• SDN Site Updates

    Hey everyone! The site will be down for approximately 2 hours on Thursday, August 5th for site updates.

  • How To ACE Your Medical School Interview

    In this webinar hosted by SDN with experts from BeMo Academic Consulting, you will learn a simple five-step process to help you translate your interview invitation into an acceptance.

surfsurg

Junior Member
10+ Year Member
7+ Year Member
Mar 20, 2005
13
0
Status (Visible)
As doctors most people expect us to be perfect although clearly no one is. Did you ever make any mistakes that made you re-think whether you should continue your training?

List some mistakes you have seen (and what level of training it was made) that made you think that the resident was incompetent?

How frequently can you make mistakes before you are considered incompetent?
 

resxn

Full Member
10+ Year Member
Oct 2, 2006
912
26
Status (Visible)
  1. Attending Physician
I think what you'll see is that the same trend that exists in malpractice exists for residents.

In other words, the most common suit brought against a physician is "failure to diagnose." You'll probably see that happen the most in residents as well. Fortunately, most of us have attending back up, but there are cases where you don't. When I was a resident we essentially had no attending supervision at the VAMC and I can count at least quarterly where someone missed a diagnosis--and I'm talking cancer here not benign disease. Now this sometimes affected prognosis, but usually didn't because the follow-up was close enough.

However, there are other times, on weekends especially, where the resident didn't call something urgent when in fact it probably was--whether this was an infection getting out of control, a new murmur (missed pericardial friction rub, for example), or unchecked CXR or lab with an abnormality.

I think that it is at least relatively rare for a surgical resident to blow something big during surgery. I saw it yearly in one department or another, but it wasn't as frequent as I would have expected. I think missing important labs or physical findings that delay diagnosis is the biggest issue and I saw this frequently.
 

dynx

Yankee Imperialist
15+ Year Member
Jan 22, 2003
4,584
209
IN YOUR HEAD...let me out!
Status (Visible)
  1. Fellow [Any Field]
As doctors most people expect us to be perfect although clearly no one is. Did you ever make any mistakes that made you re-think whether you should continue your training?

List some mistakes you have seen (and what level of training it was made) that made you think that the resident was incompetent?

How frequently can you make mistakes before you are considered incompetent?

Not my mistake but here goes: I'll leave out details but briefly a little old lady was given too much of a drug because the intern didn't know the dosing and took the lady at her word as far as what her ussual dose was...unfortunatly she forgot the decimal point and ended up in the ICU, could have died. The intern was wrong for many reasons, failure to look up the dose in the chart where it was documented, failure to know the common doses (what he gave was the far end of acceptable for a large man taking the drug chronically...hence it cleared the pharmacy), but most of all failure to know his limits...when writing the prescription he should have thought "hey, I don't know what the ****ing dosing is for this drug...I should look it up" If he had done that he could have fixed his first two problems. Im sure he doubted his ability to be a good physician when the **** hit the fan that particular day. He was incompetent in that instance. However, like you say, we're all going to do stupid ****. He was sorry, knew he made a mistake and more importantly knew that the mistake wasn't not knowing his dosing...it was not knowing his limitations.
So he learned from his mistake. I think that last part is the distinction between those who are going to be dangerous for the rest of thier practice and those who are just sporadically ******ed like we all are.

As far as your last question, its not the frequency its the situations. If you do things without knowing the risks and don't know what your limitations are, you are dangerous period.
 
About the Ads
V

VAspa

Films after chest tube placement are always a good time. There is atleast one that ends up being shown at an M&M annually.

As earlier, medication errors happen. Seems as though they always happen in the middle of the night.

Just know to have a high ASCOT value as an intern. (Anal Sphincter Coefficient Of Tightness). Follow-up on everything.
 

LanceArmstrong

Level X Elite User
10+ Year Member
7+ Year Member
Jan 21, 2006
173
0
Status (Visible)
  1. Attending Physician
Things surgical residents have done wrong that come to mind that I have seen...
1. Chest tube in the Vena Cava
2. partial nephrectomy during lap chole
3. Multiple times - CBD disection during lap chole
 

toofache32

Full Member
15+ Year Member
Apr 19, 2003
3,863
42
Status (Visible)
  1. Resident [Any Field]
Things surgical residents have done wrong that come to mind that I have seen...
1. Chest tube in the Vena Cava
2. partial nephrectomy during lap chole
3. Multiple times - CBD disection during lap chole

4. Consulting the face team at 3am for a "mobile maxilla" that turned out to be a denture.
 

NeuroFP

Full Member
10+ Year Member
Feb 21, 2007
43
0
Status (Visible)
  1. Pre-Medical
In a book by Katrina Firlik entitled, "Another Day in the Frontal Lobe," she states that if you make a mistake once, you are okay. Twice, you are scrutinized. The third time, the chief starts to question your worth as a human being.
 

