Saturday, 22 February 2014

Confidentiality


Hi,



Firstly I would like to apologise for taking so long to update my blog, and explain why this has been. One of my colleagues at work approached me a little after the last post and asked if I had a blog online. I asked her why she thought this (obviously not wanting to admit this as its confidential etc etc) and she mentioned finding the blog online while searching for F2 application information, finding it interesting reading a few posts and from them feeling that 'it sounded a bit like you'. On reading further she found more information about what I had been up to in my F1 life (such as laser tag) and linked it to me, she didn't recognise any patients, though, despite being on surgery with me. This worried me, as while I anonymise all patients I mention in the blog, changing and mixing facts about them, I don't really want this blog to be linked to me personally. This isn't because I say anything in it that I feel is inappropriate in the blog, but I feel that being able to link it to me makes it more likely I will censor the emotions and opinions I want to write about. A recent news article over a hospital worker who was disciplined over making inappropriate comments on twitter (anonymously) also scares me. This operating department practitioner said some pretty silly things (such as planning on using a patient's body hair to make him sideburns like Bradley Wiggins) and rude things about the executive board. I don't think I have said anything this serious, but this man was trawled through the media, and investigated by a professional body and cautioned. I don't want this to happen to me.

I have had a good think, and a chat to a some friends/family about what they think I should do. I think I will carry on posting but I will try and say a lot less, just little bits about what I have been up to and some funny stores. Hopefully by keeping things brief (and professional) I remove even more patient identifiable data, and minimise the information that people could use to identify me.

Over the last months so much has happened. Most importantly (to me) my favourite patient sadly died. This was someone who had been in the hospital for well over 100 days from when I was doing surgery. I have talked about them previously in the blog, and while on nights last week I was called to an arrest in the surgical ward. On arrival it was this patient who had arrested (completely unexpectedly) and we did all we could but couldn't restart the heart. I was really affected by this happening at 4AM, while I was trying to look after another patient on a different ward who was getting sicker and sicker (and subsequently died), and I had to go and sit down, have a little cry, and wonder if this was really the right job for me. Having had some time to reflect, this is the right job for me, but I am going have to get better at coping with things like this happening. I have been very lucky so far that not many of my patients have died, but things can only get worse...


And for some quick bullet points to get across some of the more eye-catching things that have happened since I last posted

- Homeless heroin user on the ward, complaining about the service that we could offer them. They are telling us on the ward round that 'they pay taxes too, and should get more methadone'. My consultant replies curtly 'there is no VAT on Smack' and walks off. Ballsy and it took some time trying to persuade the patient to stay in hospital afterwards, but very brave!

- On call repeated bleeps from 'outside lines' (often the consultant calling from home to make sure you are doing OK) actually turning out to be recruitment agencies trying to get me to join up. Lying through switchboard to get to medical people working then trying to sell. Not the best time guys!

- 30 year old obese man came to hospital with breathing problems, got stuck in his car in the car park and had a cardiac arrest: the paramedics had to dismantle the car to get him into the hospital. Fortunately he survived. It was thought he arrested because the getting trapped inhibited his already problematic breathing by putting pressure on his chest, leading to a respiratory arrest.

- A man I was clerking telling me he had a 'cauliflower heart'. Very confusing until I realised he meant he had had a Coronary Artery Bypass Graft (CABG or cabbage in medical slang)

- Behind curtains seeing one patient while another talks on their phone, unaware we are next door "get some of those chocolates for the doctors when you come in, they have been lovely.... No not those ones, they are too dear, get the 2 for £5 ones, then we can keep one" Then looking sheepish as we come to see them next on the ward round

- A patient telling me 'that was a really good session' after I performed a digital rectal examination on him. Needless to say I didn't go back and see him again, and left it to my colleagues instead!

My posts may take more of a vibe like the above in future (though more frequent, and less long). let me know what you think (if anyone is actually left reading this after this hiatus!

7 comments:

  1. I decided to check your blog out tonight after not doing so in a good few weeks now, funny you'd just posted. I completely understand your concerns about anonymity and getting caught up in some tabloid-hyped controversy is the exact sort of nightmare my paranoid mind would conjure if I was writing this blog, so I think fair play to you for posting again. I think you should do whatever you feel most relaxed doing - you have already contributed greatly and your blog is a good place to start for those curious about a life in medicine. Nobody has the right to tell you to pick up the slack if you don't feel comfortable doing so!

    Very sorry to hear about that patient - I dread my first - but I guess inevitable - day like that. Hopefully the good is outweighing the bad and you've good support when the going gets tough.

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  2. I am sorry to hear about your patient. I think the fact that you feel the way you feel shows that you are a very caring doctor. It is what patients need!

    Like above - I randomly decided to check your blog this morning!
    I think your worries are completely understandable - it is sad that as health care professionals we risk being targeted by the public on anything that we say, write and do.
    I personally love reading your blog and your stories remind me, and I am sure many others, of what medicine is all about.
    Thanks and do keep it going!

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  3. I like the way you've done the last part, it's entertaining for me as a reader to read all your anecdotes in a short punchy way! Sorry to hear about your patient as well, I can imagine I will be the same if and when I get into medical school and beyond!

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  4. Like the above people, I just checked and was pleased to see an update! Very sorry to hear about your patient though, I often worry about how I will cope with these sorts of situations when I start FY1 this year. Really enjoy your blog and hope you continue to update it if you feel able to, although understand the concerns you have too! The shorter anecdotes are still good to read :)

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  5. Thank you for all of your support and kind words :)

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  6. Keeping anonymous is a good idea to keep your opinions not only secret, but truthful. Don't want to have to sugar coat everything because people know who you are.

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  7. Very sorry to hear about that patient. Thanks for sharing and do keep it going!

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