The Blame Game

It's witch hunting time in the ole corale!

We gonna smoke us out some baddies, tar them, feather them then burn them at the stake. We'll hang, draw and quarter them then leave their rotting heads on the Tower of London to warn others of their folly.

Today it's "pick on the RMO's" day... and when it rains,... it pours!

Firstly I was asked by the nnursing unit manager to come into his office for a 'chat' (never a good sign)... he started off by saying he didn't want to tell me off, but was 'informing' me that I was the subject of a high risk category IIMS notification.

Now for the unaware, IIMS is a public hospital online complaint service for nurses. In theory... it's supposed to be an anonymous way you can rport any incidents that happen in hospital to make sure someone fixes them. In reality... it serves as a way for disgruntled nurses to exact their revenge on doctors anaonymously and make them feel more entitled than they really are.

And so today I found myself the target of such a complaint. To be honest there WAS to some degree an error on my part. I am happy to admit I shoudl have been more 'clearer' on the medication chart. But legally I purposelly wrote an invalid prescriptino on the discharge medication chart so that it would NOT be dispensed to the patient. However 2 pharmacists tried to second guess me and dealt it out anyway to the patient (but not the other dangerous drug which was below it written exactly the same way invalidly??) and so one of my IV drug user patients almost went home with a vial of Accuphase which he stupidly would have injected and killed himself immediately with.

Thankfully a nurse saw the vial in his medications and removed it. Probelm averted, crisis over right? Not by a long shot!

Because it's a 'potential' accident, it has to be investigated at the high admin levels and dealt with. Now I'm happy to cop my share of the blame... but I was told point blankly by the nurse unit mnagaer that it was in no way the pharmacies fault and it was all my problem as the prescriber (which is rubbish cos I've worked in a pharmacy and I know they are responsible too!)

So now I have to wait as the witchhunt goes on and I feel like Dr Death (the dodgy surgeon in Qld who was negligently manslaughtering his patients)...

I know that in hindsight it's probably nothing and will end up being nothing... but it makes me feel so dirty... I feel like I'm some kind of incompetent doctor whose doing more harm than good.

The first principle of medicine is "Do no harm"... this overides the 'doing good' bit... if you can't fix them... and least don't hurt them!

But now I feel (I know differently, but I still feel this way) like I can't even uphold THIS principle. Grrr!

Then I found out today one of the other interns who has been wokring harder than all of us got a rather blaise assessment by her lazy consultant. She had been putting in more hours than everyone else and had a huge patient load of over 40 for most of the 10 weeks and her lazy bum of a boss just couldn't be bothered to properly assess her. Understandably she wasn't happy...

We all had to front up to the Spanish inquisition this afternoon and get interviewed by the DCT (Director of Clinical Training)... it was a prety useless interview which probably had more anxiety attached to it beforehand than during the actual interview.

Then for grandrounds, we had another one of those "let's analyse a patient who died to find out which intern to crucify" and we dissected the case to find out "What went wrong?" (there was a powerpoint slide entitled this!) and generally just make the junior medical staff paranoid about initiating any management wihtout first consulting their superiors.

It's just been one of those days...

When you feel that you're being scrutinised for every clinical decision and no one gives a damn.

When you really just feel like GP-land would be the ultimate way to work.

When you really just need a good meal with some good friends.

So I'm off with the other 'terns for our end-of-term dinner. This will be our last big outing in Whoop Whoop so I guess my time up here is pretty much coming to a close.

Adios Whoop Whoop Base Hospital! Thanks Dungeon for your welcoming weeks into internship!

And watch out The Zoo! Here I come to cure your urology patient of their oliguria!

Wee!