Are you plagued with fear you've made a mistake? Are you struggling with guilt or shame following an error? Welcome to the club. We've all been there at some point in our careers.
It can be incredibly isolating. The moment we realize we've made a mistake, it can alienate us from our team, our patient, our employer, our colleagues, our family and even ourselves.
As much as you may want to quit or curl up and die, connecting with others, even if it's one trusted person, will help you to grow through this and thrive.
It really helps to talk to someone. Don't suffer through this alone. I'm here for you, and here's a list of resources to support you.
“Mishaps are like knives, that either serve us or cut us, as we grasp them by the blade or by the handle.” ― James Russell Lowell
RISK FACTORS
Look out for circumstances that contribute to errors, including:
High-pressure, stressful, fast-paced environments such as emergency departments, intensive care units, and operating rooms.
Patients at an extreme of age or high acuity
New procedures
Necessary personnel are unavailable
Multiple providers involved
Inadequate supervision of students, interns, residents, and fellows
Hesitance of the students, interns, residents and fellows to ask or clarify
Feeling tired, sleepy, hungry, or rushed, such as at the end of a shift.
Being thrown off from your standard routine of evaluating a patient, such as patients who overwhelm us with demands/complaints, or informally assessing neighbors, family members, colleagues as a courtesy.
Language barrier
Providing cross-coverage for patients
EHRs
Power distance (for example: not questioning someone in authority such as an attending.)
Remaining mindful of these circumstances may prevent errors. Learn more at this resource.
Make a personal commitment to always do your best. Things may still not turn out optimally, but when we're doing our best, we can at least have that peace of mind.
That said, no matter how hard we try, we can't always prevent mistakes.
According to this article:
"A study of medical errors showed a lot of unanticipated clinical events occur with experienced, well-intentioned clinicians surrounded by complex clinical conditions, poorly designed processes, and inadequate communication patterns."
As soon as you discover you've made a mistake, your two priorities are responding to your patient and recovering personally from it.
RESPOND
According to this legal resource, many hospitals and health care facilities in California support provider apologies when appropriate.
When approaching a patient to discuss your mistake, consider following the SPIKES protocol for breaking bad news.
"To Err Is Human asserts that the problem is not bad people in health care--it is that good people are working in bad systems that need to be made safer." Taken from a review of To Err is Human, published by the Institute of Medicine.
RECOVER
Recovering from a mistake can be very difficult. It challenges us deeply as a person and you need an "emotional code team" of people who know and love you to support you through this. If you haven't encountered a major mistake yet, it's still smart to create an emergency plan for yourself, and mentally assemble the team you'd call if you needed to.
Pick people who don't judge you, who know you well and to whom you can confide your experiences. Even if it's one trusted person, that's enough.
Why do you to connect?
This person or team will remind you of who you are. They will remind you of your goodness and help you combat the shame and negative messages we receive from others or from ourselves.
Remember:
Making a mistake does not equate failure. This one mistake does not eliminate all the good you've done throughout your career. You are not a failure.
You are worthy of being a physician. You are not a bad person. Reject the toxic shame that's so pervasive in our industry. Instead of beating yourself up, find a way to rise, learn from it and forgive yourself.
Remember you are not alone. Listen to physicians and other health care professionals share their experiences with mistakes at this podcast.
"Always remember who you are, no matter what other people say." -Unknown
You're a good person with good intentions.
How do I know? Because you didn't go into hundreds of thousands of dollars of debt, sacrifice decades of your life and risk your health and well-being to do something bad. There are WAY easier ways of causing harm.
Don't doubt your goodness. You are here on earth to do good.
You're going to make it. Hang in there. Surround yourself with support.
This is your one, wondrous life. Don't let this incident derail you. You can find a way to thrive if you look for it. Whatever happens, don't suffer through this alone.
If you have no one to talk to, please count on me to be there for you.
Sending lots of love and strength your way,
Richelle
Additional resources: