Thursday, December 16, 2010


"Its not who you are that holds you back, its who you think you're not."
- Author Unknown

Part of being in the medical field is being on a sort of stage constantly.   When you're a student you are performing for your professors, preceptors, staff and other students.  You are constantly put on the spot whether its doing presentations in class, answering questions on rounds or being pimped in the OR.  You're expected to know the answers to impossible questions and never show cracks.  Once you graduate, you're put on stage in front of your patients, colleagues and various staff members.  You are now the "the expert" and should always know the answers to every question possible.  Saying "I don't know" doesn't ever seem like much of an option.  All this performing takes quite of bit of self-confidence.  Every time something doesn't go as expected or when you really don't know the answer or have a plan, that self-confidence (and ego) takes a hit.  It can be a humbling and frustrating thing.

Well, being the new kid in the department on top of being a new graduate has done a number on my confidence levels.  I've gone from being a student, where I was expected to be knowledgeable but not an expert, to the professional (with letters after my name) who is supposed to know it all.  Its a really rough transition to make overnight.

My first several shifts I struggled mightily.  I couldn't stop thinking about how I should know the answers to every question, have an outstanding diagnostic and treatment plan for every patient presentation and know the pediatric dosing for every drug.  I also felt like I couldn't present a patient to the attending or talk to a consultant on the phone without tripping over my words, leaving out important information or giving too much trivial information.  My self-confidence was in the toilet and about to get flushed away.

Last Friday I had the chance to work in a different section of the Emergency Department where we see what's expected to be quick patients - i.e. orthopedic injuries, rashes, get the idea.  That day was a life-saver for me.  I finally felt like I knew what I was doing - I could finally ask the right questions, answer patients and parents concerns, perform procedures correctly, and make a decent plan.  I didn't get everything 100%, but I was in my element.  I sewed up a kiddo's face and was complimented by the parents on how well I did (yes!), I successfully reassured a parent who was concerned, I made accurate judgements and my treatment plans didn't need much tweaking from the attending.  I went home that night feeling great about the shift and my abilities.  I finally felt like I could do this.  My confidence was on the rise.

Since that shift, I've worked two other shifts.  My ego has taken some hits and that confidence has dwindled some, but when I sit back, take a breath and tell myself "You can do this," I truly believe it.  Yesterday, my first task of the shift was to perform a lumbar puncture on a patient.  I've seen a zillion, but have never actually performed one.  Despite my nerves and the feeling like there was no way I could do it, with some helpful guidance and careful supervision, I was successful!  It wasn't a champagne tap (meaning absolutely no blood in the fluid), but it was only my first, so I wasn't too hard on myself.

I still have quite a road ahead and a steep learning curve to master, but I'm surrounded by really supportive and understanding people who are patient and willing to teach.  Just gotta keep swimming.

"If we all did the things we are capable of doing, we would literally astound ourselves."
- Thomas Alva Edison 

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