DNASplicer

Junior Member
10+ Year Member
5+ Year Member
Nov 19, 2005
67
0
Status (Visible)
  1. Resident [Any Field]
okay, i'm not in surgery yet...

but how do you accidentally perform a nephrectomy! instead of cholectomy! laproscopicly or not.

I have heard of this, but thought it an urban myth...
 

naegleria brain

Full Member
10+ Year Member
Dec 24, 2006
296
6
Status (Visible)
i believe lap for nephrectomy

in that book by the nsg, are you sure she wasnt talkin about a medical student standing on the vaccuum? i think she was

because i'd submit that once is irritating, and two is inexcusable in real life. at least that's my experience (well, not direct experience, but some unfortunate friends with large feet)

then again, standing on the hose is a bonehead move that a four year old could figure out, much less a twenty-four year old
 

NeuroFP

Full Member
10+ Year Member
Feb 21, 2007
43
0
Status (Visible)
  1. Pre-Medical
in that book by the nsg, are you sure she wasnt talkin about a medical student standing on the vaccuum? i think she was

because i'd submit that once is irritating, and two is inexcusable in real life. at least that's my experience (well, not direct experience, but some unfortunate friends with large feet)

then again, standing on the hose is a bonehead move that a four year old could figure out, much less a twenty-four year old


Yes, she actually was. You've read it? I'm not sure what the name of the instrument is, but she said that it is the vaccuum that a NS holds in one hand many o' time with the (what ever other one-handed tool they are using) in the other.


Imagine how much it must suck to realize you screwed up like that? I mean, damn, I've screwed some menial things up, but I don't know how degrading that would feel. I guess that those people would be dedicating a more numerous percentage of their life to watching their feet (instead of their hands, which is the sad thing. The student was probably so involved in the OP that he wasn't watching anything else).
 

funkless

Apatheist, Anestheologist
10+ Year Member
15+ Year Member
Jul 7, 2003
2,782
18
Where'd Your Pleasure Go?
Status (Visible)
  1. Medical Student
One of our surg attendings claims to have a video of a resident mistaking the cava for the left crus of the right hemidiaphragm during a lap nissen.

Also heard of an anastamosis stapler cleaving without firing the staples during division of the splenic artery on a lap splenectomy. Bad times, eh?
 

NeuroFP

Full Member
10+ Year Member
Feb 21, 2007
43
0
Status (Visible)
  1. Pre-Medical
And, how the hell can you get a chest tube into a vena cava? Wouldn't you have to puncture something?
 
About the Ads

GATC

Member
7+ Year Member
15+ Year Member
Apr 24, 2002
131
0
Miami
Status (Visible)
And, how the hell can you get a chest tube into a vena cava? Wouldn't you have to puncture something?

I have seen this happen. I don't know how this resident accomplished this, but he did. Even worse, the patient did not need a central line. Her blood pressure had been low and stable for years.
 

dynx

Yankee Imperialist
15+ Year Member
Jan 22, 2003
4,584
209
IN YOUR HEAD...let me out!
Status (Visible)
  1. Fellow [Any Field]
I have seen this happen. I don't know how this resident accomplished this, but he did. Even worse, the patient did not need a central line. Her blood pressure had been low and stable for years.

I'm puzzled by what seems to be an abrupt change of subject in your post.
 

neuroticchica

Junior Member
10+ Year Member
5+ Year Member
Oct 27, 2004
24
0
Status (Visible)
Seen many errors by residents and no one was fired. This is just a minor sampling.

1) An emergent trach performed wrong (and for the wrong indications) resulting in immediate death for a healthy young patient.
2) A resident accidently cutting the face of a baby during a C section.
3) A resident causing a 3rd degree burn on the leg of a patient during a C section.
 

naegleria brain

Full Member
10+ Year Member
Dec 24, 2006
296
6
Status (Visible)
Seen many errors by residents and no one was fired. This is just a minor sampling.

