When patients Do Badly; When you Make a Mistake; When A Case Is not Going Well

During your Surgical training and career, you will encounter many challenging situations as in life.

Yes there will be times when a case does not go as expected,

When even with the utmost preparation and back up plan the case does not go as expected and your outcome is contrary to tour expectation.

How well do you prepare yourself, your teams and the patient and their family?

Here are some strategies and tips

When you make a Mistake:

Notify a senior immediately or a colleague

Acknowledge the error done and seek to have an audit and a Root Cause Analysis review and plans for mitigation

It is crucially important to also acknowledge to the patient and the family know an ensure them of your continued need to ensure the best outcome of the patient

Accept responsibility when it lies within you

Call for help if you need an extra hand or assistance

Learn from your mistake(s) and always seek for feedback on what you could have done better to prevent a similar situation or to ensure you are well prepared.

When A Case Is Not Going Well :

Stay Calm- Remember to stay calm

Remember It takes a team to successfully execute a Surgery, thus Communication is key.

Communicate with your team- The Anesthetist up top , your assistant Surgeon , the Nurse in the room and the Circulator or assistant in the room

Call for Help if you need more people in the room or resources

Once you are done with the particular case, Take some time as the Surgeon to DEBRIEF with your team and go over the Case;

What went as unexpected

What did the team do so well

Where did we as a team Not perform well

What could we do better if a similar situation arises or comes around?

When Patients Do Badly:

Bad outcomes can be emotionally draining not only for the operating surgeon but also the entire team responsible for that patient's care.

Remember to be Supportive of each other

Ensure you create safe and private/confidential environments where each team member is able to talk through the bad outcome

Allow people including the operating surgeons to have sessions to talk it through either through

Group therapy sessions

Open forum discussions

Debriefing sessions

Feelings you need to face and deal with:

Regret

Guilt

Sadness

Anger

Inferiority

Offer professional psychological therapy sessions as well as spiritual support and counselling to both the health care providers and the patients and their families.

Thus it is important to realize and accept that

Yes,...

There will be bad outcomes

There will be situations when a surgical case does not go as you expected

There will be a time when you make a Surgical mistake or error

The above can happen to you, your colleagues, team, or team members

How you prepare yourself and your teams goes a long way to ensure you empower yourself, your teams and Surgical community to still come out stronger and resilient and able to learn from our failures and bad outcomes for a better tomorrow.