SSSFELICIANO’S MAR [15-01]:The Importance of our Consultants in our Training

Indexing Title: SSSFELICIANO’S MAR [15-01]
MAR Title: The Importance of our Consultants in our Training
Date of Medical Observation: January 2015
Tag: Managing our patients with guidance from our consultants during training: a good practice
Category: Professional/Ethical – Reinforcement
It has been traditional for us to greet our loved ones and friends a Happy New Year on the first day of the year. I’ve received a few to remind me that a new start is coming for us; however, I was saddened by news from the hospital. A 14-year-old female whom I saw on December was admitted for anemia. She was a case of a late-stage rhabdomyosarcoma of the gluteal area. I immediately informed our consultant of this admission and updated him of the patient’s status. The plan was to do palliative care, since the risks for radical excision or chemotherapy at the time outweighs the benefits for the patient. With the case of the patient, he advised me to prime the parents of her prognosis which I did. Furthermore, the patient was co-managed by Pediatrics Department and I explained to them our plan of management. Patient was accordingly referred to their Hema-Oncologist consultant who agreed with our plan for the patient. During her course, I could not help but be attached emotionally to the patient since I first saw her. I made sure that our consultant was updated and that we do everything we could for her. Her parents had been very cooperative during our course of management as well and there had been no question with how we managed their child. However, despite our plan for the patient to immediately correct her blood parameters, we had difficulty acquiring the needed blood products which eventually led to the patient’s demise. Though grieving, parents were still thankful of our efforts for their child. However, what was alarming on the day the patient was about to die was that the Hema-oncologist consultant was questioning our management. It was reiterated that there was lack of aggressiveness and that chemotherapy should have been done for the patient. The consultant wanted to call for a meeting for us to explain our side.  I informed my consultant and he thoroughly explained to me why chemotherapy was not done. He was calm enough to remind me to accept what they would say and told me to explain our side as well. The meeting did not push through, but it made me reflect that this is a learning case for me-learning that being updated on the management of a case is of utmost importance and that referring to our expert colleagues is a good practice while we are still on training.
(Physical, Psychosocial, Professional/Ethical) (Discovery, Stimulus, Reinforcement)
In any field of work, hierarchy is observed-be it in a company, government office, or a private institution. In the field of medicine, what is interesting is that we have those who have studied medicine ahead of us, hence our seniors, but at the same time, they treat us not only as juniors, but our colleagues. They are more than willing to extend their knowledge and skills to us, and are the happiest seeing us grow in our own niche. Our training could not work without our consultants, for not everything is found in our books, electronic sources nor from our experiences alone. They are the ones who have been in practice ahead of us, have most likely seen a lot more patients than us,  and saved more lives than us. They might have committed more mistakes, but these shortcomings are those which sharpened their skills, proved their theory, and made them the physician that they are now; these then are being passed to us.
As has always been reiterated, being lucky of their presence in our training, let us not forget to give them the due respect they deserve. Since we are in training and they are completely accountable of what we do to our patients, let us strive hard to be better every day, and be the best to every case we encounter. Not only should we inform them of our cases but to continuously update them with our patient’s progress. This experience I had was an awakening for me. Despite absence of any relation to this particular patient, she had been so dear to me. I will soon mother a child and this patient reminds me of a mother’s love to her daughter that is why I made sure that we give everything the patient should have. With constant communication with our consultant and the co-managing department, I assumed that I will be free of any guilt if something happens to my patient. However, sadly, the event of being doubted despite the expertise of my consultant not only taught me humility but the aggressiveness to learn more. More than the respect I had for my consultants was my admiration for their priceless effort of guiding us despite any problem that may arise, as in the case of this patient. Not only did they teach us, but they were there to back us up, in cases that we fall short of what we know and what we can do. Asking for their hands to help us out, they gave not only their hands and arms, but their all and with this, I will forever be grateful to them.  
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