The Dangers of Having A Bad Day
Robert Blumm
Surgical PA, Educator, Author, Conference Speaker, Past President five Associations, PA/NP Advocate, Vietnam Veteran, Retired
Let us do a little self-reflection
It was 1970 and the saphenous vein was just harvested from our cardiac surgical patient. The vein was placed in saline and a sterile emesis basin, and I was tasked to take it to the top of the table where the heart was exposed; I slipped and so did the basin in my hand and it fell to the floor. I heard some screams from the OR nurses and some loud curses and comments from the surgical team that was working on the chest. I was directed to sit on a stool and observe for the remainder of the case. Yup, I certainly was experiencing a bad day.
My wife, Celia, went to a nearby urgent care clinic for a URI and was seen by a physician who was harsh and insensitive. She did her exam quickly and without comment and ended the session by saying “Sit here and someone will give you instructions.” A few months later, my wife returned to the clinic for another respiratory issue. She hoped that she would not have this doctor again. When the physician walked into the room, Celia immediately recognized her. But, on this occasion, she was pleasant, caring, asked the appropriate questions and did an extensive exam and politely left the room in a cheery mood. Celia said it was the best exam and experience that she has had since we moved to North Carolina. This doc was giving adept and kind care, which, I assume, is her norm. On the earlier visit, this practitioner may have been hormonal or suffering
from an argument at home or having her children pushing her to the limit before she went into her vehicle and came to the clinic. We are not whom we seem to be on one specific day. I have seen some of the best professionals present at their specialty practice, suffering from loss of sleep, stress, hypoglycemia, perhaps a severe toothache. Maybe they would have made a better decision and stayed home. But you and I know how we are driven; we do not see ourselves as employees, but we are committed to our work and think that our flaws are invisible, that they will go unnoticed.
Of importance in this short essay is how our personalities and our actions reflect on ourselves and our institutions, on the unsuspecting patient, whom you have always treated so admirably. They ask themselves if it is something that they have said or done or has our work environment changed. They leave our office feeling confused, angry, doubting our clinical decisions, and our ability to be subjective, considering something has rocked our boat today. If we have made an error, they could become aggressive and report us to the administration or initiate a litigation. It is amazing how, in five minutes, we could lose five years practicing good medicine.
A breach of medical ethics
What can we remember that will prevent or heal these violations of trust and professional care? Maggie Smith asserted, “Trust that your best tomorrow will be even better than today’s. That is healing. Keep moving.” Maya Angelou said, “You may not control all of the events that happen to you, but you can decide not to be reduced by them.” This too, is healing.
Remember that malpractice events are often initiated because of our poor attitudes, lack of asking for forgiveness if we realize from the patient’s facial gesture that we have just erred. If they have already left your office, a telephone call apologizing for your attitude, mistake or
behavior stating the causative factor goes a long way to disarm a poor patient encounter. Patient satisfaction
Written For CM&F?By: Robert M. Blumm, PA, DFAAPA, PA-C Emeritus CM&F Clinical Advisor