1) An emergent trach performed wrong (and for the wrong indications) resulting in immediate death for a healthy young patient.
2) A resident accidently cutting the face of a baby during a C section.
3) A resident causing a 3rd degree burn on the leg of a patient during a C section.

i can see the first two...
but PLEASE elaborate on the third :wow:

sometimes during a surgery the attending will mess with the residents by stepping on and off the vacuum. the younger ones don't think of someone stepping on the tube so they freak out and replace everything and go nuts

the older residents seem to have gotten the hint and do it back to the younger ones

so i guess when a med student does it, it brings memories of their earlier days of being messed with on a regular basis

to be totally honest, i certainly woulda done the same thing had i not read her book first. i also was concentrating so hard on not falling into the table; it wasn't till my third surgery that i was able to just relax and actually get into what theyre doing rather than praying not to screw up something
 

goldie

Senior Member
10+ Year Member
15+ Year Member
Jul 25, 2001
112
0
MA
Status (Visible)
Hmm....

Not recognizing that general anaesthesia loosens the bowels rather quickly...and looking in the wrong place.

Hct of 22 is okay!

"Sure, I'll volunteer."

All for now.
 

flashman

Junior Member
7+ Year Member
15+ Year Member
Aug 30, 2003
19
0
Status (Visible)
In one case, a laparoscopic spleen:

Verese needle into duodenum AND vena cava

morcelating the spleen and then its plastic container bag-essentially atomizing a spleen in a patient with medically refractory ITP
 

Brooklyndo2.1

polytrauma monkey...
10+ Year Member
5+ Year Member
Oct 4, 2006
137
0
PA
Status (Visible)
  1. Attending Physician
open colectomy as a med student.... the GIA fires... all is good.... and then we have two sections of colon and everything is blood and **** spilling out. The surgical attanding, actual chief thereof, was trying out a new GIA model, and it cut without stapling.

good, ive never seen an old man sow bowel together so fast in my life.
and, It was everyones fault. I mean everyone elses

anyone want to guess the medical training of the person being allowed to use the gia at the moment? Lets just say I never want to use one again.
 

Shodddy18

Senior Member
10+ Year Member
15+ Year Member
Jan 15, 2004
581
7
Maine
Status (Visible)
  1. Attending Physician
I saw a term infant loose a finger in a non emergent c-section. Thank god for malpractice insurance, and thankfully I was just the human retractor on that one.
 

Tigger14

Ready to move
7+ Year Member
15+ Year Member
Feb 28, 2002
152
0
Status (Visible)
  1. Resident [Any Field]
open colectomy as a med student.... the GIA fires... all is good.... and then we have two sections of colon and everything is blood and **** spilling out. The surgical attanding, actual chief thereof, was trying out a new GIA model, and it cut without stapling.

Staplers can be dangerous. I was getting ready to fire a TA, the attending put the pin down, and all of the staples fell out (no firing necessary). :eek: And just FYI, there is no need to sew quickly in this setting... just put rubber bands or bowel clamps on the ends to control further spillage. Sewing quickly can lead to more problems...

I am curious though... there shouldn't be "**** spilling out" if the bowel was prepped...
 
About the Ads

Winged Scapula

Cougariffic!
Staff member
Volunteer Staff
Apr 9, 2000
39,956
18,683
forums.studentdoctor.net
Status (Visible)
  1. Attending Physician
Staplers can be dangerous. I was getting ready to fire a TA, the attending put the pin down, and all of the staples fell out (no firing necessary). :eek: And just FYI, there is no need to sew quickly in this setting... just put rubber bands or bowel clamps on the ends to control further spillage. Sewing quickly can lead to more problems...

I am curious though... there shouldn't be "**** spilling out" if the bowel was prepped...

I was thinking the same thing...unless of course, it was an emergent case. At any rate, those staplers misfire more often than I'd care to admit if I was the manufacturer.
 

Tigger14

Ready to move
7+ Year Member
15+ Year Member
Feb 28, 2002
152
0
Status (Visible)
  1. Resident [Any Field]
I was thinking the same thing...unless of course, it was an emergent case.

