Collateral damage: The effect of patient complications on the surgeon's psyche

Patel, Ashok; Ingalls, Nichole K.; Mansour, M. Ashraf; Sherman, Stanley R.; Davis, Alan T.; Chung, Mathew H.

doi:10.1016/j.surg.2010.07.024

Cited by 39 publications

(48 citation statements)

References 10 publications

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“…24 Low rates of institutional support after adverse events appear to be the rule rather than the exception. 12,25,[29][30][31] Even among the surgeons with suicidal ideation reported by Shanafelt, only 26% of those contemplating suicide obtained formal support. 23 Anesthesia personnel fare no better.…”

Section: Caring For Emotional Needsmentioning

confidence: 99%

Care of the clinician after an adverse event

Pratt

Jachna

2015

International Journal of Obstetric Anesthesia

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Section: Caring For Emotional Needsmentioning

confidence: 99%

Care of the clinician after an adverse event

Pratt

Jachna

2015

International Journal of Obstetric Anesthesia

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“…Although most studies concentrated on the emotional impact of being involved in a surgical incident, others discussed the importance of personal and organizational learning from such incidents. Sharing the lessons learned was seen as vital for improving patient care , , , . As outlined above, reflection played an important role in surgical trainees' learning.…”

Section: Resultsmentioning

confidence: 99%

“…Offering one‐to‐one support sessions to those affected by a surgical incident was viewed as particularly critical , , , . This could take the form of an informal one‐to‐one discussion with a senior colleague soon after the incident, with a second follow‐up meeting if necessary.…”

Section: Resultsmentioning

confidence: 99%

“…One UK general surgeon highlighted the importance of having someone more senior to speak to following the incident: ‘… it's very good to have someone a little more senior that if you have a problem you can say, ‘What am I going to do?’ or ‘What happens next?’ That's very, very unofficial’. Some studies , , , proposed that clinicians from various specialties be trained to support staff involved in an incident. One Canadian surgical trainee made comparisons with other industries, such as aviation, and how trained psychologists would carry out formal debriefing sessions with individuals to help them ‘figure out what went wrong, what was random’.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of psychological, emotional and behavioural impacts of surgical incidents on operating theatre staff

et al. 2017

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BackgroundAdverse surgical incidents affect both patients and health professionals. This study sought to explore the effect of surgical incidents on operating theatre staff and their subsequent behaviours.MethodsEligible studies were primary research or reviews that focused on the effect of incidents on operating theatre staff in primary, secondary or tertiary care settings. MEDLINE, Embase, CINALH and PsycINFO were searched. A data extraction form was used to capture pertinent information from included studies and the Critical Appraisal Skills Programme (CASP) tool to appraise their quality. PRISMA‐P reporting guidelines were followed and the review is registered with PROSPERO.ResultsA total of 3918 articles were identified, with 667 duplicates removed and 3230 excluded at the title, abstract and full‐text stages. Of 21 included articles, eight focused on the impact of surgical incidents on surgeons and anaesthetists. Only two involved theatre nurses and theatre technicians. Five key themes emerged: the emotional impact on health professionals, organization culture and support, individual coping strategies, learning from surgical complications and recommended changes to practice.ConclusionHealth professionals suffered emotional distress and often changed their behaviour following a surgical incident. Both organizations and individual clinicians can do a great deal to support staff in the aftermath of serious incidents.

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“…In addition to its direct emotional effect, complications can negatively impact a physician’s performance; Patel et al reported that 12.2% of surgeons felt it impaired their ability to perform their job, and 2% even avoided certain procedures as a result ( 66 ). Survey participants who were negatively affected by a complication reported difficulty concentrating, declining clinical judgment, loss of confidence, trouble sleeping, and difficulty enjoying leisurely activities and daily life—symptoms that overlap with clinical signs of depression ( 67 ).…”

Section: Emotional Effect Of Complications On Physiciansmentioning

confidence: 99%

Complications: acknowledging, managing, and coping with human error

Helo¹,

Moulton²

2017

Transl. Androl. Urol.

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Errors are inherent in medicine due to the imperfectness of human nature. Health care providers may have a difficult time accepting their fallibility, acknowledging mistakes, and disclosing errors. Fear of litigation, shame, blame, and concern about reputation are just some of the barriers preventing physicians from being more candid with their patients, despite the supporting body of evidence that patients cite poor communication and lack of transparency as primary drivers to file a lawsuit in the wake of a medical complication. Proper error disclosure includes a timely explanation of what happened, who was involved, why the error occurred, and how it will be prevented in the future. Medical mistakes afford the opportunity for individuals and institutions to be candid about their weaknesses while improving patient care processes. When a physician takes the Hippocratic Oath they take on a tremendous sense of responsibility for the care of their patients, and often bear the burden of their mistakes in isolation. Physicians may struggle with guilt, shame, and a crisis of confidence, which may thwart efforts to identify areas for improvement that can lead to meaningful change. Coping strategies for providers include discussing the event with others, seeking professional counseling, and implementing quality improvement projects. Physicians and health care organizations need to find adaptive ways to deal with complications that will benefit patients, providers, and their institutions.

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Collateral damage: The effect of patient complications on the surgeon's psyche

Cited by 39 publications

References 10 publications

Care of the clinician after an adverse event

Care of the clinician after an adverse event

Systematic review of psychological, emotional and behavioural impacts of surgical incidents on operating theatre staff

Complications: acknowledging, managing, and coping with human error

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