just remember

It's never your fault, and if it is, never admit it.

What brings this up, Andrea? Oh, apparently, it is Risk Management Month (once again I say: who knew?) and in honor of such, we've been getting a Risk Management "tip of the day" in our work email. I dearly wish I had had time to write this post while I was still at work, so I could quote verbatim***, but for the short version, see above.

Never admit to the patient you've screwed up. Never admit or suggest to the patient that someone else has screwed up. If you feel the need to apologize to or console the patient or the family because of a bad outcome, you may do that, as long as you do not admit you or anyone else is, or could possibly be, at fault. I've been reading these "tips" and thinking various thoughts. One thought may have been, "How do these Risk Management wonks sleep at night?" Another may have been, "See, this is exactly what is wrong with this society." And a third may just have been, "Oh, yeah, clinicians! we're just like American politicians!"

If I myself were in the position of having had an adverse consequence from medical care, whether because of human error or bad judgment, I would be much less likely to sue their asses if my caregivers apologized and took the blame. People make mistakes. If there is anyone reading this who would like to say they've never ever made an error in the course of their job, I would like to tell them they are a big fat lying liar. Everyone makes an occasional error, no matter how knowledgeable, skilled, conscientious, and careful they are. When you go into surgery, or the ER, you hope that today is not that day for your surgeon, nurse, anesthesiologist, etc, and that if it is, someone else catches it before anything bad happens. But if you are not a complete and clueless idiot, you know it could happen. You accept there is some risk involved in any treatment. That's why you sign those consent forms no one reads. But for a mistake to be made and then no one will admit to it? That's the kind of thing that pisses people off inordinately.

Now, I'm sure the Risk Management wonks are very good at their jobs--or they wouldn't be getting paid far, far more than I do, right?--and if they say "never admit" is how you protect yourself from lawsuits, who the hell am I to disagree? But it all feels as if it's lacking in both honor and morality to me. Do you remember a few weeks ago when some pitcher whose name I cannot remember and cannot be arsed to google right now because I'm already taking too long to write this was cheated out of his perfect game when the first base umpire made an outrageously bad call? Well, Mr Indemnity was kind of teasing me about why I hadn't written a frothing-at-the-mouth type blog post about that, and I had to say, I was not frothing. The umpire in question, upon seeing the replay, immediately took full responsibility for fucking it up and made an abject apology to the pitcher (who, himself being a class act, very graciously accepted it, saying what I said above: everyone makes mistakes.) Maybe it's completely different because there's no legal precedence for suing someone because they falsely took away your perfect game. But I can't help but think the world is a better place when everyone behaves like that.

In my quest to be a better person, that's one of the things I've been working on for years: taking responsibility for my own behavior and apologizing if I have wronged someone else, whether by accident, from negligence, or from pure weakness, without making excuses for myself. It's the last part that's the hardest for most of us to get right, I think. Explanations are fine, but letting explanations lapse into excuses is not. Imagine if that umpire had apologized and then said, "...but I couldn't help it because my view was obscured" or "if only MLB allowed instant replay on these calls, it wouldn't have happened." A whole different thing than "I take full responsibility and I am so very sorry." Anyway, that is what I am shooting for. I don't think I am there yet or maybe anywhere close, but I'm working on it day by day. But I'd better not AT WORK, I suppose!

xoxo

*** Though I'm kinda thinking that leaking that stuff in a public forum may possibly be the kind of thing that gets one fired. Or given a timeout, a spanking, something.