Today I had a very pleasant working day, learned a lot, and had some very enjoyable talk with my supervisor doc, until 5 minutes before I finished my job. I realize that I made a very very silly mistake, when the pharmacy called me, I felt so embarrassed because any doc with any common sense will not write an order like this, no harm was done thanks to the careful work up from pharmacist, but the acutely dropped self esteem almost killed me literally.
I was told by quite a few Chinese friends who are also in medical field during my USMLE preparing, my matching process and before I started my residency, that I would do a great job because I was comparatively newly graduated, with several year clinical experience.
But things are not working like that, I still make mistakes, I had a difficult start, I progressive slowly, and I am so scared in deep my heart. I look around, all other interns look so confident and professional which makes me doubt, why this program ever recruited me, maybe I am not as good as they think, or not even as good as I think.
After I talked with my supervisor on phone about this mistake, I could not control my frustration, I so much want to impress him because he has been really nice and patient to me, disappointing him with such a stupid mistake is the last thing I want to do, but...
little bit frustrated
Aladdin's 发表评论于
Luo Hua - I hope you feel ok by now. As people say, everybody makes mistake, but we all don't want it happens. I understand your feelings. I think it's one kind of 'growing pain'. We learn from our mistakes!
杏林香雪 发表评论于
落花妹妹，写一篇文章和你共勉，不好意思在你这占篇幅，我把它放在我的博客里.
ease 发表评论于
Don't worry. I am sure you have learned the lesson, then let it go and move forward. I have been there too - confidence comes and goes during my learning process, though I am in the business sector. Things will get better.
I am so impressed by how much you have achieved at such a young age. Please keep the faith!
I am so impressed by how much you have achieved at such a young age. Please keep the faith!
Angelboy 发表评论于
Luohua, thanks for your response, although I am not sure how your hospital physician order system work, a well-designed and user-friendly CPOE should be able to incorporated the situation like your one, what about order with PRN? Is your system an in-house built?
No matter how careful we are when we perform our daily tasks, we can make mistake, because we are human beings. The same error can happen to me again another day, or to another person if nothing is changed in that working environment or setting. In most of other industries, error causes accident which directly affect worker and company, but in health care, the harm can happen to the third part - the patient. Adverse events resulting from human errors may indicate in a organization and in some level the system failed.
I totally agree with your point that the rules were only set up to limit the number of working hours but not the level of workload and stress. Health policy makers usually created rules based on the hard evidence, the scientific evidence. When assessing the likelihood of medical error resulting from variety of risk factors, quantifying working hour is much straightforward compared with the stress. So the question is still remained: what degree of stress could cause physician making error.
Thanks again for sharing your experience, like your articles. Best.
No matter how careful we are when we perform our daily tasks, we can make mistake, because we are human beings. The same error can happen to me again another day, or to another person if nothing is changed in that working environment or setting. In most of other industries, error causes accident which directly affect worker and company, but in health care, the harm can happen to the third part - the patient. Adverse events resulting from human errors may indicate in a organization and in some level the system failed.
I totally agree with your point that the rules were only set up to limit the number of working hours but not the level of workload and stress. Health policy makers usually created rules based on the hard evidence, the scientific evidence. When assessing the likelihood of medical error resulting from variety of risk factors, quantifying working hour is much straightforward compared with the stress. So the question is still remained: what degree of stress could cause physician making error.
Thanks again for sharing your experience, like your articles. Best.
杏林香雪 发表评论于
大家都经历过类似的经历，刚开始压力太大，有时我会问离开了>该怎么办，慢慢地习惯了.一个好医生是在许多大小不同的错误中锻炼出来的，全世界都一样，没有造成不良后果就好，不要过分责怪自己；正因为考虑医生不可能不犯错，才需要严格训练出来的药师. 多注意休息吧！日子还很长.
