst case your PD) where you basically say exactly what you said in the OP and that’s the end of it.

 

[anonperson]

I said something along the lines of yeah unfortunately your injuries are severe due to the mechanism and drug use. Then I turned and ran out to prep the procedure. He had not been made aware of the drug use results prior, and I delivered it poorly.

Another attending was comforting him. I am an intern.

I'm not sure if they've made a complaint yet. I'm hoping to apologize and make some type of amends.

Just out of curiosity, what was the drug?

Meth? Cocaine?

 

[GoSpursGo]

I agree with both to a degree. I would probably not bring it up again and just try to learn from it. No reason to bring it up to YOUR attending either unless it comes up IMO

I mean, in general I actually do agree there is nothing that NEEDS to happen here. However, clearly this experience affected the OP. There are some toxic programs where you should probably keep your head down and not draw attention to a negative experience, but I would like to think that in most programs the OP could have a private 1:1 conversation with their attending and get some useful feedback.

 

[dozitgetchahi]

I agree with both to a degree. I would probably not bring it up again and just try to learn from it. No reason to bring it up to YOUR attending either unless it comes up IMO

I still don’t get how a patient on a trauma service with a positive UDS was somehow traumatically harmed psychologically by being told they had a positive UDS

But to actually answer the OP I wouldn’t really expect repercussions at worst I think a 2 minute chat with your attending (or absolute worst case your PD) where you basically say exactly what you said in the OP and that’s the end of it.

I agree with you. I would actually lean more towards letting sleeping dogs lie here. I wouldn’t get into this with your attendings if nothing more comes of this incident.

This basically sounds like a nothing burger to me. It’s inpatient medicine - there will be a lot of situations where something happens very urgently, and you have to break away from one patient to go deal with another. Unless you said something horribly offensive to this patient, I wouldn’t be too concerned. Saying something like “look, this happened because you were doing something stupid while you were doing drugs” is direct, perhaps is a bit undiplomatic and maybe could be worded better…but it’s not exactly a catastrophe. Some doctors (particularly surgeons) would view this as typical and appropriate communication (lol).

Bluntly telling a patient with a positive UDS that you know they have a positive UDS isn’t exactly a crisis either. Sounds like the patient’s ego took a bit of a hit. Sounds like you could have been a bit less blunt. Not perfect, but not a total disaster either.

 

[Apollyon]

Bluntly telling a patient with a positive UDS that you know they have a positive UDS isn’t exactly a crisis either. Sounds like the patient’s ego took a bit of a hit. Sounds like you could have been a bit less blunt. Not perfect, but not a total disaster either.

Makes me think back to my EMS days. Addicts would OD, then get just irrationally (or maybe rationally) angry that you blew their high when we Narcaned them. I remember one dude saying, "you know how much that dope cost?" No, I didn't. We would say whatever we wanted to them, like, you got this close to dying, or, that's what happens. I worked with a guy that actually did this: gave one mg Narcan, titrate to respiration, then blast in the second mg on the way into the ED. He thought it was funny to precipitate acute withdrawal.

After becoming a doc, I was amazed to realize what I didn't know at the time.

 

[Entadus]

I think the rule learned in intern year is,

"before you panic about the patient you are ABOUT to (NEED TO🤢😵) go see, quickly wrap things up as 1.) safely and 2.) courteously as you can with the patient that you are CURRENTLY seeing"

Simple but a little tricky sometimes, especially as a newbie.

like, tripping and falling on your face cause you're running distracted.

 

[WildWing]

One option if you want advice on how to handle this in the future would be to ask for it as a hypothetical rather than citing this particular incident. Something like - "What suggestions would you have for handling Situation X?" Then you can get input/help without pointing out your mistake.

 

[emergentmd]

Man, maybe things have changed in the past 30 years and every pt has to be treated with soft gloves but you did nothing wrong. I would never have given it a second thought. If you felt, bad then apologize if it makes you feel better.

You were somewhat abrupt because you had to go care for a potentially dying pt? This is akin to jaywalking.

 

[AlbinoHawk DO]

How is this something where repercussions should happen? Oh no, you weren't extra tactful but we're just truthful. Lock him up!