RAMOSA’S MAR [15-04]:Fulfillment amidst toxicity

Indexing Title: RAMOSA’S MAR [15-04]
MAR Title: Fulfillment amidst toxicity
Date of Medical Observation: March 2015
Tag:   Handling abundant workload positively
Category:  Professional/Ethical, Reinforcement


It was a busy day at the wards. It was the night before our elective operations and there were about ten patients who were scheduled for operation. We had to prepare all of the patients, make sure they were cleared by Anesthesiologists and Internists. We also need to ensure that they had all the anesthetics and materials needed for their respective operations. Aside from that, there were also critical patients at the wards who had to be closely monitored for various reasons (i.e. oliguria, desaturation, persistent hypotension). You could say I was having one of those ‘toxic’ duties. As if all of those were not enough, there came three new referrals from different departments: a neonate due to hypospadia, a 57-year-old male due to Benign Prostatic Hyperplasia, and a 34-year-old female post-partum for CVP insertion. I was starting to panic because I still had a lot of things to do. I was already ranting to myself and had almost done it out loud. I was starting to get irritated with the referrals and was already questioning why the referrals had to be done at this hour? But then I realized, I was doing the same thing to Anesthesiologists and Internists. I was also “bugging” them so to speak. I also realized I had no right to complain, I was in residency training. I need these cases to learn more. Thus, with a different perspective, I went to see the referrals and tried to finish all of the tasks at hand. 

INSIGHT: (Physical, Psychosocial, Professional/Ethical), (Discovery, Stimulus, Reinforcement)

Given the amount of tasks placed in our plates, especially as first year surgery residents, we may perceive referrals as additional workload. We may try to deny it to others, even to ourselves, but there are times that we tend to choose to grab the opportunity to sleep, even for a few minutes, than to go and see the referrals from other departments. But then, come to think of it, we do not only deprive other departments or doctors of our own inputs as a surgeon, but also deprive ourselves of the learnings that come along with the cases that were referred to our department.

Attending to the referrals will also gear you toward a better attitude that will be beneficial for future practice as surgeons, especially in developing interdepartmental harmonious relationship. As surgeon, there will always be a point in your life wherein you will come across cases that will inevitably require you to consult other specialties. Seeking other’s help is not a sign of weakness, but rather, a sign of strength, that you know your limitations as a surgeon, and accept it.

Fast forward to 6 years after, we would be dealing with surmountable number of referrals from doctors of various departments, hospitals, and even from different provinces in the country.

With these, more cases means more experiences leading to more learning. Ultimately, all of these will not only benefit us, as physicians, but more importantly, to our patients.

ROJoson’s Notes (17feb19):

Just have to look at the workload of referrals positively – more learnings and more public relationship!

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