My first major mistake (documented incident).
I’m 3 months off orientation in the Trauma ICU at a L1 trauma center.
I recently had lots of help settling a complex poly-trauma after a stat head CT at 0300 (9 drips, 2x chest tubes, ETT, etc). Our night shift crews are generally tight nit (sink or swim as a team type of energy), so I was extremely grateful for the extra hands.
PTs sedation and analgesia demands kept slowly creeping up over the next few hours, and got to the point where they were maxed on dex, prop, ketamine, and getting as many PRN pushes as I could give. Through all of that, still noncompliant with the vent, CPOT through the roof, and I can’t think of anything else to do for this poor person. For context, they had a serious history of IV drug use, so I just chalked it up to pain control management on our end, and the massive surgery they had the day prior.
Remember those 2 chest tubes? In the hustle of settling them, I didn’t catch that they were hooked up to suction, but that the suction was off. I missed this as the output was the same consistency, quality, and the volume was relatively unchanged. Even after looking at the multiple times throughout the night, I was blind to the obvious.
Change of shift, a resident came by and caught the mistake immediately. I gave report and left, came back the after a few days off, and was told that the suction helped him reach a much more reasonable level of comfort very quickly.
Pulled in by management today, and as soon as I heard the patient’s name, I knew immediately what it was about. The resident filled a safety report out, and deservingly so. I caused them pain. I could have given them a pneumo. I could have set their recovery back even further. I didn’t, thank god, but I am filled with an immense amount of anger, self doubt, and frustration.
Our job demands perfection, and I wasn’t in this moment, and I’m just really grateful that this person is okay.
I have no one in my personal life to relate to with work stuff. I’m a dude, and none of my friends can help with the weight of the job. So I’m just screaming into the void. Thanks for letting me vent.