Pride and prejudice on the wards...

As medics, we often criticise surgical colleagues for being minima in their involvement and turfing everything to medics. But I’ve had some good experiences with surgical specialities recently.

So I have a patient with a really unsual wound, requiring rather specialised input. Last night I stayed late with the urology registrar trying to catheterise the patient (which is usually straightforward, but this time was much trickier than it should be). Altough I didn’t technically need to be there, and it was well past my hometime (because things always kick off at hometime)  it was my professional courtesy to get things ready for them, given that I was asking a senior colleague to help our patient’s care. They were very helpful and polite, even though they probably assumed I must be a really flappy SHO indeed if I couldn’t even catheterise a patient or let the nurses do it. It quickly became clear to them why I had required their expertise, and they admitted that they had initially planned to let me do it but realised that it was truly difficult. They didn’t let their suspicions get the better of then, and I made it clear that I appreciated their helpfulness and support.

This is why you should never assume too much about a situation before you’ve been to review. At the very least, don’t let your preconceptions cloud your treatment of your colleagues. Speaking of preconceptions, let’s contrast that with another team. General surgeons weren’t particularly involved when they admitted the patient, and today the plastics SHO was rather brusque on the phone, trying to bounce me to refer to tissue viability without really listening. In the end I passed the phone to my consultant because clearly playing nice was getting me nowhere.

1) I’m your equal in training please don’t speak to me as if you are speaking to a child. It’s bad form.
2) Did I stutter*? If I wanted TVN, I’d contact them. As a professional, please don’t assume I have no idea who to contact regarding my patient’s condition. Sure, people mess up sometimes, but please don’t assume all your colleagues are incompetent as a default or that you should treat them as such.
3) I mean, I probably did stutter. Because I do sometimes when under stress. Which is all the more reason not to be mean to someone and to listen to what they are actually saying.
4) you’d better have a darn good reason for trying to bounce a patient before you’ve even seen them or heard the story. How can you say that they aren’t appropriate for your speciality without having a clue?
5) You’re wrong. So it’s going to look silly when you have to eat your words.

Anyhow, the SHO came, saw the patient, then ran off without documenting anything Tip for new docs: NOTHING short of a crash call or peri-arrest should stop you from documenting before you leave a ward. They’d told the nursing staff that they would contact their consultant for advice. Nothing written. Um, please don’t be that guy or gal.

Fortunately the consultant came, just as I was about to leave,  with one of their specialist nurses and they were very helpful. They had a long chat with the patiet’s relatives and took the time to update me.  And they told me they’d never seen anything like it, just like the urology registrar had said.  I ended up staying late, again because most specialities tend to swoop in, write a small amount of illegible text and disappear.  Another top for new docs: if you can, always discuss with the ward team if you are reviewing. Or if you are getting a review from another team, try to speak to the team as soon as they are done with the patient, don’t just rely on what is written in the notes. It’s a lot more helpful to speak to each other directly.

I have to admit I was flattered when they asked me what I wanted to do, and tried to persuade me to defect to plastics because they thought I was genuinely really interested in my patients cases and that was something they valued in their team. Because I stayed late to speak to them asked a lot of questions, I guess. There’s no greater compliment in medicine than someone telling you that you’d be good n their speciality. I appreciate that compliment, even if they were the youngish, flirty kind of surgeon who swoops into a ward dressed like they’ve just strolled out of theatre, and regails you with tales of how they almost went into gastro.

Anyhow, be nice to colleagues, whenever you can. And even if you secretly think they are being an idiot, keep it to yourself until you’ve confirmed that they are in fact, being an idiot, otherwise you’ll look like the bigger idiot. Personally, I think you should keep it to yourself either way, because being mean achieves little. And constructive advice is so much more helpful.