Chapter 13 — The White Coat Oath

One week after the ethics committee meeting, Associate Professor Truong convened an open meeting with the entire hospital board of directors to officially present a project to reform the comprehensive on-call regime - a direct result of the painful lessons learned after Dr. Phat's incident.

Yen and Khoa were invited to attend as representatives of the resident doctors' team, along with Nghia and a few other young doctors from related departments, all dressed neatly in white blouses, sitting in a separate row at the end of the large hall.

"The project we proposed," Associate Professor Truong presented to the hall full of leaders, "including three main pillars: a maximum limit of sixteen hours for a continuous shift, increasing recruitment of human resources to ensure enough people to cover shifts, and building an automatic monitoring system that warns when doctors exceed safe working hours."

An elderly leader, head of the hospital's Finance Department, immediately spoke out against it, his voice filled with cautious skepticism. "This project requires a significant budget for recruiting additional human resources. In the context that the hospital is having to balance many other expenses - from upgrading equipment to expanding facilities - I am afraid that it will be difficult to approve immediately without further detailed analysis of financial feasibility."

"I understand the budget concerns," Associate Professor Truong replied, his voice still calm even though he could not hide some of his determination. "But we need to consider the costs of inaction. A serious medical error, if it leads to litigation or loss of reputation, will be far more damaging than the initial cost of reform."

Yen, sitting in the row reserved for resident doctor representatives, asked for permission to speak, her voice still shaking a bit because this was the first time she stood in front of such a hall full of senior leaders. "Dear leaders, I want to share my perspective from the actual experience of a doctor directly working in the current night shift routine."

She briefly but convincingly presented the specific risks that overload causes, not only citing the BS case. Phat, but also through personal experience of moments of fatigue that make it difficult to maintain the necessary concentration in work that requires absolute precision, moments where even a small mistake can cost a person's life.

"We don't ask the hospital to work easier," Yen concluded, her voice filled with determination, her eyes scanning the entire hall. "We just ask for a working environment that is safe enough to be able to take the best care of patients possible, just like the oath we took when entering the medical field - an oath that I believe, every person present in this room has also solemnly recited."

That speech received applause from many members in the hall, some people even lightly applauded in agreement. Even the head of the Finance Department, although still cautious, had to nod to acknowledge the reasonableness of her argument, his eyes no longer retaining the original skepticism.

Khoa continued, adding specific data that Nghia had painstakingly compiled - data on the correlation between the number of consecutive hours on duty and the rate of medical errors recorded in hospital records over the past three years.

"Numbers don't lie," Khoa said, pointing to the chart displayed on the big screen. "The error rate spikes significantly after the twentieth hour on duty, and continues to increase even more after the twenty-fifth hour. This is not an individual problem, but a systemic risk that needs to be thoroughly addressed."

He just added another chart, comparing the estimated cost of hiring more staff with the potential costs of lawsuits and medical compensation that other hospitals have suffered because of similar incidents. "In the long term, investing in patient safety is not an expense, but a profitable investment — both financially and in terms of the hospital's reputation."

The Head of Finance was silent for a moment, carefully reviewing the presented data, then nodded slowly. "I have to admit, your presentation is quite convincing. I will propose a more flexible budget plan to support this project."

Before reaching the final decision, another leader - the head of the Obstetrics Department, who is famous for being cautious in all decisions - asked one more question. "If a limit on duty hours is implemented, will it be possible to ensure that the handover of cases goes smoothly, without interrupting the patient's treatment process?"

"This is a legitimate concern," Associate Professor Truong said, nodding without avoiding the difficult question. "We propose to develop a standardized, detailed shift handover process, ensuring all important patient information is fully communicated between shifts, avoiding information loss during the transfer process."

"I think," Yen added, "we can apply a standard checklist shift handover model, similar to the aviation industry, where every check step is clearly recorded, not depending on the memory of a single individual."

That idea received widespread agreement from many members in the hall, seeing it as a practical, feasible solution to address concerns about continuity in patient care.

After nearly two hours of heated discussion, the board of directors agreed to approve the project with a few adjustments to the implementation roadmap - instead of immediately applying it throughout the hospital, it will be piloted in the Emergency Department and General Surgery Department first, then evaluate the effectiveness to replicate in other departments.

"This is a good start," Associate Professor Truong told Yen and Khoa after the meeting ended, unable to hide his satisfaction, his face relaxed much more than his usual serious expression. "Thank you both for your valuable contributions today. Without the data and practical experience you brought, perhaps the project would have been difficult to convince the council."

"This is what we should do, dad," Khoa replied, his eyes full of pride. "I hope that this project will truly create meaningful change for the whole system, not just words on paper."

"I hope so too," Associate Professor Truong nodded, his voice filled with determination. "Dad will personally follow the progress of the pilot implementation, ensuring that all commitments today are implemented as promised."

Leaving the meeting room, Yen could not hide her excitement, her steps were as light as flying in the air. "I can't believe we just contributed to changing such a large system."

"This is just the first step," Khoa said, holding her hand, his eyes full of hope. "But I believe this will be a very important first step, paving the way for many other positive changes in the future."

Nghia ran after them, patting both of their shoulders excitedly. "I can't believe it, the numbers I worked so hard to collect can actually make such a big impact. It feels like my hard work is finally paying off."

"Thank you for always supporting us throughout this journey, Nghia," Yen said, hugging his friend in shared joy. "Without you, we wouldn't have such convincing evidence."

"Don't be polite," Nghia smiled and waved his hand. "This is the effort of our entire team. Now, I think we should celebrate this achievement a bit."

All three laughed and decided to stop by a familiar restaurant near the hospital to celebrate together an important milestone they had just achieved - not only a victory for themselves, but also a meaningful step forward for the entire medical system that they are all working together to build and protect, a system that they believe will become increasingly safer for both patients and the medical staff themselves.

On the way, Khoa received a text message from his father, just a few short but meaningful lines: "Thank you and your colleagues for a meaningful day at work. I believe this will be the beginning of a new, better chapter for our hospital."

Khoa read that message, filled with pride and hope for what the future would bring, not only for his own career, but also for the thousands of other patients and colleagues who would benefit from the changes he and Yen had helped create, a legacy they would both always look back on with pride.