Clinical Challenges in Emergency General Surgery: Acute Care Surgery Complications

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 28 November 2024

⏱️ 24 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode by the Emergency General Surgery team, we explore the inevitable in acute care surgery- complications. Once a taboo subject, we are now beginning to understand how surgeons and care teams are affected when things don't go as planned. The team discusses two articles that explore the impact of surgical complications on surgeons, both in the short and long term, as well as ways to rehabilitate and support surgeons when they face a challenging complication. Drawing on the article, as well as personal experience, this episode works towards the ongoing shift in surgical culture around outcomes and supports improved surgeon wellness.

Hosts
Dr. Ashlie Nadler
Dr. Jordan Nantais,
Dr. Graham Skelhorne-Gross
Dr. Marika Sevigny

References

Zhu A, Deng S, Greene B, Tsang M, Palter VN, Jayaraman S. Helping the Surgeon Recover: Peer-to-Peer Coaching after Bile Duct Injury. J Am Coll Surg. 2021 Aug;233(2):213-222.e1. doi: 10.1016/j.jamcollsurg.2021.05.011. Epub 2021 Jun 7. PMID: 34111530. https://pubmed.ncbi.nlm.nih.gov/34111530/
Han K, Bohnen JD, Peponis T, Martinez M, Nandan A, Yeh DD, Lee J, Demoya M, Velmahos G, Kaafarani HMA. The Surgeon as the Second Victim? Results of the Boston Intraoperative Adverse Events Surgeons' Attitude (BISA) Study. J Am Coll Surg. 2017 Jun;224(6):1048-1056. doi: 10.1016/j.jamcollsurg.2016.12.039. Epub 2017 Jan 16. PMID: 28093300. https://pubmed.ncbi.nlm.nih.gov/28093300/

Learning objectives

Understand the psychological impact of surgical complications on the care provider
Explore the role of peer-to-peer mentoring in support and rehabilitation of surgeons

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Transcript

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0:00.0	Behind the Night, The Surgery Podcast, relevant and engaging content the next episode of Behind the Knife.
0:25.7	We got something different planned this time around, but first I want to welcome the rest of the group.
0:30.0	The whole gang's here today.
0:31.3	So we got Dr. Ashley Nadler from Toronto and Dr. Graham Sculler and Gross Gross, coming to us from Bacolo now.
0:38.7	Hi, everyone. I'm excited about today's topic. As am I. Hi, everyone. And today we're also
0:45.1	welcoming back Dr. Marika Savani, who's been off on maternity leave. Welcome back. Thanks, Jordan.
0:50.5	I'm happy to be back and looking forward to an interesting discussion. So today we're
0:54.8	going to be talking about a really important subject and something I'm sure we've all faced at
0:58.3	some point in our training and careers even early on. What happens when things do not go well
1:03.2	despite our best efforts? The dreaded complications and how they impacted us. I got a pit in my
1:09.1	stomach just hearing the word complication. Yeah, it's often part of
1:13.8	the job with acute care surgery especially. You can't plan what comes in. You can't select your
1:20.0	patients and the conditions are often suboptimal. Yeah, and even when you think everything has gone
1:25.3	right, you've got the right patient, you've done the right operation, right technique.
1:28.9	Sometimes there's just forces that seem to wreak havoc anyway.
1:32.7	Yeah, it's something that we all face, but really have for many years, let's be realistic, not openly talked about.
1:39.0	Yeah, it's definitely changing, but it's still not easy.
1:42.3	We've got a better culture around morbidity and mortality
1:45.0	rounds at our center, which we've actually called QI rounds or quality improvement rounds for some time.
1:51.0	When this is done right, it can enable great discussions and without placing blame, so that's good,
1:58.0	but it's hard to deal with your own feelings around the bad outcome.
2:02.0	Completely agree, Ashley. I feel like as a resident, I never heard my staff talk openly about
	...

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