Practicing on Patients
許多行業都是師徒制,讀再多書,要真正操作在病人身上,又會遇到學習曲線。沒有人想被當作實驗品,不論是患者對新醫師而言,或是洗腎室患者對新護士打針也是同樣的擔心。
一位心臟內科看著一位資深的心臟外科醫師,把一個心臟功能不好的病人轉給資淺的心外醫師開刀,心中十分擔心,不知如何去阻止這樣的事。
另外,作者說了一件,CV的fellow 2把拉出balloon pump工作,準備交給沒經驗fellow 1,而這位病人先發制人的問「你們應該不是要在我身上練習吧?」當時,這位fellow 2只好說了個謊,說這fellow 1已經做了很多次了之類的。
A few weeks ago, a second-year cardiology fellow told me that he had taught a first-year how to pull out a balloon pump. “When we went in the room, the patient said, ‘You’re not learning on me, are you?’ And I had to lie and say: ‘No! He’s done this many times. We’re going to do it together. You get two for the price of one.’ That calmed him down. Then I had to talk the first-year through the entire procedure, pretending like I was explaining it to the patient.”
另外,作者最近要求外科同仁幫忙患者放 left ventricular assist devices (LVADs),這位外科同仁也許因為少做此項術式,對作者說
「Whether my patient wouldn’t be better off being transferred to a hospital that had more experience? “Do we have the best team in place to manage potential complications?」 he asked.
「If it were your father, he said, what would you want?」
很好的問題,讓我們深思
Sandeep Jauhar is a cardiologist
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