Chapter 15 — The White Coat Oath

One month after the reform project was approved, the pilot phase officially kicked off at the Emergency Department and General Surgery Department. The new duty schedule was put into effect, with a maximum limit of sixteen hours for each continuous shift, accompanied by a shift handover system according to the standardized checklist that Yen proposed.

The first days of implementation were not easy. The medical staff, who were already familiar with the old working pace, needed time to adapt to the new process, while recruitment of additional personnel was still underway, leading to many complaints and concerns from some older colleagues who had been accustomed to the traditional way of working for many years.

"What do you think about these changes?" Khoa asked Yen on a rare afternoon when both of them could rest on time, something that was almost unthinkable before.

"To be honest, I was a little worried at first," Yen admitted, taking a sip of cool orange juice. "I was afraid that limiting duty hours would disrupt the patient monitoring process. But after a month of application, I realized that the standardized shift handover process actually helps information to be communicated much more fully than before."

"I also have the same feeling," Khoa nodded. "And what I see most clearly is that everyone in the department is much more alert and focused. There are no longer haggard faces and dark circles under their eyes after a thirty-hour shift like before."

Minh Thu, head nurse of the Emergency Department, joined the conversation as she passed by. "I must say, the working morale of the entire department has improved significantly. People are much less irritable, and there are fewer small errors in recording and prescribing."

"That's exactly what we hoped to achieve," Yen said, smiling with satisfaction.

"I also heard," Minh Thu added, lowering her voice with excitement, "that the Department of Obstetrics and Internal Medicine are also closely monitoring the results of our pilot, it seems they also want to apply a similar model if everything continues to go well."

"Is that so?" Yen asked, unable to hide her surprise mixed with joy. "I didn't think things would spread so quickly."

"Good news always spreads quickly," Minh Thu smiled, patting Yen's shoulder. "Especially when it is directly related to the health and safety of our medical staff."

Khoa nodded in agreement, his eyes full of hope. "If that's true, this will be a very positive signal for expanding the project to the entire hospital sooner than expected."

That afternoon, the first test case for the new system appeared — a complex multi-trauma patient admitted to the hospital right at the shift between two crews. Yen, whose shift was about to end, had to hand over all information to the receiving doctor according to the new checklist process.

"Male patient, forty-two years old, work accident, open femur fracture with suspected traumatic brain injury," Yen presented clearly and completely according to each item in the checklist, without missing any important details. "Injected pain relief, temporarily immobilized the broken limb, waiting for brain CT results."

The doctor taking over the new shift, even though he had never directly examined the patient, still fully grasped the situation thanks to the detailed handover system, and continued to handle the matter smoothly, without any information gaps that could endanger the patient, just as the whole team had expected when designing this new process.

"See," Khoa said to Yen after witnessing the entire process, "the new system really works effectively. This is the most vivid evidence that patient safety and the health of medical staff can completely go hand in hand."

A few days later, the multiple trauma patient's family returned to the hospital to thank the team for their dedicated care. The wife, her eyes still showing signs of worry from the past few days, held Yen's hand tightly and the doctor took over the case afterward.

"Thank you so much, doctors," she said, her voice choking. "My husband said that even though he changed shifts midway, the new doctor still understood all the information and didn't have to ask again from the beginning, which made him even more confused."

"That's thanks to the hospital's new case handover system," Yen explained, smiling warmly. "We just applied it, and we are very happy that it was effective in your husband's case."

Witnessing the sincere happiness of the patient's family, Yen felt more clearly than ever the true meaning of the reform efforts that she and Khoa have worked hard to build - not the dry numbers on the report, but the smiles and happy tears of each family that directly benefits from that change.

News about the initial success of the pilot phase quickly spread to the hospital board, becoming an active topic of discussion in many briefings of different departments. Associate Professor Truong personally visited both departments to observe directly. He could not hide his satisfaction with what he witnessed. His eyes followed the urgent pace of work but still maintained the necessary calmness of the entire team.

"You and Yen have done a great job," he told Khoa, his voice full of pride. "I have received a preliminary report, the medical error rate in the past month has decreased significantly compared to the same period last year."

He took out a report from his briefcase and pointed to clearly presented charts. "Look, the rate of incidents related to medical staff fatigue decreased by nearly forty percent after just one month of the pilot. This is far beyond my initial expectations."

"I was really surprised by such quick results," Khoa said, looking over the report with excited eyes. "I think, when the board of directors sees these specific numbers, expanding the project to the entire hospital will be much easier."

"I think so too," Associate Professor Truong nodded. "I plan to present this report at next month's board meeting, proposing to expand this model to all remaining departments in the hospital."

"It's the effort of a whole team, dad," Khoa replied, modestly but unable to hide the joy evident on his face. "I only contributed a small part in it. The biggest contribution must go to Yen and Nghia, who diligently collected and analyzed data for many weeks."

That evening, Yen and Khoa and a group of close friends — Nghia and Minh Thu — gathered to celebrate the initial success of the reform project, marking another important milestone in the journey they have built together over the past months.

"We've come a long way," Yen said, raising her glass of soft drink to congratulate the group, her eyes sparkling with pride as she looked around at each familiar face. "From a controversial shift, to a serious medical incident, and now a systemic change for the entire hospital."

"And I believe, this is just the beginning," Khoa continued, clasping her hand under the table, his eyes full of hope as she looked towards her close friends who were celebrating together. "There are many other wonderful things waiting for us ahead, not only in work, but also in each person's personal life."

The whole group raised their glasses and clinked glasses in bustling laughter, temporarily putting aside all work pressures to fully enjoy happy moments with friends and colleagues who had gone through so many challenges together to reach success today.

Minh Thu, after a few glasses of soft drink, began to tell funny stories about the process of adapting to the new shift handover system. "In the first few days, we were frantic with the new checklist. Some of us even forgot to mark important items, so we had to run back to the previous shift's doctor to ask for additional information."

"I also made a mistake the first time I applied it," Yen admitted, smiling awkwardly. "Fortunately, the doctor who received the case discovered it in time and did not cause any serious effects."

"That's normal when applying any new system," Nghia consoled, smiling. "The important thing is that everyone tries to learn and improve over time, not expecting perfection from the beginning."

"You're right," Khoa nodded in agreement. "I think this is the most important lesson we have learned from the entire journey - positive change always takes time, patience, and tolerance for small mistakes in the learning process."

The whole group nodded in agreement, a warm, close atmosphere enveloped the small banquet table, marking a meaningful evening between friends who had overcome many difficulties together to achieve today's worthy results.