Made a careless mistake

[u/BluebirdBackground93]

Hello there.

I am not sure if I should write it here, but please help me out.

I am young doctor working for 3 months in IM unit. I am not from USA but EU. I made careless mistake of forgetting of reading CT scan result. I also forgot to tell another doctor to check it out. The Patient was a woman with 3 day of icterus and she had meteorism. She didnt have belly pain otother symptoms. She admitted drinking alcohol and having a party.She was admitted on friday.

During Monday I ordered CT scan but forgot to check result. She had obstructive icterus with dilated ductus choledochus. Thursday my boss noticed it when he was checking patient. The worst thing is I had only 3 patients, so not too much work, yet I still forget. I checked it, but there were no CT results. They came just before the end of my shift, maybe 30 minutes. The thing its very small hospital and it happened around Christmas so we should have to move her to another clinic. She didnt die, her bilirubin levels got better. The only thing happened that other diagnoses would be delayed by few days - 2-3 days. She had sonography which I order and it was normal.

I just feel irresponsible, careless and stupid for making such a trivial mistake especially if I had only 3 patients. My boss is very angry at me, which I understand and I apologised multiple times. I am worried that he will fire me and I will had to leave my medical degree forever, because of such stupid mistake. I am also terrified to see him on Monday. Thank you for you comments. Please be realistic. I am thinking of leaving medical life behind me. I am sorry for my bad English.

Edit: Thank you everyone for your responses, especiall how quick you had answer me. I also wants to thank everyone for the good ideas. Yes I intent to do a chcek list and before the end of my shift I would set an alarm clock in case I forget about it. There are lots of things I have to learn and have more attention. I want to go to other hospital which will give an opportunity to grow. The problem is, that I feel like most of the doctors doesnt like the job they are doing and I feel like I become careless towards patients because of them. When I am alone in emergancy department then I feel like I am doing my best. Which is bad because I still need guidance.

Edit 2: the patient doesnt habe obstructive icterus. They have done ERCP today and she didnt have any obstruction.

[u/esophagusintubater]

I’m out of residency now. But, when I was a second year resident. A patient came from an outside hospital on multiple pressors with a central line. She was a very difficult to get an IV too, history of IV drug use. Our policy is to exchange central lines of coming with an outside central line. Anyway, I was told to exchange central line BUT I took out the central line without putting a new one in first.

So, I had a patient maxed out on Levo and vasopressin, with no IV access. I called a nurse immediately and her reaction was “what the fuck did you do”

Had to put an IO in an awake patient. Worst experience ever

[u/BluebirdBackground93 → u/esophagusintubater]

Thank you for your response. I aprretiate your honesty. I would probably made the same mistake as I am become very nervous in such situations. Especially if I should do some invasive work on patient. 

[u/CatNamedSiena]

I assure you. Your boss has made the same mistake himself. No one is firing you. He'll forget about it in a week.

Use it as a learning expefience.

[u/nahvocado22]

It was a mistake, for sure, but doesn't sound like it led to harm. I imagine if she had deteriorated clinically, someone would have looked at the CT and seen that finding. But, in this case, it wasn't needed. That doesn't make this less of a mistake, to be sure, but I also would be surprised if you lost your job over it. Just resolve to keep a stringent checklist of things you need to follow up on from now on. By the end of each shift, everything should be checked off or signed out to the next doctor.

[u/BluebirdBackground93 → u/nahvocado22]

Thank you very much for answering.  This is something I will be doing. At the beginnig I always tried to check my phone for notes, butnI got too many of them. So I am thinking of having an alarm clock just before leaving. This is a problem in my clinic. We dont have something like checking list or sitting in afternoon. If we had I would surely not forget to tell them. 

[u/BluebirdBackground93 → u/nahvocado22]

I also know that I should gather information the most before administraring drugs, but in stressful situations (in ER) I often make the mistake of telling nurse to administrate drug before seeing patient. I am trying to fight it, but I still blure out drugs name when nurse ask me what to give. I was working alone for a week for 8 hours in emergency department before making this mistake.

[u/y2k247]

Circumstances don’t matter, only state of being matters (your thoughts and feelings). Remember you can choose what belief to hold on to. If you see it as a mistake it will be, if you see it as an opportunity to learn how to create a system that works for you on how to prevent events like this from happening again then you’re golden. It can also be part of your interview for a higher position later on. How you handled a situation that didn’t go your way. Here’s your chance to shine. You’ve got this, you didn’t get this far just to get this far my friend.

[u/snoozebutt_off → u/y2k247]

Of course circumstances matter! Would you say the same thing if the patient came to harm because he forgot to check the ct scan? While I definitely agree this is a learning opportunity, he DID make a mistake and he was lucky the patient didn't suffer from it.

To OP: Relax, every doctor makes mistakes, your boss does too. But it's your job as a doctor to know your patients - I don't mean know every lab and medication by heart, but you need to know the history, clinical findings (otherwise, how will you know if something changes) and what diagnostics have happened and what is still pending. I used to write a to-do-list by hand after rounds, and worked the list for the rest of the day. If something was still pending like your ct-reading, i would write it on tomorrow's list. I needed to have it all on a piece of paper though that I carried around in my pocket. You will learn very quickly what works best for you. And I promise, with experience it will get easier to keep track of everything.

[u/makersmarke]

If you made a 1 time mistaken that didn’t kill anyone and just extended diagnosis/length of stay a few days, you likely will not be fired. Even attending physicians make those mistakes every day at most hospitals.

[u/drkdn123]

If your boss attempts to fire you, contact me. I will support this as a learning opportunity and that in the right kind of organization culture, we aim for non punitive management. You feeling this bad is a good outcome. It shows you care. It shows you care.

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[u/pmphx5]

We all make and learn from mistakes. You will fine. Chin up. I have cried many a times thinking it was the end while I was a resident.

[u/BluebirdBackground93 → u/pmphx5]

I am sorry. I cried all day (today) rhinking about my mistake and my future. I am so tired that I feel like I will pass out. 

[u/chiddler]

These posts come up frequently here. I think I've made a few in the years I've been apart of this subreddit. It's one of the hardest parts of the job alongside working with the strong personalities that medicine tends to attract.

I'm sorry to hear about your mistake. It's an awful feeling and it makes you go crazy with so many emotions, like guilt worthlessness and imposter syndrome tends to flare way up. We are only human and sometimes it's in our path to make us stronger docs. Come Monday, don't even talk about the error just move on.

[u/OriginalRabidHaggis]

Old hospitalist here. Give yourself some grace. We've all done similar. Agree with using it as learning experience.