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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...
I am so impressed by how much you have achieved at such a young age. Please keep the faith!
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.
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.
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.
是的。也許你不夠自信，但是，要盡量地表現為自信，裝自信裝多了，就真的變得自信了。
好好加油阿。最多我負油錢好了。：）
豆沙小月餅, 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.
黃大皇, 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.
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?
有時候不犯錯，永遠都不知道自己還會在這處疏忽。犯錯誤沒有造成傷害是好事，下次就不會再犯了。
落花加油！