3 ms·

I've seen this too, but I've found ego is much more of a problem. I've seen doctors get locked into a course of action and get fixated on it. At that point, f

I've seen this too, but I've found ego is much more of a problem. I've seen doctors get locked into a course of action and get fixated on it. At that point, facts don't matter. They HAVE to be right. The other staff fall into line, because they have an ongoing work relationship, and only a transient connection to the patient. It's good that at least for now there is still choice in facilities in our country. This would have been a much different outcome otherwise.

mnw21cam 8y ago
Hospitals in the UK have for the last few years been receiving training to counter this, based on the lessons learnt by the airline industry - Cockpit Management. This was set in motion by an airline pilot whose daughter died in a hospital because of a mistake made by a senior surgeon who wouldn't listen to the junior staff who had noticed it. The tl;dr of it is that saying "Stop, I think you are making a mistake" is an effective way for junior staff to get senior staff to pay attention, and can save lives.
- nailer 8y ago
  I'm not sure it's entirely solved. Anecdote: I had whooping cough a few years ago, unbeknownst to me, during a national whooping cough epidemic, where the NHS had put out a bulletin telling doctors to look out for whooping cough. During this time I had fits where I wouldn't be able to call an ambulance because of the shaking. I also could have potentially killed infants I came into contact with. Both the NHS and private doctor ignored the possibility of me having the disease - my partner's mother, a registered nurse, even suggested I ask them to look for it - simply because they didn't think of it when they first arrived. And of course both the private and NHS doctors arrived late, don't apologise, and insist I call them by their title rather than their name. My general feeling of the medical industry in the UK is that it has more respect for formality than professionalism.
koboll 8y ago
In another thread on long hospital shifts, commenters made the point that the detrimental effect of subtle information lost during a shift change often outweighs the effect of sleep loss during a long shift, when looking at patient outcomes. I wouldn't be surprised if doctors here were gaming the rules because they knew a transfer would cause more harm than good. On one hand, it's bad to disregard patient autonomy and legitimate guardianship, especially in such an extreme way. On the other hand, if I was a professional convinced that not doing so would be likely to cause the death of a patient, I can't tell you for sure that I wouldn't do the same thing. The Hippocratic Oath does not say "First, follow the law; Second, do no harm".
- dsfyu404ed 8y ago
  >In another thread on long hospital shifts, commenters made the point that the detrimental effect of subtle information lost during a shift change often outweighs the effect of sleep loss during a long shift, when looking at patient outcomes. >I wouldn't be surprised if doctors here were gaming the rules because they knew a transfer would cause more harm than good. Well then they could have told the family that was their line of reasoning for not wanting the transfer. If they had a defensible reason they would have worked that angle before using the system to try to make an end run around the patient's/family's wishes.

mnw21cam 8y ago

Hospitals in the UK have for the last few years been receiving training to counter this, based on the lessons learnt by the airline industry - Cockpit Management. This was set in motion by an airline pilot whose daughter died in a hospital because of a mistake made by a senior surgeon who wouldn't listen to the junior staff who had noticed it. The tl;dr of it is that saying "Stop, I think you are making a mistake" is an effective way for junior staff to get senior staff to pay attention, and can save lives.

nailer 8y ago
I'm not sure it's entirely solved. Anecdote: I had whooping cough a few years ago, unbeknownst to me, during a national whooping cough epidemic, where the NHS had put out a bulletin telling doctors to look out for whooping cough. During this time I had fits where I wouldn't be able to call an ambulance because of the shaking. I also could have potentially killed infants I came into contact with. Both the NHS and private doctor ignored the possibility of me having the disease - my partner's mother, a registered nurse, even suggested I ask them to look for it - simply because they didn't think of it when they first arrived. And of course both the private and NHS doctors arrived late, don't apologise, and insist I call them by their title rather than their name. My general feeling of the medical industry in the UK is that it has more respect for formality than professionalism.

koboll 8y ago

In another thread on long hospital shifts, commenters made the point that the detrimental effect of subtle information lost during a shift change often outweighs the effect of sleep loss during a long shift, when looking at patient outcomes. I wouldn't be surprised if doctors here were gaming the rules because they knew a transfer would cause more harm than good. On one hand, it's bad to disregard patient autonomy and legitimate guardianship, especially in such an extreme way. On the other hand, if I was a professional convinced that not doing so would be likely to cause the death of a patient, I can't tell you for sure that I wouldn't do the same thing. The Hippocratic Oath does not say "First, follow the law; Second, do no harm".

dsfyu404ed 8y ago
>In another thread on long hospital shifts, commenters made the point that the detrimental effect of subtle information lost during a shift change often outweighs the effect of sleep loss during a long shift, when looking at patient outcomes. >I wouldn't be surprised if doctors here were gaming the rules because they knew a transfer would cause more harm than good. Well then they could have told the family that was their line of reasoning for not wanting the transfer. If they had a defensible reason they would have worked that angle before using the system to try to make an end run around the patient's/family's wishes.