Mar 20, 2010

Getting it Right

While it feels sometimes like all I do is critique our medical system, I have to say this: when they get it right, they really get it right.

Two weeks ago, I lost a dear member of my family. That day came too soon for us. What started out as a simple bladder infection turned to sepsis in a matter of hours.

When it was clear that her situation had become grave, the staff in the ER could not have been more wonderful. They helped us through the difficult decision to withdraw treatment and move to palliative care.

The doctors, nurses, social workers, chaplain, housekeeping staff - were all kind and attentive. It was a busy night in the ER with patients stacked in the hallways; and yet they managed to give us private space to be with her while she passed. They brought us juice and crackers. They walked us through every stage of her death.

When the Canadian system functions well, it is a thing of beauty to witness.

Mar 15, 2010

Shame-based medical education: Is there a better way?

While working on a literature review on medicine and power, I came across this unfortunate quote. I really, really hope that this is not the general opinion of physicians, but I am curious what others think...

"I think that our working relationships [Between ICU doctors and nurses - ETA] are very forward—we are all part of the team—if the doctor isn’t there it fails, and if the nurse isn’t there, it fails.
. . . I think we (doctors) lead the team by involvement and motivation.

We promote, motivate, demonstrate respect, call each other by first names. I think that some of the nurses may feel that there is a hierarchy, but I think that it’s their problem. They’re shit scared of medicine, but that’s their problem.

The junior staff (junior doctors) have a rough ride if they don’t know the patient. They are trained by embarrassment [BBM -ed]. Nursing is different, it’s high on molly coddling. Nurses appreciate handholding."

-- Anonymous ICU Physician

Coombs, M. (2003) Power and conflict in intensive care clinical decision making. Intensive and Critical Care Nursing 19, 125–135