落花飘零 发表评论于
谢谢happyljx，加州油钱很贵的，呵呵，我需要经常加油的，你负担可很重啊。
bali，because this silly mistake i have to call my supervisor who is at home to let him know, he didn;t say anything, but i felt horrible to bother him for my own mistake. i should've double check before i wrote it down.
angelboy,actually we do have that system, about computerized drug input and interaction check, but for one time dose, we still use handwriting order because it's quickest. mistakes can be avoided by nurses, pharmacists, and first line, careful writing by doctors. that's my major responsibility to deliver safe and efficient care to my patients. failure to do so is untolerated.
as to the resident life, there actually is a law now to protect residents from over working, but law can only determine the hours, not the stress, actually it force us work even more at certain amount of time because working time is limited by the law.
bali，because this silly mistake i have to call my supervisor who is at home to let him know, he didn;t say anything, but i felt horrible to bother him for my own mistake. i should've double check before i wrote it down.
angelboy,actually we do have that system, about computerized drug input and interaction check, but for one time dose, we still use handwriting order because it's quickest. mistakes can be avoided by nurses, pharmacists, and first line, careful writing by doctors. that's my major responsibility to deliver safe and efficient care to my patients. failure to do so is untolerated.
as to the resident life, there actually is a law now to protect residents from over working, but law can only determine the hours, not the stress, actually it force us work even more at certain amount of time because working time is limited by the law.
Angelboy 发表评论于
also there are some papers published in the current issue of JAMA, focusing on risks to residents related to their training environment. Ayas et al present evidence of risk of percutaneous injuries associated with working extended duration work shifts, and Zheng et al describe signs of vascular inflammation and changes in endothelial function associated with extended work shifts and sleep deprivation. West et al found an association between self-perceived medical errors and measures of subsequent distress, including assessments for quality of life, burnout, loss of empathy, and symptoms of depression.
Angelboy 发表评论于
Not sure my posting will generate multiple bugs here, if it happens, I'd apology in advance.
Regarding the medication error, there are tons of papers published in the medical literature. After the IOM report ‘To Err is Human’ in 1999, medication safety become a major concern of the general pubic and policy makers. You may find many evaluations of the role of computers in improving medication prescribing in hospital. Recently many attention are brought to the computerized physician order entry system, CPOE, which includes the basic clinical decision support such as suggestions or default values for drug doses, routes, and frequencies, while more sophisticated one can perform drug allergy check, drug-drug interaction and drug-lab check, plus reminders and guidelines to the doctor at the time of drug ordering. Unfortunately this kind of system is currently limited in the US healthcare system, only a few hospitals have been implemented.
If you like to know more about leading experts’ opinion on the error in medicine, here is a link to one of the papers [http://www.annals.org/cgi/content/full/132/9/763] . Hopefully it will help, and Looking forward to the fall foliage season in my living area.
Regarding the medication error, there are tons of papers published in the medical literature. After the IOM report ‘To Err is Human’ in 1999, medication safety become a major concern of the general pubic and policy makers. You may find many evaluations of the role of computers in improving medication prescribing in hospital. Recently many attention are brought to the computerized physician order entry system, CPOE, which includes the basic clinical decision support such as suggestions or default values for drug doses, routes, and frequencies, while more sophisticated one can perform drug allergy check, drug-drug interaction and drug-lab check, plus reminders and guidelines to the doctor at the time of drug ordering. Unfortunately this kind of system is currently limited in the US healthcare system, only a few hospitals have been implemented.
If you like to know more about leading experts’ opinion on the error in medicine, here is a link to one of the papers [http://www.annals.org/cgi/content/full/132/9/763] . Hopefully it will help, and Looking forward to the fall foliage season in my living area.
Bali 发表评论于
LHPL, you are obviously pretty good, at least as good as the others that the program recruited you. You said that it was a silly mistake so it couldn't be a life threatening one. I bet your supervisor has seen enough silly mistakes over the years to worry over this one. Anyway you know you have tried you best....take it easy, and relaaaax...........
happyljx 发表评论于
有时候，犯错误是不可避免的，只能想办法，double check，我也经常犯低级错误。他们的配药的都是培训过的。也是为了再把一次关。
是的。也许你不够自信，但是，要尽量地表现为自信，装自信装多了，就真的变得自信了。
好好加油阿。最多我负油钱好了。：）
是的。也许你不够自信，但是，要尽量地表现为自信，装自信装多了，就真的变得自信了。
好好加油阿。最多我负油钱好了。：）
wuximm 发表评论于
Luohua, I suggest you to view a presentation at http://www.theinterviewwithgod.com, I was very touched when I first saw it and still inspired by it although I am not a religious person. Remember" To learn that it is not good to compare themself to others", "To learn that it is not enough that they forgive one another, but they must also forgive themself".