With all due respect, if there was that much contamination, I would be thinking "ostomy", not "anastomosis". I know the trauma literature says you can reanastomose unprepped bowel, but my understanding is that this applies in the setting of limited spillage, and that is not the case reported here. Please correct me if I am wrong, though. :confused:
 

Winged Scapula

Cougariffic!
Staff member
Volunteer Staff
Apr 9, 2000
39,956
18,683
forums.studentdoctor.net
Status (Visible)
  1. Attending Physician
With all due respect, if there was that much contamination, I would be thinking "ostomy", not "anastomosis". I know the trauma literature says you can reanastomose unprepped bowel, but my understanding is that this applies in the setting of limited spillage, and that is not the case reported here. Please correct me if I am wrong, though. :confused:


I'm not sure why you're quoting me here, since I agree with you.

If there were feces spilling out, and especially if it was a large amount (which isn't clear from the person telling the story), an anastomosis would be risky, although as you note, it has been done. Not my cup of tea though - would rather divert them for a short period of time (since its been consented for, right?) and come back another day to take it down cleanly.
 

Hallm_7

Senior Member
10+ Year Member
15+ Year Member
Feb 18, 2002
685
3
38
Status (Visible)
  1. Post Doc
A urologist I've shadowed since undergrad told me a story last summer from his residency days:

There was an attending that liked to time himself on nephrectomies. Apparently he had gotten in the 30-40-minute range for a nephrectomy. One day the urologist I know was with him for a nephrectomy, and the attending was evidently looking to break his best time. They started, the attending quickly found the kidney, took it out, and sent it off for a path report. They closed and went on with their work. The path report came later that day and all it said was "normal spleen."

He swore up and down that he was telling me a true story, but that still seems really bizarre. I guess the renal and splenic arteries look alike, so maybe it is plausible. But it seems like he would have noticed it was a spleen on the table instead of a kidney.
 

droliver

Full Member
Moderator Emeritus
15+ Year Member
May 2, 2001
1,588
152
Status (Visible)
  1. Attending Physician
List some mistakes you have seen (and what level of training it was made) that made you think that the resident was incompetent?

1. trans-hepatic chest tube twice by the same E.R. resident

2. an awake bronch using Norcuron on a trached floor patient by a pgy-2 surgery resident. Contract not renewed at the end of the year.

3. mistakenly (aggessively) fenestrating the renal pelvis instead of the adjacent pelvic lymphacele in a transplant patient leading to graft loss.

4. placement of shiley dialysis catheters into the common carotid (this one happens fairly often). I've seen 2 strokes from this.

5. amputation of an attendings' fingertip with a bone cutter during an orthopedic externship by a visiting medical student. This actually happened at UAB ~ 1997

6. Anastamosing bowel into a closed circuit (by getting confused making a roux limb). I've seen that twice.
 

Disco

General Surgery Intern
10+ Year Member
5+ Year Member
Aug 20, 2004
27
0
Status (Visible)
NG tube hooked up to high flow oxygen on accident--perforated stomach with more free air than you can imagine.
 

RajMahal

Guitar Hero
7+ Year Member
15+ Year Member
May 18, 2003
180
2
41
Albuquerque, NM
www.myspace.com
Status (Visible)
  1. Resident [Any Field]
ER resident who placed a chest tube with the most proximal fenestration OUTSIDE the chest wall, leading to massive subcutaneous emphysema in a patient who had a 30% PTX. The guy had rice crispies from his eyelids to his scrotum. His only complaint the next morning was he couldn't see. poor guy.
 

Twizzler

Full Member
10+ Year Member
5+ Year Member
Nov 15, 2006
18
0
Status (Visible)
  1. Resident [Any Field]
These are the reasons why I take notes at M&M and then review them later, so I can avoid most avoidable mistakes.
 

spreebee

Junior Member
10+ Year Member
5+ Year Member
Aug 7, 2006
271
1
Status (Visible)
  1. Post Doc
Not my mistake but here goes: I'll leave out details but briefly a little old lady was given too much of a drug because the intern didn't know the dosing and took the lady at her word as far as what her ussual dose was...unfortunatly she forgot the decimal point and ended up in the ICU, could have died. The intern was wrong for many reasons, failure to look up the dose in the chart where it was documented, failure to know the common doses (what he gave was the far end of acceptable for a large man taking the drug chronically...hence it cleared the pharmacy), but most of all failure to know his limits...when writing the prescription he should have thought "hey, I don't know what the ****ing dosing is for this drug...I should look it up" If he had done that he could have fixed his first two problems. Im sure he doubted his ability to be a good physician when the **** hit the fan that particular day. He was incompetent in that instance. However, like you say, we're all going to do stupid ****. He was sorry, knew he made a mistake and more importantly knew that the mistake wasn't not knowing his dosing...it was not knowing his limitations.
So he learned from his mistake. I think that last part is the distinction between those who are going to be dangerous for the rest of thier practice and those who are just sporadically ******ed like we all are.

