I was walking down the corridor today when I almost bumped into one of my colleagues. When I say “bumped into” I mean he nearly knocked me down the stairs in his effort to pretend I don’t exist.
The three people with me were greeted with cheerful ‘hellos’, but I have evidently committed a crime for which I must be soundly ignored. I’ve no idea what this offence is - perhaps he holds me, as clinical director, personally responsible for the hospital’s economic doldrums.
Whatever it is he’s kept this up for six months now without accidentally letting slip even a hint of a smile when we pass one another in theatre, so you have to admire his reflexes and persistence. It must be quite an effort to be so consistent about this - I doubt whether I could remember whom I’m not saying ‘hello’ to quite so successfully. Perhaps he keeps a list written on the back of his hand.
Talking about blame, there’s been lots of it around this week. The internet is full of the shocking story of the two year old who had a plaster of Paris cast applied to the wrong arm. This wasn’t noticed by anyone until the following day when mum was so traumatised that she had to go straight to the press.
This report is followed by the inevitable seven pages of public vitriol, the gist of which is that doctors and nurses are an overpaid, underworked bunch of idiots who can’t even tell right from left and should be sacked. Or worse. The fact that the nurse involved had tried to calm the distressed toddler by putting a cast on her teddy bear first only seemed to fan the flames of public outrage, as apparently they had managed to treat the correct arm on the teddy, but sadly not on the child.
Anyone who has tried to treat a distressed, screaming two-year-old will understand that it wouldn’t be immediately obvious which was the arm with the greenstick fracture. Presumably all the angry citizens expressing disbelief that the NHS can be so crap have A. never made a mistake, and B. never heard of ‘human error’.
I suppose it’s just more fun to post, while frothing at the mouth, about how some incompetent junior doctor, who might even have been foreign, took three attempts to put a drip up when you were in casualty. Of course, what the hospital in question needs to do, after publishing a grovelling apology, is institute a checklist system in A&E whenever a procedure like that is performed, even when the patient is awake.
We’re already doing this in theatres using the WHO check list which has been mandated by the National Patient Safety Agency. It’s entirely about avoiding human error - children can’t tell you when you’re doing the wrong thing, and even wide awake adult patients will allow nerve blocks, for instance, to be performed on the wrong side, without a word of protest.
Despite what we might think from the internet message boards, most patients assume we know what we’re doing. Whether they’re always justified in doing so is another question.