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Hear no evil, see no evil, say no evil and don't post any evil !

On my first day in residency, my attending said "good morning everyone! rule number one: hear no evil, see no evil, say no evil and don't post any evil!". I wasn't sure what he exactly meant by that quote especially the part that said post no evil. For a moment I thought he was referring to Facebook. I think the rest of the team of residents and medical students didn't know either what he meant. They were looking at each other whenever he said that quote. No one dared to ask.

Time goes by, I had the chance to work again with him on medical wards and he mentions rule number 1 again on the first day of the rotation. I shook my head and went on with the rounds. At least, I haven't posted any evil on Facebook since that day, if that's what he meant!

Next day, one of our colleague physicians wrote a note in a patient's chart mentioning the name of another physician and was a bit offensive. Our attending came in that morning and was very angry to see that note on the patient's chart and he repeated the famous quote. He then added: "we are medical professionals, we should maintain good behavior and professional attitude with everyone, in real life and on charts". The group was silent for a couple of seconds and we resumed our rounds then.

Days went by and I keep on remembering what he said. Each one of us has this inner urge to write something evil at any point, but we have to hold it and not do so. They say, "whenever you are angry, count till ten and then say nothing". Sometimes what you write might not be offensive on purpose but the way it is written will be perceived as evil.

There are always different ways to describe what happened without offending anyone. For example, instead of saying "Dr Nolasix didn't place the orders for the patient to get more diuresis", you can say "Mr Smith still has fluid overload and needs more diuresis". Another example, "Dr Notele lost the telemetry strips for Mr Vetach and so we cannot diagnose his episode last night", instead you can say "I couldn't find the telemetry strips for Mr Vetach".

Interns are usually the most to do such things and place evil notes on charts. They are new to the system, frustrated with their patients and want to find a way to load off some anger. No wonder my attending said the quote on the first day of the rotation, he has supervised many generations of interns and knows how our intern genes work.

Facing frustration in the work environment is difficult to deal with sometimes but I always remind myself that the patient's chart is just for "the patient" and not a place to host the "game of thrones". Time flew by and I have advanced into my training, and every week I have new interns and medical students rounding with me. I found myself echoing what my mentor taught me, "rule number 1: hear no evil, see no evil, say no evil, and don't post any evil regardless on Facebook or on patient's charts".

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