As far as your last question, its not the frequency its the situations. If you do things without knowing the risks and don't know what your limitations are, you are dangerous period.

A common sense uncalled for mistake... He should be prohibited from future practice... He played someones life like it was nothing by not taking the precautions...
 
About the Ads

dynx

Yankee Imperialist
15+ Year Member
Jan 22, 2003
4,584
209
IN YOUR HEAD...let me out!
Status (Visible)
  1. Fellow [Any Field]
A common sense uncalled for mistake... He should be prohibited from future practice... He played someones life like it was nothing by not taking the precautions...

It was a common sense mistake I'll give you that. Im not sure he should be prohibited from practice due to it.
 

MS3er

New Member
10+ Year Member
Apr 1, 2006
16
1
Status (Visible)
  1. Medical Student
A common sense uncalled for mistake... He should be prohibited from future practice... He played someones life like it was nothing by not taking the precautions...

Correct me if I'm wrong, but I looked at some of your other posts and aren't you APPLYING for medical school right now? So your neither a med student, nor even been an intern, nor a resident, not an attending. If the above is true I think your background in being able to have a credible understanding in what context mistakes like this occur is shallow at best.

I'm an MS4 that will be beginning his surgery residency soon and just being a medical student it amazes me every day how many mistakes are made and how many mistakes are caught before something big could have happened such as the outcome here. I'm not justifying the mistake at all, but its an unfortunate reality of life that a large part of residency appears to be a process of learning from what you did wrong before..and I think your deceiving yourself to think that, especially coming from someone that hasn't even started medical school yet, that you would 'automatically' be 'more competent' then some 'reckless resident' that could 'ever make' such a mistake.

Much of these stories on this thread have been stories about mistakes OTHER residents have made. But I would venture to suggest that there is no resident/attending here that has never made a mistake that could have potentially had a very bad conclusion to a patient. Again, there arent justifications but just a dose of reality.
 

SLUser11

CRS
15+ Year Member
Feb 22, 2005
2,876
808
Status (Visible)
  1. Attending Physician
But I would venture to suggest that there is no resident/attending here that has never made a mistake that could have potentially had a very bad conclusion to a patient. Again, there arent justifications but just a dose of reality.

Tell me about it. One time in med school, when I was on neonatology, I mistook a newborn for a football and the nearby open window for the uprights. I ended up punting that little guy right out the window onto a busy highway. In my defense, I was post-call......

I was, like, so embarrassed, and afraid it was going to affect my grade.:scared:

Anyway, the baby ended up being fine. Disaster averted, but still kind of a close call. This may sound corny, but I learned alot about patient care that day.....and alot about football.:thumbup:
 
S

SemperFi

Correct me if I'm wrong, but I looked at some of your other posts and aren't you APPLYING for medical school right now? So your neither a med student, nor even been an intern, nor a resident, not an attending. If the above is true I think your background in being able to have a credible understanding in what context mistakes like this occur is shallow at best.

I was just about to post the same thing. Spreebee has posts in premed, medical student, and now resident threads criticizing and offering asinine advice (see "entering medical students" under allopathic medical students). I'm not afraid of criticism, but at least save it until you know what you are talking about. Yes spreebee, like you, other people on SDN visit a variety of forums. You better get used to getting called out if you keep up this kind of pattern.
 

Jejton

Full Member
10+ Year Member
Oct 30, 2006
449
0
Brooklyn, NY
Status (Visible)
  1. Pre-Medical
I understand that mistakes happen, and I understand that medicine is not engineering in that sometimes everything is done correctly but the outcome is still not good, but reading these posts gives me an idea of why malpractice is what it is. Flame away.
 

spreebee

Junior Member
10+ Year Member
5+ Year Member
Aug 7, 2006
271
1
Status (Visible)
  1. Post Doc
Correct me if I'm wrong, but I looked at some of your other posts and aren't you APPLYING for medical school right now? So your neither a med student, nor even been an intern, nor a resident, not an attending. If the above is true I think your background in being able to have a credible understanding in what context mistakes like this occur is shallow at best.

