Just when you thought it was safe...

...to love your job.

Just when you started to think you knew what was going on.

Just when you thought you were pretty good.

You screw up.

This one wasn't so bad, really but I'm taking it hard. Basically, a patient came back from procedure in need of open heart surgery. Not emergent, but urgent - surgery should be scheduled first thing in the morning. So, the patient came back to me, and new orders were being written frenetically - we need a nitro drip, now. We need a Heparin drip, now. We need and ICU bed, now. The surgeons are here, now. Get a carotid duplex, now.

I focused on getting as much done for the patient as I could. Get the chart all in order before sending care off to the ICU nurse - send as many labs down as possible. Get the drips started as soon as possible.

I was wrong. I should have sent the patient to ICU as soon as the orders to transfer were there. I should have let the ICU nurse do most of that stuff. I should have done some of it, but not tried to do all of it. I should have concentrated on getting that patient to ICU. I interpreted the patients' returning to our unit as an indication that I was supposed to continue to care for her.

In my defense:

1. The patient was stable


2. No one stopped me from continuing on the path I chose.


3. When all was said and done, I got the majority of orders done for the patient as quickly as humanly possible. I even got her dinner ordered.


4. When it was all over, I asked for feedback. This is how I found out my priorities were misaligned.


5. I probably would not have gotten that feedback if I hadn't asked. This is good. Because, next time, if I had made the same choice in a similar situation, I'd feel worse. I would have thought that I was misled this time.
   

I learned, and no harm was done. I guess that's the best outcome given the situation.

I need to get over it and just learn. As I've said in a previous post, this feeling that "I have failed" is torture to me, though. A gloomy rainy day after a week of rain does not help me maintain healthy perspective, either.

Now, I will continue to be thoughtful, but I should go do some quilting.