It was the first one of my series of night shifts at the Emergency Department – I was excited to work in the ED again (one of my favorite places to work at) and was looking forward to having a productive and rewarding night.
Unfortunately, not quite having adjusted to the night schedule, my brain was foggy and my body was exhausted. I still tried my best to be chipper with the team and present for my patients, reminding myself of my goal to be a good team player and a healing light. Despite my efforts, I made two consecutive mistakes within the first 3 hours of my shift – both small mistakes not affecting patient care, but still quite a deviation from my usual performance. I tried to not think about it and move on, telling myself that I need to be more careful tonight as I am having an “off day”.
After suturing a patient at 3AM in the morning who had decided to do laundry in the dark in the wee hours of the morning, my staff and I had a disagreement over the type of sutures I chose to use. I decided to go with patient preference in the choice of sutures, and he wished that I had used a different suture which has evidence for causing less scarring. It was a matter of opinion and practice, and he did not hold this against me in any way. He just provided me education and made it clear what his preference would be if we were to suture another patient that night. Normally, I appreciate this kind of straight forwarded communication because it allows for a smooth shift and running of the team. That night though, I found myself getting extremely angry over this, thinking to myself “HOW DARE he decide to make an issue of this on a very busy overnight shift”.
Recognizing that my anger was completely out of proportion and irrational, I took a small break and sat in the lounge area where I could take off my mask and breathe. I went over my shift and my experience working with him so far. He was a great supervisor – he had clear communication, let me know right away what he likes and what he doesn’t like, and allowed me a good amount of independence. Why then, was I so upset with him over this small disagreement?
In situations like this, psychiatrists recommend that patients go back to the time before the argument had even started, to check in with their emotional states that may have influenced their reactions to the argument or discussion. In that moment, it became crystal clear to me that I was already very upset at MYSELF for making those small mistakes in the earlier hours of the shift. Despite my best efforts to suppress these thoughts, my mind was already on edge by disparaging thoughts targeted at myself. Specifically, I was telling myself that I was a failure and a bad doctor because I had made those mistakes.
Everybody has off days. Doctors and nurses are human, and therefore, are vulnerable to making human error. The mistakes that I made had not harmed anyone, although they did cause minor inconveniences. I took a deep breath and meditated. I looked at the sigils I wrote on my badge – protection, peace and patience. I thought of my goddesses and asked for their guidance. I then thought of what I often tell my patients – What would you have told your friend if they made these mistakes? This made it clear what the issue was. I had no compassion or patience for myself and immediately jumped into a judgmental mindset – an attitude I would have NEVER taken towards any of my colleagues. The consequent feelings of being a failure was so painful to sit with, that I had displaced my anger towards myself to my supervisor as soon as there was opportunity for such transference.
Displacement, according to Freudian principles, is one of the maladaptive defense mechanisms where one unconsciously transfers/ displaces their inner conflict, usually stemming from earlier life experiences, to a situation or a person that is not a part of that inner conflict.
I was grateful for the guidance of my goddesses for giving me the space and calm to realize that self-compassion, or lack there of, was at the root of this issue. I inwardly expressed my gratitude to my goddesses and allowed myself to feel the feelings of shame and disappointment at myself for the mistakes I had made. I then told myself “I forgive you – I forgive you for these mistakes and for being harsh on yourself. I honor that your desire for perfection came from a place of wanting to be a healing light. I embrace you and I love you”. Immediately, I felt a sense of relief come over me.
I was able to return to my shift and had a great night – we helped many people and my supervisor and I made a fantastic team through a very busy ED shift. While this shift had not gone exactly as I had planned, I was grateful it happened. It was a wonderful reminder of the importance of self-compassion and forgiveness. I was also reminded that when all else fails, I will always have my spirit guides and higher self to show me the way.
Ena's worlds 