03 December 2010

On the silent side...experts at your fingertips

Today I attended our Toronto Health Science Library Consortium AGM (a wonderful group of highly skilled people) including a talk from Dr. Brian Goldman, physician and author of the new book "The Night Shift: Real Life in the Heart of the ER" and Radio presenter of the CBC show "White Coat, Dark Art".  There were a few things that struck me, number one being the silence amongst clinical staff about errors: once may be fine, twice, well let's not talk about twice~.  Of course this view is changing, especially with new Ontario legislation supporting physicians in voicing errors without fear of legal retribution; however, this may not cut to the core of the issue.  What if it's not just legal retribution but reputation and professional personas? Clinical staff have a lot on their shoulders, have a lot expected of them, a lot of responsibility.  We all 'mess up' in our jobs but those errors are not as often remembered; whereas, for a Physician or Nurse a 'mess up' usually has much more memorable consequences.

The second part I was intrigued by in his talk is what he claims is a pervasive feeling of 'not measuring up'.  Again most professionals probably feel this at some point in their careers but when your job is to be responsible for people's lives voicing those feeling of inadequacy seems daunting or even impossible.  There are so many factors that foster these feelings and the silence without a single cure-all answer; however, there are individual things that can be done. Despite speaking to a room full of Librarians the connection wasn't made explicitly between feelings of inadequacy and what a Library offers (though he did state the desire to see mid-career re-education/refresher certification). 

For someone in the information field it seems there's a clear connection between these issues and continuing education and I'm not talking just the CE courses.  I mean the everyday attention to details, investigating further, using the quick and often easily accessible information tools/experts to help make the correct diagnosis.  Point-of-Care tools like UptoDate, Dynamed, BMJ's Clinical Evidence, Nursing Reference Centre, Rehabilitation Reference Centre are excellent tools (not replacements!) to aid your clinical knowledge.  These tools are likely paid and provided by your Library (and of course like most things in  an efficient health system they are very expensive).  If you're using these tools or would like to have access to them remember to throw your support behind the Library!  This sort of 'at-the-bedside' information is proven to reduce medical error and help clinical staff feel confident in their patient care decisions: it's like having some of the best international minds ready to consult at a moment's notice: silent but in this case, powerful.

If your hospital is using a different point of care tool than you're used to don't avoid it, ask your Library staff for a quick tutorial!  Five minutes of training could be the difference between a confident decision and one you want to be silent about.


Check these links out for more information about Dr. Brian Goldman's new book The Night Shift or his radio show White Coat, Black Art

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