Fondazione Zoé

One of my Masters students has just sent me via e-mail a report that will form part of their exam.

The assigned theme ‘How much a routine affects your practice’. I purposely chose the topic for my Masters students studying Nursing and Midwifery because they are people who have already worked for years and if they decide to study again, they are evidently very motivated. The student’s report does not surprise me, as he is very attentive and has many years of experience, working under a structure of ‘fame’ in Milan. It begins by explaining his own experience as a patient- some months ago, his leg was badly fractured in a motorbike accident- and from his first experience of A&E, his colleagues do not recognise him and state in front of him that his leg is shattered and that it just took a turn for the worse…’.  It is not a unique experience, if we make a mental note of everything, we cannot forge a relationship with everyone who arrives especially after a long day. They are not a person who is ill and worried, even if we consider them this without malice, it is a conditioned reflex that has arisen out of our routine. The fiftieth student that asks you the same question, the colleague that always chooses the most inopportune moment to talk to you about work and so on. The repetitiveness of the situations is dependent upon the procedures, the guidelines, experience, overall it creates a short circuit where the attention to that particular person with a particular problem, becomes diluted in practice. On the other hand, many studies have shown that medical error grows exponentially over time in the patient-doctor relationship. Contrary to what we thought, if the doctor that has been treating me for over five years, he will fatally not take my stomach pain, headache, illness, into serious consideration. How many times have we told him before? And what would make it different telling him now? My fantastic student told me that he understood that you cannot take the patient-doctor relationship lightly, that he has become more attentive in not expressing his annoyance to the patient who returns and I am sure that he is serious.  In the end, he had to have pins inserted into his leg and the story is still very much en vogue. I would like to see him again in ten years and see if it is still the case or if this habit has returned with a vengeance. For me, after reading his work, I started to respond to all the strange creatures who are all my students, even if they ask me the same things and even if it is not nice of them to send me questions and/or tasks between Saturday night and Sunday morning (do they never go to the cinema or clubbing????) because I guess they are just anxious to know if the result is positive. Until tomorrow. Tomorrow I am meeting my colleagues and they will tell me that I have to be less available and they will ask me not to cause problems. Am I also a victim of situation? Probably a little yes. Good thing that my students have understood this and hound me at night and at the weekend.

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