GOOD SURGICAL PRACTICEGOOD SURGICAL PRACTICE

ObjectivesObjectives Understand and accept your responsibilitiesUnderstand and accept your responsibilities Commit yourself to the care and well-being of your patients and preserve their Commit yourself to the care and well-being of your patients and preserve their

confidentiality.confidentiality. Work within your capabilitiesWork within your capabilities Allocate your time sensiblyAllocate your time sensibly Keep good notesKeep good notes Be a good team playerBe a good team player Preserve your integrity Preserve your integrity

TRY NOT TO BE A MAN OF SUCCES, BUT TRY TO BE A MAN OF VALUE[ Albert TRY NOT TO BE A MAN OF SUCCES, BUT TRY TO BE A MAN OF VALUE[ Albert Einstein] Einstein]

You mustYou must behave competently and honourably behave competently and honourably

Towards Towards PATIENTS , COLLEAGUES AND SOCIETY , and PATIENTS , COLLEAGUES AND SOCIETY , and maintain openess to inspection.maintain openess to inspection.

Aim to achieve high standards in all aspects of your life.Aim to achieve high standards in all aspects of your life. Incompetence or dishonesty detected in one area implies similar Incompetence or dishonesty detected in one area implies similar

failings in other areas.failings in other areas.

Society regards us more critically than formerly, and we need to Society regards us more critically than formerly, and we need to help restore former reputation. help restore former reputation.

CLINICAL COMPETENCECLINICAL COMPETENCE

Foundation of all professionalismFoundation of all professionalism

Most under strain in emergency circumstancesMost under strain in emergency circumstances

Not once –and – for all achievementNot once –and – for all achievement

KEY points KEY points Surgical improvement does not develop by merely Surgical improvement does not develop by merely working hard . Stand back , identify weaknesses , search for working hard . Stand back , identify weaknesses , search for improvements and implement them.improvements and implement them.

Patient trustPatient trust

Communicate with themCommunicate with them Involve them in the decision makingInvolve them in the decision making Be open with them in admiting ignorance e.t.cBe open with them in admiting ignorance e.t.c Respons to the patients anxieties regarding their outlook, discomfort or pain, Respons to the patients anxieties regarding their outlook, discomfort or pain,

complications, loss of function and dignity complications, loss of function and dignity Provide patients agree , inform and discuss with relatives at all stages what is Provide patients agree , inform and discuss with relatives at all stages what is

happeninghappening Protect patients confidentiality and preserve their dignityProtect patients confidentiality and preserve their dignity

ProfessionalismProfessionalism

Performing competently and autonomously without the need to be directed , Performing competently and autonomously without the need to be directed , in order to produce a satisfactory resultin order to produce a satisfactory result

Four CsFour Cscommon sense, competence, commitment , compassion common sense, competence, commitment , compassion Maintain your professionalismMaintain your professionalism Part the pruducts of our teachersPart the pruducts of our teachers Preparing to teach forces you to be ready to justify statements that you Preparing to teach forces you to be ready to justify statements that you

make , and actions you take make , and actions you take

RecordsRecords

To be considered as people of action, rather than reporters of action . To be To be considered as people of action, rather than reporters of action . To be acountable acountable must keep acurate records. Others , wishing to inspect your must keep acurate records. Others , wishing to inspect your action , must be able to confirm them.action , must be able to confirm them.

Write or dictate record as soon as posible after the event . Record not only Write or dictate record as soon as posible after the event . Record not only posotive findings but also the negative ones.posotive findings but also the negative ones.

There are no more important record than those describing surgigal There are no more important record than those describing surgigal operation. Detail what you found , what you sought but did not find. operation. Detail what you found , what you sought but did not find. Describe all the procedure , any difficulties and the situation at the end of Describe all the procedure , any difficulties and the situation at the end of the operation.Make sure you inform those who look after the patient under the operation.Make sure you inform those who look after the patient under what circumstances you wish to be informed. what circumstances you wish to be informed.

Hubris /Excessive prideHubris /Excessive pride

No one can claim to make the right decision and perform perfectly No one can claim to make the right decision and perform perfectly every time . Protecting your pride is a dangerous path on which to every time . Protecting your pride is a dangerous path on which to embark;each step racks up the likelihood of disaster.embark;each step racks up the likelihood of disaster.

Do not be too proud to call for – and accept- help or advice , or the Do not be too proud to call for – and accept- help or advice , or the taking over of your patient by someone who is more capable than taking over of your patient by someone who is more capable than you are.you are.

Do not too proud to admit error to your patients, your peers and Do not too proud to admit error to your patients, your peers and paticulatly, yourself.paticulatly, yourself.

Time managementTime management

This is often self management . YOU MUST RANK your commitments and This is often self management . YOU MUST RANK your commitments and review the ranking at intervals, as a previously non urgent problem may review the ranking at intervals, as a previously non urgent problem may suddenly become urgent.suddenly become urgent.

Except in an emergency , ensure that you fully complete one task before Except in an emergency , ensure that you fully complete one task before leaving it to start another.leaving it to start another.

Some people apply pressure on you for immediate action , against your Some people apply pressure on you for immediate action , against your better judgement. If other problems are more important , you may need to better judgement. If other problems are more important , you may need to refuse. Be diplomatic as posible but do not make undeliverable promises.refuse. Be diplomatic as posible but do not make undeliverable promises.

Key pont Key pont React to changed circumstances. Compare the urgency of React to changed circumstances. Compare the urgency of competing demands, decide the correct action and carry it out. competing demands, decide the correct action and carry it out.

Team membershipTeam membership

In the past , surgeon were undisputed team leaders and decision makers.In the past , surgeon were undisputed team leaders and decision makers. The mores have change dramatically. The best team work in harmony, with The mores have change dramatically. The best team work in harmony, with

each member feeling important, respected and therefore loyal to the team.each member feeling important, respected and therefore loyal to the team. Each opinion is ,or should be, judged on the merits of its logic and the Each opinion is ,or should be, judged on the merits of its logic and the

evidence offered to support it. evidence offered to support it. Being a good team member offers you many benefits.Being a good team member offers you many benefits. Team membership , however , places you in circumstances of conflicting Team membership , however , places you in circumstances of conflicting

layalties layalties

Teaching and trainingTeaching and training

KEY point KEY point As a surgeon in training, always seek your chief As a surgeon in training, always seek your chief‘’s ‘’s approval before delegating responsibility or practical procedureapproval before delegating responsibility or practical procedure