Clinical Challenges in Emergency General Surgery: Acute Care Surgery Complications
Nov 28, 2024
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Dive into the emotional rollercoaster of surgeons facing complications in acute care surgery. Discover how personal experiences shape their journeys and the transformative impact of peer coaching. Explore the importance of mental health support in surgical teams and the barriers that prevent open discussions about mistakes. The conversation emphasizes fostering a supportive culture, sharing experiences, and improving surgical practices to enhance both outcomes and surgeon wellness. It's a candid look at the human side of surgery.
The podcast highlights the psychological impact of surgical complications on surgeons, emphasizing the need for supportive environments that encourage open discussions without judgment.
A peer-to-peer coaching program for surgeons post-complications showcases the importance of collaborative learning, emotional support, and mentorship in enhancing surgical practices and recovery.
Deep dives
Addressing Surgical Complications
Complications during surgery are an inevitable aspect of practicing acute care surgery, as unforeseen factors can lead to adverse outcomes even when protocols are followed correctly. It is emphasized that experiencing complications does not reflect poorly on a surgeon’s skills or dedication, highlighting the emotional toll this reality can impose on medical professionals. The conversation touches on the importance of establishing a supportive environment where discussions about complications can occur without judgment, fostering a culture of quality improvement. This approach allows surgeons to process their experiences and enhance their abilities, ultimately benefiting patient care.
Peer Coaching After Adverse Events
The implementation of a peer-to-peer coaching program for surgeons who have suffered bile duct injuries has demonstrated the value of collaborative learning and emotional support in the aftermath of complications. In a study involving six surgeons, the coaching included video analysis of their procedures and discussions about safe practices, fostering professional development. Participants reported a decline in self-confidence following the injuries but found solace in the structured support, highlighting the importance of continual learning and mentorship throughout a surgical career. This program illustrates that even skilled surgeons can benefit from guided reflection, which aids in personal and professional recovery.
Cultural Challenges in Reporting Complications
Surgeons often encounter significant emotional distress after intraoperative adverse events, with many reporting feelings of anxiety, guilt, and depression associated with these experiences. This discomfort is compounded by a surgical culture that discourages open dialogue about mistakes, leading to underreporting and a lack of systemic support for those affected. Approximately half of the surgeons expressed the inadequacy of existing reporting systems, which are often perceived as hostile instead of constructive. By re-framing the narrative around complications to focus on systemic improvements rather than individual blame, the surgical community can work towards a healthier and more supportive environment for practitioners.
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
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.