Monday, March 15, 2010

Keeping myself up at night

    Last night I had a difficult time getting to sleep, visions of patients flowing through my mind, stress hormones circulating through my blood stream. I kept running over my day:
                               *Did I forget to chart her edema?
                              *What if I misinterpreted her bleeding and she hemorhaged after I left?
                               *That blood pressure cuff and machine didn't appear to be working correctly....
                               I was going to get another machine and come back to retake her BP, but the end of
                               my shift got busy and I forgot... what is she develops Eclampsia? More women develop
                               it after birth than before!!!!!
                              *Why didn't I go into that patient's room more often?
                              * There really are people who won't feed their baby unless you remind them?
                              *What if that baby goes home and gets even more dehydrated? There's nothing I can do
                              about that, is there?

         Yesterday I began to get a real felt sense for the importance of having a routine. There are so many details to keep track of when things follow an expected course. When they deviate from that course there are even more details to be aware of, to be responsible for! I will have to work at developing my own routine, integrating elements from those I've observed, those I work with, to provide the best, most coherent care for the patients I work with.
        I am going to forget things. I will most likely make many mistakes. If I am diligent they may not cause any gross damage to those I am caring for. I need to remember I am not doing it alone. I have a host of team members available to assist me. It doens't help to think that if I make a mistake when I'm in the orienting phase my poor preceptor will be responsible too! Even when I am the responsible party I can still stop, take the time to ensure I am making the best choice for my patient and for my self. Otherwise I will not be getting any sleep. Then I won't be any good to anyone!   

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