I'm an MS4 that will be beginning his surgery residency soon and just being a medical student it amazes me every day how many mistakes are made and how many mistakes are caught before something big could have happened such as the outcome here. I'm not justifying the mistake at all, but its an unfortunate reality of life that a large part of residency appears to be a process of learning from what you did wrong before..and I think your deceiving yourself to think that, especially coming from someone that hasn't even started medical school yet, that you would 'automatically' be 'more competent' then some 'reckless resident' that could 'ever make' such a mistake.

Much of these stories on this thread have been stories about mistakes OTHER residents have made. But I would venture to suggest that there is no resident/attending here that has never made a mistake that could have potentially had a very bad conclusion to a patient. Again, there arent justifications but just a dose of reality.

First off, I've already applied and been accepted... Does that matter? Not to you...Also, do I care where I post... No... I just hit new posts and once I find something interesting I make a comment... Anyways, I feel I have unwantedly been stirring up SDN for a week or so...Sorry... From a patients point of view, criticizing the resident with my above statement was only proper. Disagreeing to my opinion would be encouraging malpractice. What would you do if you were prescribed a way lethal dose of asprin or something that a chart 3 rooms down could have prevented? I just thought checking a dosage before distributing was a common sense move...Expecially if you aren't sure.. That is not like some of the other mistakes that involve much practice before perfect execution like in surgery...I've heard of people taking out the wrong organs and stuff.. Is there a right to criticize that? Sure, knowing that good medical schools have cadaver labs and should already be familiar with everything in the body... Hell, I dissected human cadavers in undergrad human anatomy when I was a freshmen... If I know the difference between the spleen and a kidney or liver, etc... A med student sure as heck should...This is an occupation with guts... Criticizing will only push to make better doctors...Let's hear the fire...
 

dynx

Yankee Imperialist
15+ Year Member
Jan 22, 2003
4,584
209
IN YOUR HEAD...let me out!
Status (Visible)
  1. Fellow [Any Field]
First off, I've already applied and been accepted... Does that matter? Not to you...Also, do I care where I post... No... I just hit new posts and once I find something interesting I make a comment... Anyways, I feel I have unwantedly been stirring up SDN for a week or so...Sorry... From a patients point of view, criticizing the resident with my above statement was only proper. Disagreeing to my opinion would be encouraging malpractice. What would you do if you were prescribed a way lethal dose of asprin or something that a chart 3 rooms down could have prevented? I just thought checking a dosage before distributing was a common sense move...Expecially if you aren't sure.. That is not like some of the other mistakes that involve much practice before perfect execution like in surgery...I've heard of people taking out the wrong organs and stuff.. Is there a right to criticize that? Sure, knowing that good medical schools have cadaver labs and should already be familiar with everything in the body... Hell, I dissected human cadavers in undergrad human anatomy when I was a freshmen... If I know the difference between the spleen and a kidney or liver, etc... A med student sure as heck should...This is an occupation with guts... Criticizing will only push to make better doctors...Let's hear the fire...

I ALMOST agree with you. BTW this was a "top 10" surgical program. My thoughts is that if they stopped worrying about producing lab rats and got some good practitioners these problems would decrease in frequency.
 

The_Sensei

Membership Revoked
Removed
10+ Year Member
Dec 28, 2005
526
0
Status (Visible)
  1. Attending Physician
First off, I've already applied and been accepted... Does that matter? Not to you...Also, do I care where I post... No... I just hit new posts and once I find something interesting I make a comment... Anyways, I feel I have unwantedly been stirring up SDN for a week or so...Sorry... From a patients point of view, criticizing the resident with my above statement was only proper. Disagreeing to my opinion would be encouraging malpractice. What would you do if you were prescribed a way lethal dose of asprin or something that a chart 3 rooms down could have prevented? I just thought checking a dosage before distributing was a common sense move...Expecially if you aren't sure.. That is not like some of the other mistakes that involve much practice before perfect execution like in surgery...I've heard of people taking out the wrong organs and stuff.. Is there a right to criticize that? Sure, knowing that good medical schools have cadaver labs and should already be familiar with everything in the body... Hell, I dissected human cadavers in undergrad human anatomy when I was a freshmen... If I know the difference between the spleen and a kidney or liver, etc... A med student sure as heck should...This is an occupation with guts... Criticizing will only push to make better doctors...Let's hear the fire...


Wait until you've done it before you offer up any criticism. Otherwise, your "take" on things are the idiotic mumblings of a mere tyro.
 

