Earlier this month, medical graduate Dinesh Palipana became Queensland Health’s first quadriplegic intern, reportedly joining 90 fellow graduates who will start their medical careers at Gold Coast University Hospital.
In an amazing display of tenacity and dedication, Dr Palipana completed his medical degree after an accident left him quadriplegic part way through his studies.
While Palipana’s situation is unique, his thoughts on how to approach patient care, quoted in the Gold Coast Bulletin were both mature and generalisable.
“Whenever I need assistance from a colleague, I’ll be asking for it … I’ve worked really, really hard to make sure I’m skilled to the best of my ability … and whenever a patient walks in a room, it’s all about them.”
As interns around the country start work this month, Croakey has obtained permission to share with you a message from veteran paediatrician and Emeritus Professor, Kim Oates, which has this principle at its heart. It’s a message that applies to anyone who works in health care.
The article was originally written for final year students at Notre Dame Medical School, and published in December 2016 in the School’s Yearbook. You can also read the adapted version in its original location at John Menadue’s Pearls and Irritations.
Emeritus Professor Kim Oates writes:
The end of medical school is a time for congratulations, celebration and reflection. It opens the door to a new, exciting future. But what sort of future will it be?
Becoming an intern is a time of new experiences, vastly increased responsibility and times of great satisfaction, interspersed with occasional moments of anxiety and terror. It’s a bit like the first year of life when the infant brain, constantly bombarded with new information and experiences, establishes new learning pathways and when more information is accumulated than in any other year of life.
In addition, the intern year is the time when you become acutely aware of the privilege and responsibility this job brings.
Hopefully you’ll keep learning and as you do, you’ll realise that medical school is just one part of the continuum of medical education. New facts and new techniques will be discovered. You’ll even find that as knowledge increases, some of the things you’ve learned in your medical degree have become obsolete, outdated, overtaken by new information.
First, put the patient first
But some things never change. One of these is the need to always put the patient first. It sounds so simple, but there will be subtle temptations to put your patient’s need lower on your list of priorities.
Many events and people will influence you. Some of the events will be errors you or others will be involved in. Research into why errors occur has found that the majority of errors in a complex environment, such as a hospital, are not the fault of an individual, although the individual may be the last link in a string of contributing causes.
Many errors are the fault of a system where the safety of the patient is not always paramount. And when errors occur, they should always be seen as opportunities to learn and improve.
Choose your influencers
Then you’ll people meet and work with people who can influence you. Not all of them will be good influences. Some will be arrogant, some will cut corners, some will ignore protocols, some will not show respect for their patients or for other health professionals. Some will not put the patient first.
Fortunately, you’ll meet others who treat all staff and all patients with respect, who aren’t self-promoting, who sit at the bedside to talk with their patients, who listen, who understand the value of other members of the care team, who want to learn as well as to teach, who include the patient as part of the team and who put the patient at the centre of every decision.
Both groups have the potential to be role models, particularly if they have strong personalities and are more senior than you. Pick your role models with care. Decide which ones you want to be like and which ones you don’t want to be like. It may take some careful thought.
Here are 10 tips simple for new graduates, tips that will help you as interns and then right through your career. More importantly, they are simple concepts that will help your patients, improve the quality of care they receive and keep them safe.
- Never forget that patients are vulnerable.
- Remember that you are a guest in your patient’s illness.
- Listen to your patients. “What’s the matter with you?” is a good question, but your care will be better if you also ask, “What matters to you?”
- Use simple, clear language with your patients and remember that good communication also involves listening.
- Work collaboratively with and learn from nurses and allied health professionals. They have much to teach you.
- Admit your mistakes, own up to them, learn from them and use them as opportunities for improvement.
- Don’t accept standards and behaviours that aren’t in the best interests of the patient. The standard you walk past is the standard you accept.
- Keep learning; stay up to date.
- Never let people put you on a pedestal. Stay humble.
- Always put your patient first, never forgetting that in every situation “It’s all about the patient”.
*Kim Oates is a Paediatrician, an Emeritus Professor at the University of Sydney, and a Clinical Consultant at the NSW Clinical Excellence Commission