Just Another White Coat

Monday’s M&M #14

A few posts back after my lengthy hiatus from Tumblr, I mentioned in a bullet point about being on the receiving end of an ugly tirade from one of the attendings. I mentioned that a separate post would follow. Well, here it goes.

The background events leading up to the ugly tirade was as follows:

• Patient admitted to the observation unit by yours truly under the ortho spine attending’s name to be evaled by the spine team in the morning. (The ortho trauma team takes spine trauma call every 3 weeks)
• Patient was not seen by spine resident in the morning.
• Patient sits in observation unit over 24 hours before nurses page the spine attending inquiring of patient’s status.
• Attending goes on warpath.

While there were a lot of factors leading up to this specific tirade, it’s far too lengthy to divulge the details in a single post. To summarize, this particular attending lectured me on the basics of “continuity of care” and how spine patients usually pretty much trumps ortho trauma patients. Then the attending goes on about how this is the second time that I have “screwed” with his patients and if I screw up again, it’s my butt that gets booted and they will personally ensure that I’m never hired by any other physician practicing in the city. And the only words I was allowed to utter was “Yes sir” much less say anything in my defense. So needless to say, afterwards I was upset and a big ball of emotions calling up my supervisor, who told me to not worry about it and to not let it get to me. The residents were all supportive and came to my defense, again reassuring me that I did nothing to harm the patient in question and that ultimately the problem came down to adequate communication between the different teams and residents. 

For me however, it was an eye-opener that once again, I’m no longer behind that protective curtain of being a student. Now that it’s all water under the bridge, I look back at it as a humbling experience. During my rotations, my preceptors would praise me for picking things up quickly, being hard working, and being perceptive enough to catch things that others may not have seen. I was used to the praises so while it sucks to get cut down, it’s a good reminder that I’m not infallible. I can still make mistakes but I have to learn from them.

So the lessons I learned from this experience:

1. Avoid this particular attending at all costs. (Just kidding, because there will be a time that I will have to interact with this attending again.) 
2. C.Y.A. - Cover your a**. Document everything. My mistake was that in my note, I should have written that I contacted the spine resident the night before and that I made him aware that this patient was being admitted to his service. Because there was no note or mention of it, the attending just assumed that I willy-nillyed admitted this patient without notifying anyone.
3. Try not to ugly-cry - When I get upset and angry, I tend to cry. It’s rather embarrassing and it’s something I need to reign under control. I need to work on channeling my anger towards something more useful than getting puffy-eyed and snotty-nosed.