Uh oh, part 2

Right, well then.

I guess this is going to happen more and more. I've not sworn people to secrecy, but I'm not going to mention it in class. Primarily because I don't want to be "everyone read my blog" guy in class. If people find it, read it and figure out it's me, fine.

It does raise some interesting issues around confidentiality, though. I've asked one of the ethics lecturers about my potential concerns about blogging and the impact it might have on my standing with the British Medical Association re: appropriate behaviour for a medical student. He said he'd contacted the BMA and the MDU (medical defence union) about numerous issues around breaching confidentiality and said he'd not got much in the way of a firm answer. This came up because he'd lectured us on how discussing your day with your spouse was a breach of confidentiality (at least in a literal, textbook way), even if you changed the names to protect the innocent and whatnot. I know most medical types shoot the shit in the pub after a bad shift, talking in generalities in public, and most might unload to a wife or husband or whomever at home to clear their heads - never mentioning a name or age or ethnicity or anything that might identifiable information. That this is fundamentally a breach of confidentiality, I find troubling and a little difficult to wrap my head around. So that gave me pause for thought about all of this.

Certainly within the field of blogging, we all say we anonymise patient information but there is always the chance (however microscopic) that someone might recognise themselves and decide to pursue legal advice - something no-one wants to have happen. My lecturer seemed to think that there weren't any hard and fast rulings on issues of confidentiality re: blogging because no case had come up yet, coupled with the fact that the BMA didn't want to prevent doctors (and presumably medical students, too) from what is arguably reflective practice, albeit done in public.

I have seen some people have signed up to the healthcare blogger code of ethics which I think is an excellent idea and I have every intention of signing up after I finish this post. I mean to behaviour in an ethical way and never to breach a patient's (or a co-worker's, for that matter) confidentiality. It is so essential to medical practice, so very valuable to a healthy and successful relationship with your patient or your own healthcare provider, that we should never belittle it. It is a standard that we should hold as high as any other as it reflects on us as professionals and as people, too.

As for my blogging, no-one has suggested anything I have done is inappropriate and this is something I coming to value more and more as the course becomes more demanding. So I shall keep on as I am doing until I hear otherwise, hopefully entertaining and maybe even educating y'all as I spill my brainguts to the internet at large.

30 Day challenge: Day 3

Day 3: Your views on drugs and alcohol

An Old Fashioned from ReeseCLloyd's Flickr stream

In an act of unintentional irony, I am blogging drunk.

Which I guess tells you a lot about my attitude to alcohol if nothing else. In my defence, I should point out that I'm not in school tomorrow or working or doing anything (other than maybe going for a run tomorrow morning) which require me to be up early. Not that I generally drink to excess. Generally.

I think drugs is a topic that can be very complicated. For an individual, I think it can represent any number of subtleties in their personality. All the dreadful aspects of the drug trade and all the ills it brings on the world aside, I think if you can't handle your high, you should probably leave any mind-altering substance well enough alone. I particularly think that becoming intoxicated and getting behind the wheel of an automobile is one of the most awful things a person can do.

I can't think of much to write on this topic without sounding judgmental in one way or another, so maybe I need to go away and think on this some more. Maybe that's the point of this exercise - to go and explore topics you thought you had pegged?

Of roles and expectations

I've just finished listening to another excellent episode of Pseudopod, a weekly podcast of horror short stories and this week's was particularly interesting for me. It focuses on a woman who comes to a village under the guise of helping when in fact she has a darker motive.

Alasdair, the host of the podcast, does a wonderful job (as always) of deconstructing the themes of the story. For anyone in healthcare they are juxtaposed between being an everyday part of the job and so very important that if you stop and think about it, our responsibilities are staggering.

The patient will see you as a caraciture

People put their lives in our hands and, more often than not, accept that whatever we do for them or ask them to do is in their best interests. When I push the drug trolley around people accept that because I am dressed like a nurse, seem quite comfortable and friendly, I must be giving them the right medication at the right time etc. etc.

Every nurse I know has made at least one drug error.

Every doctor I know has made at least one drug error/ misdiagnosis.

And yet they come to us. Because we look the part, because they believe in us, our uniforms, our stethescopes, our strange language. There is another component, I think. We have entered into a social contract. We have chosed our roles and promised to fulfull them to the best of our abilites. That, I would argue, is the reason people come to us.

It is both a privilege and a responsibility.