Not My Fault
How do you apologise for something that's no fault of yours?
Over the years I have had to put on a brave smile to endure hostility, anger and disappointment hissed at me from disgruntled patients. Drip finished, still not replaced. Drugs administered late. BP not checked but charted. Urine bag on the verge of bursting and not emptied. Bed too high. Bed too low. Ward too hot. My MRCP training dictates that I have to be impartial, objective, calm and empathic. And so I have always been impartial, objective, calm and empathic. I always apologise on my nurses' behalf, on the hospital's behalf, and heck, on the Health Ministry's behalf! All this while the patients, sensing a diplomacy they mistake to be guilt or fear, intensify their tirades against all the wrongs that have been committed against them.
We have nursing sisters who should be overseeing such things. Today a patient of mine complained incessantly about poor nursing practices that had befallen her (she being a former nurse herself). I asked my ward sister to join our "discussion" (mostly one-way sonar traffic with the patient doing all the talking and us listening) hoping that she could come up with some solutions.
She spent the whole morning grumbling about how she always had to apologise for things she didn't do! Hmm.
These days, I take diplomacy a bit further. I take the patient's side. Ever so subtly I nudge them towards making a formal complaint. Let the hospital director hear about our shortcomings. Maybe then things will improve.
We always have to learn the hard way, don't we?
10 comments:
Haiya...always happened to me too when i was in the hosp...even now oso , in my own clinic , if my nurse did anything wrong , I have to apologise on their behalf oso wat..but to me , if by saying sorry will de-fuse the situation..I will lor..
But it sucks to have to be the punching bag all the time...
Punch the nurses loh. that works for me. I ask them to write an explanation letter which potentially may be in their record book. They may hate me but things get done.
To be honest, if i may....i think we malaysian are just living in a 'blame-culture' community. The best thing to do is to have a risk management team... so things like 'drugs given without prescribing' would be triggers for incident reporting and actions taken appropriately thru (possible repeated) education and training... in a NON BLAME manner.
Saying sorry can diffuse matter....but apologising and then not taking action subsequently would just enable a chain reaction to happen... I say sorry today, tomorrow and the day after...so lama lama saying sorry but just for the sake of it only...aiyo.... get a patient advise liason services running and then when complaints gets thru...we get people moving and doing something...
My two cents worth anyways..
Patients who make the loudest noise, get the best care.
Hosp Slave : Patients who make the most noise almost certainly have the highest complication rates as well!
Fibrate,
Can I be assured enough that those "complications" were not a result of retribution against patients who make the loudest noise?
BTW, prescribing Amlodipine for your own mother-in-law??? Is it even legal to do so?
Hosp Slave : Can't speak for all of my fellow colleagues but my conscience is clear. I treat all my patients equally, whether or not I like them.
My mother-in-law has been unfortunately "discharged" from the care of a physician who started her on amlodipine. The polyclinic she goes to now does not have the budget for drugs like amlodipine. Hence she has to get it from somewhere. I am in no way treating my own family, just getting her the supply of medication that her primary doctor prescribed in the first place. That, I believe, is legal. And by the way, that is the healthcare system in my country. It is not seamless.
Fibrate,
If I may just have one follow-up question.
If the polyclinic in question does not have the budget for Amlodipine,and you are now signing a prescription for her, does it mean that the budget for your m-i-l's Amlodipine will have to come out from your hospital budget?
Unless your hospital is running on a limitless budget (I doubt so), then surely your action will inadvertently preclude other patients from your hospital from getting the treatments that they so deserve?
BTW, no healthcare system in the world is seamless.
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