Kicking Yourself About Tough Calls

[DwayneEMTP]

Why? Death is death. Sorry no difference in death of a newborn or granny. Learn from every call and go forward.

Though I most often disagree with Spenac as he tends to parrot the more popular opinions expressed by those before him, I do think he makes a half assed decent point here.

My first call on my own truck at the service I work for now was a 3 month ped arrest. First friggin' call. In fact it was relatively famous locally. I got pulses back but the child died when removed from life support two days later.

There were tears all around me, but what did I feel? Nothing but an intense need to review my personal performance as well as my direction of the team. I was told by others that I would be damaged after I had a chance to think, but thanks to Akflightmedic I'd had Afg to refer to and knew differently. This child was in a trouble not of my making, and though I did the best that I could, I made many significant errors in treatment. But, on this day, it was my best.

One of the many debts I owe to EMTCity, Dustdevil, Ak and many others is that I entered that situation with the knowledge that it was unhealthy to let other, non psychiatric professionals, tell me how I should react to that situation. You did, in my opinion, exceptionally well with your pain. EMS is going to bring pain sometimes. We know that, and should accept it I believe. But deciding whether to seek sympathy, or instead find the help we need to stay healthy and then move forward separates the men from the boys.

I'm glad you let us see, hear, and thus learn from your experience. It was brave, and we're all the better for it.

Look me up if you get to Colorado.

Dwayne

[Dustdevil]

I was told by others that I would be damaged after I had a chance to think, but thanks to Akflightmedic I'd had Afg to refer to and knew differently.

Word. That was a great move for your professional development. If anyone in EMS has any problem with the death of total stranger patients here in the world, then don't even think about going to combat, where the victims are people you know and live with every day. You'll eventually crack. It took me three wars, but I cracked, and I have NEVER had any problem with death in civilian EMS.

[HERBIE1]

I stand corrected.

I thought I was a cold-hearted SOB, but I'm a warm and fuzzy teddy bear compared to some here.

[kevkei]

I had the most critical call I've ever been on the other night. It seems that I missed something that would have given us a slight chance to save a life (very slight). There were multiple critical pt's so I was trying to do a million things at once, and I missed something huge. My boss, my partner, and my one friend I have told about it all stand behind me, but I can't get over the fact that I took away that .01 percent chance at life. ... Also, I don't really want to talk about the call specifics thanks (I know that's kind of a dick move, but please respect it).

Now that you have had time to decompress and reflect, are you more comfortable telling more of the story to allow those here to provide more insight? To be honest, it's hard to provide honest feedback without knowing what it is you are holding back.

On the surface, based on what you are saying a very slight increase in saving a life (0.01%) though statistically is possible, practically is impossible. It is probably speculation at best that anything would have helped. If what you missed truly was 'huge' then the statistical odds would probably have been much better in favor of the patient.

I'm sorry to say that I remain suspicious of your intent. If you missed something huge and messed up, like others have said, accept responsibility, ask for forgiveness, learn from it and move on. It will make you a better practitioner.

If it was a long shot in the dark, hindsight is always 20/20 and you can critique until the cows come home. You can't change the past, only what you do in the future. If you look at hindsight, you will always be stuck in the past and will never move forward and won't make progress.

Learn to trust your instincts and respect the decision you made. If you can't, no one else will be able to trust you either. As long as you made the best decision based on the information that was available to you at THAT time, don't ever question it. It might not always be the right decision, but that's why you learn from it.

[Dustdevil]

Kev makes a great point, as usual. There is ALWAYS "something else" that could have been done. Always. It may be something you forgot. It may be something you never even learned. It may be something outside of your protocols. Most times it's just a total shot in the dark "feel good" measure that would have made no difference at all in the outcome. But remember, there is ALWAYS something else that could be done, so there is no point in agonising over it, because it makes no difference in the bottom line.

Of course, this is not to stay that you should not critically review each and every run. You should. And when you have that revelation of the major step that you overlooked for whatever reason, the finality of the situation should drive the point home in a way that never again allows you to forget. But it IS going to happen. Period. You can either deal with it or not. But your career depends on you discovering that method which helps you to do so. That is where conversations such as this one are valuable. Nobody here can tell you how YOU should deal with it. We have no way of knowing what will work for you. The best we can do is to share what has worked for us, and for you to then go with your best instincts. On that, I wish you luck.

