Monday, February 23, 2009

Bad Work Habits 2

I read during cases

Now last year I interviewed propective anaesthesia residents (I did this year too). We ask them all kinds of stupid questions that have nothing to do with their suitability to safely deliver an anaesthetic in 5 years time but are more geared towards, can we not stand this person at all or do we like him just a little more than the others. Anyway one of the questions somebody else asked dealt with how you deal with long cases. The prospective resident answered something about this is a good time to bring the laptop into the room. When we discussed this poor fellow at lunch, the program director promptly stated, "well he is not getting a residency in our department." I looked at another interviewer who I know also reads during cases and we rolled our eyes. I feel sorry for the program director who has to wittle 50 applicants down to a short list for 5 positions but....

I read during cases, I frequently bring in my laptop, I write letters and I make a powerpoints. I have written several published book reviews and one CME article for an anaesthetic journal and I largely have done these while a patient was under anaesthetic. I don't just restrict my reading to anaesthesia and pain material. I read the newspaper, occasionaly books and magazines.

I am not sure where I fall safety wise in the anaesthesia community. I think I am around the middle. I know that obsessive-compulsive-wise I fall near the bottom (We had a very OC anaes. at the Cof E named Gray, the residents and nurses called me "the Anti-Gray"). I am not ashamed of this, I am rather proud. Over the years I have had the odd patient who didn't do well, I have made mistakes which hurt patients one of which I blogged about on this blog. One thing I can say is that I have never hurt a patient by reading or innattention. In fact some of my near misses have been while teaching residents and medical students. While I would like to, I am not going to (and cannot) stop teaching them.

Anaesthesia is for the most part boring, this used to frustrate me until I realized what the option to boredom was. Reading keeps me alert, the sheer guilt of reading forces me to look at the monitor more regularily, and keep the chart up to date. This is rationalizing I know; I stand guilty.

Reflecting on My Sexual Harrassment Complaint

Since coming clean I have had some time to reflect on the whole mess.

Was I actually in the wrong here?

The answer is of course yes to a certain extent. I really shouldn't have been so sarcastic on the phone. I was a little irked at what I thought was an inappropriate consult at an inappropriate time. I still had a grudge against the burn unit which is where the call came from.

It could be argued that I should have come over and seen the patient. I was after all just across the street. Fact is, I really thought that ordering PCA in a trached and ventilated patient (probably already getting a fentanyl infusion) was safe if not completely necessary. This was what I had been doing for over 10 years. If our group had said, "we think every such consult request should be dealt with in person" and I knew everybody was making these evening trips back to the hospital I would have done the same.

But was this sexual harassment?

I don't think so. It was just the whole concept that because this complaint has been filed as a sexual harassment rather than a clinical concern that there is no possibility of successfully defending myself, bothered me.

Just had to get that off my chest.

Oh and by the way, after I left the CofE, their residency program was placed on the highest level of probation for....ongoing sexual harassment of female residents. Karma?