Tuesday, November 25, 2008

Just another day at the office

I've worked in the ER long enough to feel confident in what I do. I can do that 12 lead ECG with my eyes closed, I can get the IV first time and draw blood without bruising my poor unsuspecting patient. I *can* do it. I do do it... and most of all, I enjoy it. Well, at least until the end of last week. I think the universe decided I was getting too big for my boots and knocked me clean out of them.

Without going in to enormous amounts of detail, towards the end of my shift, we had a 30 something year old lady come to us with chest pain. She had a significant family history (both parents died of MIs before 40) and her ECG showed huge ST elevation. Oh and before I forget - she was 38 weeks pregnant... and she coded.

So, skipping over the gory bits (for my sanity as well as yours), there was a very quick and dirty c-section in the ER, not an OR with dad watching. Mom didn't make it but the baby is going to leave the NICU tomorrow morning.

I didn't know that pregnancy increases the risk of the patient aspirating and that I needed to apply cricoid pressure. I didn't know that my hand position for chest compressions should be moved up the sternum or that the uterus needed to be displaced. I didn't know, I didn't know, I didn't know...

I've learned a lot from it and in that respect, I'm grateful for the experience. I just wish I hadn't been left feeling like I've failed... but I guess thats the price you pay for for all the great stuff being in medicine gives you the chance to take part in.

5 comments:

Bernice said...

Life always seems to find a way of keeping us in check.

And I would be willing to bet that you wont ever forget what you learned either.

Hang in there.

B

Zumstin said...

I'm confused at why you feel like you failed? From what I read, you didn't fail at anything. Maybe I missed something. Sure the mother died, but her baby didn't. You didn't know a lot of stuff relating to obstetrical procedures, but I imagine you were not the only one there. Don't feel like a failure, feel accomplished that the baby lived and that next time you will be better prepared.

rookie bebe said...

I don't feel you failed because you took her seriously, instead of blowing it off as heartburn.

Matt Dinnery said...

You didn't fail at all.
You did as best you could with the knowledge you had. You were in an A&E dept, presumably with lots of doctors and nurses, who were also helping.

The best thing about the scenario as that you recognised that you could learn from it. The best medics (of whatever discipline) are the ones who recognise that they still have a lot to learn, and reflect on their practice as much as possible.

Squeezey said...

You can't save everyone, but you did save someone, and that is a success in itself. You treated this patient with the best possible care and were there with the family, and that is definatly a success. There will always be jobs that are difficult but with your help you have given this man the most precious thing in his life: a child.

*on a side note, I have only just discovered your blog, but I am really enjoying reading it. Please keep it up :)