MS3er

New Member
10+ Year Member
Apr 1, 2006
16
1
Status (Visible)
  1. Medical Student
First off, I've already applied and been accepted... Does that matter? Not to you...Also, do I care where I post... No... I just hit new posts and once I find something interesting I make a comment... Anyways, I feel I have unwantedly been stirring up SDN for a week or so...Sorry... From a patients point of view, criticizing the resident with my above statement was only proper. Disagreeing to my opinion would be encouraging malpractice. What would you do if you were prescribed a way lethal dose of asprin or something that a chart 3 rooms down could have prevented? I just thought checking a dosage before distributing was a common sense move...Expecially if you aren't sure.. That is not like some of the other mistakes that involve much practice before perfect execution like in surgery...I've heard of people taking out the wrong organs and stuff.. Is there a right to criticize that? Sure, knowing that good medical schools have cadaver labs and should already be familiar with everything in the body... Hell, I dissected human cadavers in undergrad human anatomy when I was a freshmen... If I know the difference between the spleen and a kidney or liver, etc... A med student sure as heck should...This is an occupation with guts... Criticizing will only push to make better doctors...Let's hear the fire...

No one was arguing the point that the intern made a mistake and that it was careless. But your knee-jerk response that the proper result should be some resident that should 'never be allowed to practice' is equally careless given your complete lack of understanding of what context in which these errors occur.

From what I gathered your are in the process of taking of taking your MCAT soon and likely applying to medical schools. If I could make a comparable analogy. Say you forgot to pay your rent this month because you were 'eagerly studying' for the MCAT and likely had 500 other important things running in your head and that it slipped your mind until your landlord brought it to your attention by telling you 'you should be prohibited from ever living in an apartment' because you 'clearly' are unable to follow a simple regulation like paying your rent monthly' and that you 'should just be evicted immediately no discussion needed'. You might likely respond and say 99% of the time you pay your rent on time but this 'one time' you had 500 other things going on (like your MCAT coming up) and that it was a careless mistake.

The consequences of the mistake for the intern were more severe, but the context in which it occurred were likely similiar..the intern likely didnt spend one hour on this patient's medication list because he most likely had 100 other more pressing things simultaneously going on (patient with a lower GI bleed in the next room, 10 different discharges, 4 consults, getting yelled at by the resident for something he didnt do yesterday that he needs to do today, getting crap from nurses for stuff he needs to do, getting chewed out by attendings for basically being an intern). Now does that make the intern an 'incompetent idiot that should never be allowed to practice', or just someone who made a careless mistake that alot of other people might easily have made in that situation too but who unfortunately didn't have it picked up on by safeguards in place to detect those mistakes? Think about it.

Medicine is a human endevour and as such mistakes are inevitable...again this is ABSOLUTELY NO WAY justifies, excuses, or condones them but it just points out an obvious fact. Yes, there is a point where mistakes from a physician become pathologic, then sure such people should not be allowed to practice. But if your future outlook is to only surround yourself with physicians who have never ever made a careless mistakes you will find yourself in an empty room.
 

eastcoastyall

Wisdom Onslaught
10+ Year Member
5+ Year Member
Feb 17, 2007
87
0
Status (Visible)
Spreebee, you can join this conversation after you have had to forgive yourself for your first mistake. Until then...
 

spreebee

Junior Member
10+ Year Member
5+ Year Member
Aug 7, 2006
271
1
Status (Visible)
  1. Post Doc
Wait until you've done it before you offer up any criticism. Otherwise, your "take" on things are the idiotic mumblings of a mere tyro.

What's this:

I swear by Apollo, Æsculapius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath.
To consider dear to me as my parents him who taught me this art; to live in common with him and if necessary to share my goods with him; To look upon his children as my own brothers, to teach them this art if they so desire without fee or written promise; to impart to my sons and the sons of the master who taught me and the disciples who have enrolled themselves and have agreed to the rules of the profession, but to these alone the precepts and the instruction.

I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.

To please no one will I prescribe a deadly drug nor give advice which may cause his death.

Nor will I give a woman a pessary to procure abortion.

But I will preserve the purity of my life and my arts.

I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art.

In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves.

All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.

If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.
"


According to NOVA, the Oath is, as follows:

Hippocratic Oath -- Classical Version

" I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:
To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art - if they desire to learn it - without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else.

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.

If I fulfil this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.

