I suck at procedures

[Steel_City]

Well I don't actually...but damn can it be frustrating when I miss one. I'm a PGY-1 in the middle of my internship at a small community program. Next year I'll be a CA-1 and I can't wait. Here's the deal...

Yesterday I was paged to do a LP in a 7-day old and I pride myslef on doing these right the first time. Well, for some reason, I couldn't get this one...felt good but no flow. The peds attending tried and couldn't either so we had to tell mom that we failed. Ultimately, the most senior peds attending came in after office and got in on the second try.

Thing is that I have a hard time dealing with failure on these procedures. Does anyone else experience the same frustration when they can't do a procedure, whether it be intubation, art line, epidural etc. This literally ruins my day.

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[jetproppilot]

Well I don't actually...but damn can it be frustrating when I miss one. I'm a PGY-1 in the middle of my internship at a small community program. Next year I'll be a CA-1 and I can't wait. Here's the deal...

Yesterday I was paged to do a LP in a 7-day old and I pride myslef on doing these right the first time. Well, for some reason, I couldn't get this one...felt good but no flow. The peds attending tried and couldn't either so we had to tell mom that we failed. Ultimately, the most senior peds attending came in after office and got in on the second try.

Thing is that I have a hard time dealing with failure on these procedures. Does anyone else experience the same frustration when they can't do a procedure, whether it be intubation, art line, epidural etc. This literally ruins my day.

I've been doing this biz ten years, Dude, and I still miss stuff sometimes. Granted its only once in a blue moon now, but no matter how long you do this for a living you'll come across something that is difficult.

You will get better with time.

If you knew everything now and hit every procedure now I wouldnt have a job!

Keep your head up.

 

[Noyac]

I can only add one thing. Don't get bothered by it. Be willing to ask someone else to try for the patients sake. If they get it fine, if not fine. But as time goes by you will most definitely be able to return the favor to your partner that bailed you out and then you will feel redeemed. Trust me you won't get to a point that you never struggle to do something that you can usually do blindfolded. It just comes much less frequently.

 

[jwk]

The fact that one of the attendings tried and failed, someone who presumably has significantly more experience than you do, should also put your mind at ease.

Everyone misses here and there. I miss an IV twice? I'll let someone else try - sure I'd get it sooner or later, put the patient won't be happy. I miss an intubation twice (a rarity, just like Jet ) then I'll let someone else try unless I can see exactly what my problem is to begin with. That's one thing that's good about anesthesia care team practices - there's always someone else around to help out.

 

[MarchMover]

Truth is that you are putting too much pressure on yourself to succeed. The procedures are opportunities to learn for you right now, you are an intern. Kick yourself for missing an LP after you have finished residency, done a peds fellowship, and spent 10 years in practice... then it will be your fault.

Remember your errors and learn from them. Don't set yourself up to fail by putting too much pressure on yourself.

 

[bubalus]

In general most people get better with procedures as time goes on. You first get a handle on the easiest ones and the ones you do most often. Then you get better at the more difficult ones. Some times you'll miss one and someone else will get it. The fact that an attending failed should make you feel better. I've missed procedures and had to have an attending get them and I've nailed procedures that attendings have missed. It happens, and it will happen less frequently as you go on (remember this when you start doing thoracic epidurals). The key is to learn from your mistakes and fix them before they cause problems, i.e., recognize esophageal intubations, don't stick a cordis into a carotid, etc.

You're an intern, and it's only October. I'm not saying that in a condescending way. It's a fact. You haven't been doing this as long as others, but pretty soon, you'll be on the other end. You'll feel pretty on top of your game at the end of your internship, and feel like you're back to square one when you start your CA-1 year. When you start your CA-2 year and spend time with the new CA-1s, you'll be surprised how much you've learned, and how good you are.