Hey guys; I know that this is going to sound cringe as fuck. But I am feeling very insecure about myself lately. For context I am a surgical resident in Latin America; I am PGY 2; so PGY 1's are under my command and I have a fuck ton more responsabilities (I filter patients in the ER and determine wether they are surgical candidates or not, I must know every single patient in the ER; and I must also take responsability for every hospitalizaed patient on the surgical floor, that's the job of the PGY 1, but since they just began their residency, I am therefore responsible for them)....
So for context, a patient died last shift, and he was recently operated because of a volvulus; according to the chief surgeon and my PGY 4 (the chief resident), he was just fine and was going to be discharged from the hopsital soon; howver my PGY1 and myself, we are sure this patient died because he had a bronchoaspiration event; we were notified a tad later than usual that the patient was having trouble breathing while he was having dinner, we arrived at the scene and performed CPR as soon as possible. However my chief resident and my chief surgeon are adamant that we are at fault, and they are both eyeing punishing us, all of the Surgical PGY 2 at my hospital... For starters such old practices are almost non existent anymore ( we have had our experience with HR from both our hospital and our university)... I am at a loss at what to do; supposedly tomorrow we will have a meeting with the chief surgeon and chief reisdent to decide our punishment; but I really don't know how to respond; I have sometimes a short temper, and I am afraid I might loose my cool :/ ; I was also thinking about bringing up the law; where it was very recently clearly stated that residents and attendings cannot punish other residents...
Please help :) I am very nervous right now; I just went to the gym early today just to clear my mind off, but I keep thinking about that :/
MrSupreme 17h ago
If you're really stressed, try and take a full day (or 6 hours if you don't have time) to actually mourn the life of the man, before you continue thinking about your career. Just do some grieving, pray, meditate, talk to yourself if you have to but do take some time off for that. Then go back to your own living problems. You gotta live that part of the process too as you're human yourself. Then go back to solving your issues with a much clearer mind.
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GeorgeIII 2d ago
Hey dude, I don’t think it’s all your fault. I know medicine is not a miracle, and it does not keep everyone alive in all circumstances.
As for your meeting, there may be cultural specifics to Latin America that I don’t know. In my culture (western US), number 1 is to not lose your temper. Even if you are correct, it just doesn’t make you look good.
As for punishing residents under them when something goes wrong, I guess your higher ups are trying to cover their own asses, as this looks bad for them. I’d keep the law about not punishing residents in your pocket in case needed. Don’t wave it around like a dumbass to start, but do have it ready.
If the “punishment” ends up being very light or just a warning, carry on. But if it’s really catastrophic, like you lose your job, be ready to use the law to your advantage.
Since you guys did actually go and do CPR, it doesn’t strike me as gross negligence. If the good things that you did are documented, you may be legally protected or able to bring a legal case against your higher-ups. Someone dying under your care after you tried to help vs someone dying cause you did nothing are two different things.
But again, I don’t know the inside-out of being in surgery, or working in Latin America. I think you stand a decent chance of coming out just fine.
Vermillion-Rx Admin 2d ago
1) keep cool
2) escalate to higher ups or relevant agencies depending on potential punishment
3) don't do any knee jerk actions out of impulse or emotions
Gather all relevant written policies and documents you've ever signed or been presented with
Not sure what the legal implications are but if you are being wrongfully punished in a way that affects your career, consider a lawyer who resolves such matters
First-light 2 2d ago
I am sorry to hear of your trouble.
Don't get angry and argue but do be firmly resolute in your innocence and in the fact that they are not people who can legally discipline you.
I would initially say "None of us want to do harm. If harm has been done or even if a patient has had a negative outcome, we want to talk about how to make sure it is not done again not to punish. If you start accusing and punishing instead of seeking the root of the problem and the future solutions, then you put you and me on opposite sides, when we are supposed to be on the same side in this."
If they persist say "If you put me on the opposite side of it, in a way that I feel is unfair, I have to look to my own interests not our interests, like I want to. I know you can't legally punish me."
If they still persist, then you say "I will defend myself with the law. I will hire a lawyer. I thought about it before I came here but I felt that to do it before we had spoken would be to have done the very thing I did not want to happen -put us on opposite sides. I want us to be on the same side looking at how we can reduce the risk of future events like this"
Lone_Ranger 3 2d ago
this sounds like the classic symptoms of stress. Are you getting enough sleep? enought time away from the hospital? If not, you loose perspective.
If you are worried about the meeting, I suggest you say aboslutely nothing at the meeting or as little as possible. If they ask why you are not talking, then say the following;
This meeting sounds like a trap - medical liabilty is a complex issue, and probably not best suited for conversation or a chat. If you wish to make an accuastion of medical negligence, then please put this in writing, detailing any evidence for such a claim, and then my representative can address this.
I assume you are part of a union?