落花飘零 发表评论于
thank you Wen09, i do realize people all have up and downs, when i had training before i started residency in this hospital, a psychology PHD actually gave us a lesson about how to handle the frustration and stress at work, but i guess it is always easier to say it than actually encounter it, hehe. I will be fine, thank you.
豆沙小月饼, you are always so sweet to me, it's true that everybody makes mistake, but the problem is in my career, one mistake can kill a life, i cannot afford. i need to be more careful and thoughtful.
黄大皇, how is the late summer in russia?:) enjoy it when you can, long winter is coming.:)
thank you for the encouragement.
wuximm, nice to see you again, every input from you is always so insightful and intelligent. i know every word you wrote down is from your own memory and experience. i really appreciate that. i hope i will grow stronger and stronger, and one day become an outstanding lady like you.
豆沙小月饼, you are always so sweet to me, it's true that everybody makes mistake, but the problem is in my career, one mistake can kill a life, i cannot afford. i need to be more careful and thoughtful.
黄大皇, how is the late summer in russia?:) enjoy it when you can, long winter is coming.:)
thank you for the encouragement.
wuximm, nice to see you again, every input from you is always so insightful and intelligent. i know every word you wrote down is from your own memory and experience. i really appreciate that. i hope i will grow stronger and stronger, and one day become an outstanding lady like you.
wuximm 发表评论于
Look at your sweet smile, I saw myself 10 yrs ago. We have a lots of similarity except I am not quite as tall as you are.
I have a OBGyn intern doing rotation with me this month. After 2 months of internship, she has been beaten up. She is a blond AMG, smart and quick thinking. She has made decision to quit OBGyn residency and try to find a spot in our FP program. Last yr, one of her senior did the same thing and now is in our program as a second yr resident.
Today, when I was precepting, one of the intern asked me about how he is doing in my opinion. I sincerely told him which area he should work on and how to summarize the histories, the purpose of the visit, and to form a treatment plan, etc.
I mention about true events to you, want you to realize no intern is confident or any better than you are, it may appear so on the surface, but underneath is the same. Don't feel bad if you make a mistake ( mg, mcg err?). Tell you the truth, when I precepts, I probably get paged 5-10 times per half day from pharmacists for all kinds of preion mistakes made by residents including 2nd or 3rd yrs. People tend to make more err when they are multi-tasking. So cheer up. What rotation are you doing this month?
I have a OBGyn intern doing rotation with me this month. After 2 months of internship, she has been beaten up. She is a blond AMG, smart and quick thinking. She has made decision to quit OBGyn residency and try to find a spot in our FP program. Last yr, one of her senior did the same thing and now is in our program as a second yr resident.
Today, when I was precepting, one of the intern asked me about how he is doing in my opinion. I sincerely told him which area he should work on and how to summarize the histories, the purpose of the visit, and to form a treatment plan, etc.
I mention about true events to you, want you to realize no intern is confident or any better than you are, it may appear so on the surface, but underneath is the same. Don't feel bad if you make a mistake ( mg, mcg err?). Tell you the truth, when I precepts, I probably get paged 5-10 times per half day from pharmacists for all kinds of preion mistakes made by residents including 2nd or 3rd yrs. People tend to make more err when they are multi-tasking. So cheer up. What rotation are you doing this month?
黄大皇 发表评论于
在人前，谁不是都装出一副神采奕奕，专业干练的样子，真正的苦恼，压力，紧张都只有自己知道。你看别人confident and proffessional，别人还觉得你sunny and knowledgable。犯错误不可怕，只要你知道自己在making progress。等你走完了residency回过头看看，会觉得每个所犯过的错误其实都是成长台阶上颜色难看的石板，虽然不好看，却是成长的必须。
豆沙小月饼 发表评论于
别急。所有的一切都是慢慢积累的。我现在做intern的时候，脸皮已经磨练出来了。
有时候不犯错，永远都不知道自己还会在这处疏忽。犯错误没有造成伤害是好事，下次就不会再犯了。
落花加油！
有时候不犯错，永远都不知道自己还会在这处疏忽。犯错误没有造成伤害是好事，下次就不会再犯了。
落花加油！
Wen09 发表评论于
老虎都有打盹的时候。姑娘别泄气！继续努力！
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