I will finally end my presence in this thread... Good Day and hope some of you utilize your medical education to its furthest in making wise decisions for you future patients...
 

boston

Junior Member
10+ Year Member
15+ Year Member
Oct 20, 2002
192
4
Status (Visible)
  1. Fellow [Any Field]
First off, I've already applied and been accepted... Does that matter? Not to you...Also, do I care where I post... No... I just hit new posts and once I find something interesting I make a comment... Anyways, I feel I have unwantedly been stirring up SDN for a week or so...Sorry... From a patients point of view, criticizing the resident with my above statement was only proper. Disagreeing to my opinion would be encouraging malpractice. What would you do if you were prescribed a way lethal dose of asprin or something that a chart 3 rooms down could have prevented? I just thought checking a dosage before distributing was a common sense move...Expecially if you aren't sure.. That is not like some of the other mistakes that involve much practice before perfect execution like in surgery...I've heard of people taking out the wrong organs and stuff.. Is there a right to criticize that? Sure, knowing that good medical schools have cadaver labs and should already be familiar with everything in the body... Hell, I dissected human cadavers in undergrad human anatomy when I was a freshmen... If I know the difference between the spleen and a kidney or liver, etc... A med student sure as heck should...This is an occupation with guts... Criticizing will only push to make better doctors...Let's hear the fire...

spreebee, i think people people are reacting negatively because your posts come off as a little bit naive.

nobody is saying mistakes are good and that they are acceptable. nobody wants to "encourage malpractice."

everyone agrees mistakes are bad. no one wants to make them. when you make a mistake and hurt someone, you feel bad.

but it is always easier to criticize and point fingers, than to offer up solutions on how to minimize and avoid mistakes. this is the whole purpose of morbidity and mortality conferences -- to analyze the root causes of mistakes and bad outcomes and see how we can do things differently to avoid them in the future.

as a surgeon or surgeon in training, you will at some point make a mistake that will hurt another human being. bank on it. even if it is not the immediate cause of death, it will contribute to and accelerate the patient's demise. and aside from mistakes, there will be a multitude of times you provide suboptimal care. this happens in spite of your best efforts and best intentions and you only realize this looking through the retrospectoscope, i.e. after the fact.

i have made big mistakes -- errors in clinical judgment and errors in surgical technique. you remember it forever. but hopefully you learn and never repeat the same ones. the only mistakes that are unforgiveable are mistakes born of laziness or dishonesty.
 

spreebee

Junior Member
10+ Year Member
5+ Year Member
Aug 7, 2006
271
1
Status (Visible)
  1. Post Doc
spreebee, i think people people are reacting negatively because your posts come off as a little bit naive.

nobody is saying mistakes are good and that they are acceptable. nobody wants to "encourage malpractice."

everyone agrees mistakes are bad. no one wants to make them. when you make a mistake and hurt someone, you feel bad.

but it is always easier to criticize and point fingers, than to offer up solutions on how to minimize and avoid mistakes. this is the whole purpose of morbidity and mortality conferences -- to analyze the root causes of mistakes and bad outcomes and see how we can do things differently to avoid them in the future.

as a surgeon or surgeon in training, you will at some point make a mistake that will hurt another human being. bank on it. even if it is not the immediate cause of death, it will contribute to and accelerate the patient's demise. and aside from mistakes, there will be a multitude of times you provide suboptimal care. this happens in spite of your best efforts and best intentions and you only realize this looking through the retrospectoscope, i.e. after the fact.

i have made big mistakes -- errors in clinical judgment and errors in surgical technique. you remember it forever. but hopefully you learn and never repeat the same ones. the only mistakes that are unforgiveable are mistakes born of laziness or dishonesty.

I agree...
 
S

SemperFi

:wow: This guy is taking presumptuous to another level. Don't leave now spreebee. That hole you're digging is getting downright impressive. He reminds me a little of the guy in my platoon at boot camp who arrived at boot camp with a large Marine Corps emblem already tattooed on his shoulder. The Drill Instructors loved that.
 
About the Ads
This thread is more than 14 years old.

Your message may be considered spam for the following reasons:

  1. Your new thread title is very short, and likely is unhelpful.
  2. Your reply is very short and likely does not add anything to the thread.
  3. Your reply is very long and likely does not add anything to the thread.
  4. It is very likely that it does not need any further discussion and thus bumping it serves no purpose.
  5. Your message is mostly quotes or spoilers.
  6. Your reply has occurred very quickly after a previous reply and likely does not add anything to the thread.
  7. This thread is locked.