GOOD SURGICAL PRACTICE

Objectives
Understand and accept your responsibilities
Commit yourself to the care and well-being of your patients and preserve their
confidentiality.
Work within your capabilities
Allocate your time sensibly
Keep good notes
Be a good team player
Preserve your integrity



TRY NOT TO BE A MAN OF SUCCES, BUT TRY TO BE A MAN OF VALUE[ Albert
Einstein]
You must behave competently and honourably
Towards PATIENTS , COLLEAGUES AND SOCIETY , and
maintain openess to inspection.
Aim to achieve high standards in all aspects of your life.
Incompetence or dishonesty detected in one area implies similar
failings in other areas.

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

Foundation of all professionalism

Most under strain in emergency circumstances

Not once and for all achievement

KEY points Surgical improvement does not develop by merely
working hard . Stand back , identify weaknesses , search for
improvements and implement them.
Patient trust
Communicate with them
Involve them in the decision making
Be open with them in admiting ignorance e.t.c
Respons to the patients anxieties regarding their outlook, discomfort or pain,
complications, loss of function and dignity
Provide patients agree , inform and discuss with relatives at all stages what is
happening
Protect patients confidentiality and preserve their dignity
Professionalism
Performing competently and autonomously without the need to be directed ,
in order to produce a satisfactory result
Four Cscommon sense, competence, commitment , compassion
Maintain your professionalism
Part the pruducts of our teachers
Preparing to teach forces you to be ready to justify statements that you
make , and actions you take
Records
To be considered as people of action, rather than reporters of action . To be
acountable must keep acurate records. Others , wishing to inspect your
action , must be able to confirm them.
Write or dictate record as soon as posible after the event . Record not only
posotive findings but also the negative ones.
There are no more important record than those describing surgigal
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
the operation.Make sure you inform those who look after the patient under
what circumstances you wish to be informed.
Hubris /Excessive pride
No one can claim to make the right decision and perform perfectly
every time . Protecting your pride is a dangerous path on which to
embark;each step racks up the likelihood of disaster.
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
you are.
Do not too proud to admit error to your patients, your peers and
paticulatly, yourself.
Time management
This is often self management . YOU MUST RANK your commitments and
review the ranking at intervals, as a previously non urgent problem may
suddenly become urgent.
Except in an emergency , ensure that you fully complete one task before
leaving it to start another.
Some people apply pressure on you for immediate action , against your
better judgement. If other problems are more important , you may need to
refuse. Be diplomatic as posible but do not make undeliverable promises.

Key pont React to changed circumstances. Compare the urgency of
competing demands, decide the correct action and carry it out.
Team membership
In the past , surgeon were undisputed team leaders and decision makers.
The mores have change dramatically. The best team work in harmony, with
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
evidence offered to support it.
Being a good team member offers you many benefits.
Team membership , however , places you in circumstances of conflicting
layalties
Teaching and training
KEY point As a surgeon in training, always seek your chiefs
approval before delegating responsibility or practical procedure