[spenac]

Though I most often disagree with Spenac as he tends to parrot the more popular opinions expressed by those before him, I do think he makes a half assed decent point here.

I would tell you to kiss my butt but I don't want DNA from the many people that you keep your lips pressed tight on, might give me some disease. I speak my mind no matter how unpopular. Sometimes my opinions same as some often its not. I just see no reason for such a cowardly attack.

[chbare]

If I read the original post correctly, this thread is not about patient death per se, but rather about the consequences of making a mistake? What exactly is the error in question?

Take care,

chbare.

[Siffaliss]

I had the most critical call I've ever been on the other night. It seems that I missed something that would have given us a slight chance to save a life (very slight). There were multiple critical pt's so I was trying to do a million things at once, and I missed something huge. My boss, my partner, and my one friend I have told about it all stand behind me, but I can't get over the fact that I took away that .01 percent chance at life. I did. ME. "Everyone makes mistakes," or "you did your best and that's all you can do," or "most people would have missed that too," just doesn't seem to be cutting it. I'm sorry if this is repetitive, but I've read the other stress reduction polls and I'd kind of like something that addresses my situation a little more. How do you move on let alone work again after something like this? How big of a mistake is too big to make? Also, I don't really want to talk about the call specifics thanks (I know that's kind of a dick move, but please respect it).

One call I had this summer that made me feel like that. I was beating myself up about whether or not each decision I made was the right one; had I made a different choice at one of many points would things have turned out differently? I know now they wouldn't have, injuries were simply not compatible with life. I was offered a chat by one of our CISM people I trust, at the time I just wanted to go home. She gave me her cell and said to call if I needed. After I realized I couldn't normalize myself after work and was really reacting, I called and was able to arrange a meeting. That was probably the best thing I could have done; very informal, just a chance to vent and get all that stuff off my chest to someone who was able to make the time to listen (for two hours). So without minimalizing what you're feeling as I truly do understand, most or all of us have been or will be in that same position probably more than once during our careers. Definitely talk to someone, maybe take a debriefing. Get the specifics off your chest with someone trusted. Whatever happened, mistake or not, you're human. Take the initiative and talk to someone about what's bothering you, because if you don't it will quite likely eat you alive.

Edited October 29, 2009 by Siffaliss

[funkytomtom]

Now that you have had time to decompress and reflect, are you more comfortable telling more of the story to allow those here to provide more insight? To be honest, it's hard to provide honest feedback without knowing what it is you are holding back.

On the surface, based on what you are saying a very slight increase in saving a life (0.01%) though statistically is possible, practically is impossible. It is probably speculation at best that anything would have helped. If what you missed truly was 'huge' then the statistical odds would probably have been much better in favor of the patient.

I'm sorry to say that I remain suspicious of your intent. If you missed something huge and messed up, like others have said, accept responsibility, ask for forgiveness, learn from it and move on. It will make you a better practitioner.

If it was a long shot in the dark, hindsight is always 20/20 and you can critique until the cows come home. You can't change the past, only what you do in the future. If you look at hindsight, you will always be stuck in the past and will never move forward and won't make progress.

Learn to trust your instincts and respect the decision you made. If you can't, no one else will be able to trust you either. As long as you made the best decision based on the information that was available to you at THAT time, don't ever question it. It might not always be the right decision, but that's why you learn from it.

I don't know what my "suspicious" intent would be. I don't know specifically what I was looking for, but I've gotten "it." This discussion has provided me with a lot of food for thought and a lot of perspective. So...in the end I guess that's what I was looking for. Anyways, your commentary is appreciated, learning to trust my own decisions is something I have to work on indeed.

[Dustdevil]

Though I most often disagree with Spenac as he tends to parrot the more popular opinions expressed by those before him, I do think he makes a half assed decent point here.

To be fair, Spenac takes some pretty unpopular stances here too. While I don't always agree with him, I do implicitly trust that his opinions are honestly founded, and not calculated for popularity.