Facing the fear

So the fist week of being a Dr is over and I am a little less terrified now. Partly because my last shift was actually fun, where I got to see and do some cool stuff and learn a lot as well, but mostly because I have some wonderful people in my life that are prepared to listen to me talk about my fears and insecurities but more than that, they are able to give me some good practical advice on how to overcome them.

I had dinner with a Dr A this week, a good friend who has been where I am today, not so long ago herself. She understands the pressure I put on myself to be good.. Not perfect or the best (I’m certainly no overachiever) but definitely better than the average intern, and as such, is able to offer an insiders perspective.

As a teacher, senior emergency physician and the man I live with, the other person I turn to has a wealth of experience and knowledge not only in medicine, but also in handling me.

The ED I am working in has a tracking system where the most serious or urgent case will always be at the top and when “picking up” or seeing another patient, we choose the top one.  The problem with this system is you can also see what’s wrong with them,  for example it might be abdominal or chest pain, altered consciousness, self harm  or suicidal ideation, or maybe just a stubbed toe. Nothing wrong with that in itself, its always nice to be forewarned about what is wrong with you patient, the problem is the ability to choose or refuse.

I have a couple of clinical areas that I feel I’m weak in, these are including but not limited to psych, neurology and paediatrics.  With the system mentioned above, it is easy to see if the next patient in line is one I would feel comfortable in choosing, if not, I can skip and pick up a lower priority patient that is more to my liking.

Not  a good idea for multiple reasons. Firstly, if you never work outside your comfort zone you’ll never improve and always be a little frightened . Secondly…one day someone will notice if you are for example skipping all the “girly” problems and make you do every pelvic exam that comes into the ED for the next week!

So I talked my fears through, got some advice on how to handle the things I’m afraid of and decided that my next shift I would face fear head on and take whatever came – no exceptions.

That shift happened to be a late on Australia day. Public holidays put pressure on emergency departments. People drink to much, take too many drugs, do silly things, get lonely, depressed and fight with each other.  So it was good for me. An altercation with a plate glass window gave me a young man with an arterial laceration in his arm who was trying to bleed out, and too much alcohol gave me another young man whose heart an arrhythmia that I needed to shock.  Just a couple of the more exciting things for the shift.

So when I finally made it home sometime after midnight I was exhausted but exhilarated. I had worked hard, challenged myself , remained focused, organised and confident and received a lovely compliment about my work from the consultant in charge.

Six days off now and a chance to reflect before I start my first night shift later this week.