What Happens When Things Go Wrong

I’ve had some difficult patients recently. They’ve been incredibly sick and our ICU has been incredibly full.  This has meant that I’ve been pushed to take care of these sick patients for longer than I typically would.  It has moved me out of my comfort zone as an emergency medicine physician and I’ve received some subtle and some not-so-subtle feedback on my care of these patients.

The subtle feedback came in the form of some passive aggressive statements in the admitting note from one of the intensivists about the amount of fluid I gave to a patient with Covid.  I had my reasons for ordering the fluids, but in retrospect, he was right.  Less fluid likely would have been better.

The not-so-subtle feedback came in the form of a grievance filed by one of the ICU nurses questioning the fact that I hadn’t given more fluid to a different patient I admitted that night with sepsis.  This woman was one of the sickest patients I’ve taken care of in a very long time.  I felt like no matter what I did she got sicker and I later found out she died.

My first response was in both instances was to get defensive.  I was immediately digging trenches and setting up emotional barriers of which any seasoned general would have been proud.

But why was I doing that? 

I stood by my care in both cases, but I also enjoy any opportunity to improve my care in the future.  It’s hard to get better if you don’t get feedback in the first place.

I’m pretty sure that the reason I get defensive in most cases where my care is questioned is that it is feels better than the alternative.  Being defensive feels strong in my body and it feels like I have my back.

Unfortunately, it’s a big lie.

I’m defensive because, if I’m not, I’ll beat myself up.  I have a habit of being very forgiving of other’s mistakes but never of my own.  It’s a pattern I see repeated all around me.  I’ll stand by and support a friend and colleague through a bad case, but, if I have one, I’ll tear myself apart on the inside.

It’s not pretty.  Frankly, it’s a bit of an emotional bloodbath.  We’re all human.  We all make mistakes.  We all find it very difficult to forgive and support ourselves when we do.

That’s why we dread making a mistake.  It has nothing to do with the outcome.  It has to do with the emotional torture we will subject ourselves to as punishment.

You don’t have to do that though.  Just like all our thoughts and responses, this too is optional.  I stopped treating myself this way a while ago and it’s incredible.  I still get defensive at times, but rapidly I realize there’s nothing I need to defend myself against.  This approach opens me up to learning from my mistakes instead of agonizing over them and terrorizing myself for weeks afterwards.

Learning how to do this will change your life, and I’d love to teach you how.  You can start by signing up for my free course How To Feel Better On Your Next Shift and then watch your email for upcoming opportunities to work together.