Don’t Leave
The Room Until It is Perfect
Residency is all about forming the foundations on which you
will practice medicine and surgery. In particular, your residency
experiences will guide you in the operating room for your entire
professional career. There’s just no other way to learn this type of
decision making. You have to actually experience it ‘hands-on’. How will you
develop the necessary skills to navigate your way through an intra-operative
complication unless you have done just that as a resident? How will you
react to the stress of time management in getting cases done efficiently and
effectively at a surgery center unless you have had the chance to work with
a seasoned pro?
I would like to share with you a valuable lesson I learned
early in residency…one which still echoes in my head on occasion when I am
in the OR. This lesson was taught to me in one form or another by several
attendings, but it can be summed up as “DON’T LEAVE THE OPERATING ROOM UNTIL
YOU ARE COMPLETELY SATISFIED WITH YOUR SURGICAL RESULT”.
Now this may seem like a very simple and somewhat logical
statement, but I can tell you that it becomes a complex endeavor when you
are faced with the real world circumstances of a busy practice. For
instance…let’s assume you are already running behind with your cases at the
surgery center and are catching heat from the OR Staff. You are also
increasingly concerned about the other surgical patients you are keeping
waiting or the office hours that you are now late for. Your current case is
an Austin Bunionectomy which you have done hundreds of already in practice.
Everything goes just as planned except that your screw doesn’t bite as well
as usual. Your natural tendency in this high pressure situation is to breeze
over this minor detail and convince yourself that ‘everything will be just
fine’. However, if you are not happy with it now on the OR table, you will
likely be even less happy with it when the patient comes in for follow up.
The time to fix the problem is
NOW, not 2 months later when you have a
displaced osteotomy and a very unhappy patient who can’t return to work.
So always remember, don’t let the external pressures take
you away from the task that deserves your undivided attention. Never leave
the operating room until you are completely satisfied that you have done the
best possible job for that patient’s problem. If you stick to this practice,
you will not only have better surgical results, but you will also sleep
better at night!
P.S. – on the Austin patient: when you took the few extra
minutes to get intra-operative x-rays, you discovered that the screw was
misdirected and not engaging the plantar cortex of the 1st metatarsal.
Within just a few minutes you redirected the screw to get full compression
and possibly avoided months of headache for you and your patient…
Any stories, feedback or
questions about having to return to the OR?
Hear any nightmare cases about them, or lived through one? Let's make this forum
more interactive. We're not looking for gems here...just the sharing of your
personal experiences. Please share your comments by sending a
note to jsteinberg@podiatry.com
John S. Steinberg, DPM
Editor, PRESENT
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