Yesterday was . . . difficult.
I had worked a stretch of five shifts, four of which earned overtime of one to six hours. I was scheduled to renew my Pediatric Advanced Life Support credential. On just over three hours of sleep. I could have rescheduled, but chose to go ahead and get it done.
Not my wisest decision.
I stayed awake and paid attention. Ate the delicious snacks. All was well until the first megacode. It wasn’t a difficult scenario, but my imaginary patient and I crashed and burned. I took a wrong turn at the top of the algorithm that guaranteed failure no matter how well I performed from that point on (and I didn’t perform particularly well).
I was flustered. Embarrassed.
The instructor pointed out where I’d gone wrong and told me I could retest today (something called remediation) and still pass the course.
He was kind. I was upset. And so very tired.
It got worse. I, who stay calm leading real codes and cry (if I have to) in the car on the way home, cried.
People could see I’d been crying. There was nowhere to hide. Another instructor pulled me aside, gave me a moment and told me to breathe. I did.
I passed the next megacode. Did well on the written test (even though I had to read each question twice). I’d gotten the crying under control.
While I turned in my test, I ran into the instructor who (righteously) flunked me. He glanced at my test paper and said, “See? You know this.” Then he said, “I felt so bad...” and gave me a hug that threatened to start the waterworks again.
I passed the repeat megacode. Got my PALS credential. Went almost immediately to a call room bed and slept like the dead.
Today I debriefed myself. It turns out I learned some things.
Here are my takeaways:
- I’m human. So are you. Humans make mistakes. Sometimes more than one (I made several yesterday alone).
- This is not about me. The fact that I was embarrassed showed was my pride was bruised. I’m doing this to help people. Not to look good.
- Rest. You are no good to anyone when you are exhausted.
- Know your limitations. Work within them.
- Prepare. I had read the book but could have reviewed the algorithms so they came to me, if not like second nature, at least more readily under stress.
- Be grateful for simulations. Mistakes are best made in classrooms on plastic dummies.
The instructor that failed me did me a favor. I reviewed those cardiac algorithms furiously while waiting for my retest. He also did my future potential patients a favor too.
When I see that rhythm on the monitor in real life, I know what to do.