If I were Lord of Medicine, here’s what I’d command:
- Stop unnecessary oxygen. Start oxygen when patients are hypoxemic and turn it off when they’re not. Excess oxygen kills.
- Put your stethoscope on the patient’s skin. Only amateurs listen over gowns. Cotton and crackles sound alike.
- Don’t just do something, stand there. Think first. Effective medical care starts in your head.
- Proofread your notes. Chart errors can be deadly. Read before you sign.
- Document all patient encounters, however minor. Explain what happened overnight. Don’t make people guess why you gave fluids, ordered a CT, reversed the patient’s code status, etc.
- Talk to your consultants. They’re smart. If you disagree with what they say, call them. Better yet, invite them to rounds.
- Ask questions. You don’t know everything. I sure don’t. Learn from the brilliant people around you.
- Follow the Kantor rule. If something happens to a patient after you did something to them, it’s probably what you did to them that made it happen.
- Be concise. Meandering notes are unreadable. Medicine is complicated enough. Keep it simple.
- Be humane. Comfort your patients. Be a mensch. The rest is simple.
I could add more, but “10 Commandments” sounds about right…
Enjoy your Sunday, everyone. I’m off to the MICU for the last day of a spectacular rotation,
Submitted by Mark David Siegel on September 22, 2019