Values

I was called to a 39 year old male, possibly dead. As I entered the house I saw his relatives crying, and sitting on a kitchen chair was my patient. He looked dead, and wasn't breathing.
I felt for a pulse, didn't feel one – so I hooked up the heart monitor and there was no electrical activity at all.

I turned around to his relatives and told them that there was nothing that I could do for him, and that an ambulance crew would turn up shortly to help them out.

It took ten minutes for the crew to turn up, and I didn't recognise them at all, they must have come from outside our area.

Suddenly one of the crew said they had felt a pulse!

He was also breathing. Oxygen was given and he was rushed out to the ambulance – all that was running through my head was how I had 'starved' him of oxygen, and how much trouble I was going to be in.

One of the crew told me to fake my paperwork, and say that I'd given the patient oxygen. But I knew I was going to get into trouble.

I felt sick for the patient, and sick for myself – this is the sort of mistake that can cost you your job.

Then the postman rang my doorbell, and I woke up from the nightmare I was having.

It's funny how this job can play on your mind, the things that I've seen, and dealt with on this job and as an A&E nurse. Yet it seems that the fear of making a mistake with a patient is still the thing that scares me most.

I've dealt with murders, mutilations and miscarriages. I've seen death in the faces of 3 month old children, 14 year old girls and 22 year old men. I've dealt with limbs hanging off, distraught relatives and people vomiting blood until they die.

But the only thing that haunts my dreams is the fear of doing something wrong.

Shouldn't the patient have more of a place in my mind?

11 thoughts on “Values”

  1. I admire your openess… have admired it for a long time as I read your pages. I don't think we ever stop caring about wanting the best and being fearful for the worst (and consequences there of). It keeps us honest, diligent and mindful of the important work of being a frontline care provider.You asked the question, shouldn't the patient have more of a place in your mind. I counter that it does. Reread your post – you say, “I felt sick for the patient and (then) sick for myself”… or how starving him of oxygen was on your mind. You do think of your patients!!

    Kudos to you.

    Janine

  2. It's precisely because the patient has so much of a place in your mind, Mr. Potatohead. Sure, it'd suck to get fired, but I don't think that's what causes the anxiety: it's the worry that you haven't done all you possibly could have that gives you that sick-to-your-stomach feeling. IOW, it's that you care about doing your job well that gives you nightmares.Just my two cents. 🙂

  3. Hello!I appreciate your comments and information in regards to emergency medicine pre-hospital! I'm actually a paramedic from the United States and was terminated from my job because of sharing indirect details about my job! I appreciate yours though. I've been a critical care flight paramedic (advanced life support) for about 3 years and an EMT for 5. I'm also pursuing my medical doctor degree. I love your blog, please check mine out as well and leave me a comment!

    Blaine Anderson

    University of Minnesota-Twin Cities

    http://blog.lib.umn.edu/ande4192/blaine/

    ande4192@umn.edu

  4. As a former EMT I still wonder if there was more I could have done fr my patients. I can't even remember the number of times that I performed CPR, but I do remember the only time it worked. Unfortunately that terrible save rate is because most people don't bother learning how to perform CPR, or even more importantly, how to recognise an emergency and call for help. I haven't worked on an ambulance for years, but I still have the same types of dreams.

  5. The way i see it, It all about control.You have no control over what condition your patients are in when they come you / you go to them , however, you are in total control of the care that your patients receive when you are attending to them.

    It is only natural to be anxious about aspects of your job that are completely reliant on your competence, and only sensible to not spend time fretting over things that are out of your control.

    That's my take on it anyway.

    btw, really enjoy the blog, thanks for sharing

    J

  6. Read Tom Wolfe's 'The Right Stuff' – there's a prayer the astronauts supposedly say that goes, 'Please, God, don't let me fuck up.' Fucking up, you see, is their greatest fear – mine too – far greater than the fear of death itself. I know exactly what you mean.Albert

  7. The very reason that you are afraid to make a mistake IS in our best interest! It means you will do your very best. I feel very safe knowing there are fantastic people like you out there and next time I meet you in the pub I'm buying you a few drinks!Gerard who could not be arsed to register

  8. I tend to worry and dream more about 'actual' situations I have been in… what could I have done better, what if… Its good to know that I am not bonkers.Clinical debreifs still have a LONG LONG way to go… I have NEVER been offered a debreif or a chat about any arrest I have attended/found and working in the emergency departments as a HCA you find a lot.

    It seems to be a macho attitude, you just have to get on with it or get out..

    Thanks for being a venting hole for fellow health care professionals (and wannabe's like me!)

  9. It's not just you. Whenever I am looking after a woman and she ends up having a caesarean section that wasn't planned, I always think 'what could we have done to prevent this?'. Whenever I do something that was a bit wrong I beat myself up about it; am getting better at letting things go, if nobody got hurt then there's no problem, but I think the day you stop worrying about fucking up is the day you should stop treating people as you are complacent. Which is what leads to trouble.Cxx

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