Please help me deal with this student who massively stabbed me in the back.

[han14tra]

I'm a 3rd year and today the subI told us to follow him and he'd teach us stuff. This is my 3rd day of the rotation. He took us to see a pt with a foley in. The pt needed the foley removed and so he asked, "would you like to remove the foley?" I said sure, and he went and asked the nurse to teach me how to remove the foley. I've only done it once before and it was on a kid not an adult. I told the nurse that, and she said she'd be happy to teach me. So, I go in and she tells me to deflate the balloon with a 10cc syringe, and then tells me to "pull it out fast, and pull harder". I told her there was a lot of resistance and she checks it, and realizes there's still some air in it so she sucks that out. Then, she tells me to pull it again. I pull it out still with a lot of resistance and find out that the bulb was still inflated partially.

When we meet up with the resident, intern and attending later, the sub I says "Tell them what you did with the foley" without giving me any warning. I was just going to let the nurse take care of it because she said she'd call urology for recommendations because they placed the foley. I didn't find the blame game necessary. In fact, when I told my team what happened, I took full responsibility for it because I didn't want to blame the nurse. So then, they bladder scan the guy, and the subI keeps saying repeatedly "we're bladder scanning because Han14tra pulled out the foley while it was still inflated." I already felt bad that this happened to the pt. I about cried everytime he said that. Then, later in the day, the Resident says "Strong work on Mr. X" to the subI and the other med student, but not to me even though I was following the pt as well. The subI responds by saying "Yeah, Han14tra was actually the one who pulled the inflated foley." Was it really necessary to remind them of that and repeatedly make me feel horrible for what was obviously an accident? Even the other med student was shocked at how the subI was treating me.

Advice? How do I deal with this person for the next 4 weeks?

Seriously, why did he have to say "Tell them what you did." If I was in his shoes, I would've said, "Hi resident, there was an issue with the foley and it accidently was pulled with air still in it. They're going to bladder scan the guy to make sure everything's ok."

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[mmmcdowe]

I'm a 3rd year and today the subI told us to follow him and he'd teach us stuff. This is my 3rd day of the rotation. He took us to see a pt with a foley in. The pt needed the foley removed and so he asked, "would you like to remove the foley?" I said sure, and he went and asked the nurse to teach me how to remove the foley. I've only done it once before and it was on a kid not an adult. I told the nurse that, and she said she'd be happy to teach me. So, I go in and she tells me to deflate the balloon with a 10cc syringe, and then tells me to "pull it out fast, and pull harder". I told her there was a lot of resistance and she checks it, and realizes there's still some air in it so she sucks that out. Then, she tells me to pull it again. I pull it out still with a lot of resistance and find out that the bulb was still inflated partially.

When we meet up with the resident, intern and attending later, the sub I says "Tell them what you did with the foley" without giving me any warning. I was just going to let the nurse take care of it because she said she'd call urology for recommendations because they placed the foley. I didn't find the blame game necessary. In fact, when I told my team what happened, I took full responsibility for it because I didn't want to blame the nurse. So then, they bladder scan the guy, and the subI keeps saying repeatedly "we're bladder scanning because Han14tra pulled out the foley while it was still inflated." I already felt bad. I about cried everytime he said that. Then, later in the day, the Resident says "Strong work on Mr. X" to the subI and the other med student, but not to me even though I was following the pt as well. The subI responds by saying "Yeah, Han14tra was actually the one who pulled the inflated foley." Was it really necessary to remind them of that and repeatedly make me feel horrible for what was obviously an accident? Even the other med student was shocked at how the subI was treating me.

Advice? I'd especially appreciate input from the residents and attendings here. How do I deal with this person for the next 4 weeks?

Seriously, why did he have to say "Tell them what you did." If I was in his shoes, I would've said, "Hi resident, there was an issue with the foley and it accidently was pulled with air still in it. They're going to bladder scan the guy to make sure everything's ok."

Sadly, I have heard that this kind of gunning happens pretty often when there is a subI on the team with 3rd years (relative to 3rd year on 3rd year crime at least). I guess maybe they feel threatened that you might show them up or otherwise hurt their chances of matching in that program (hence him trying to place the foley blame on you so that it doesn't screw him/her over). I, fortunately, had minimal contact with fourth year students during my rotation, and thus never encountered this kind of thing. Several of my classmates did, however.

You did the right thing, you accepted responsibility and handled it maturely. Don't fight this battle, it is not worth it. Just continue to work hard and be respectful.

 

[backtochitown]

Yeah as a third year, it's your year to make mistakes. You handled it professionally so there's gonna be minimal, if any repercussion. Just study hard and know your **** and your patients and you'll be fine. In my opinion, the subI who repeatedly pinning this on you is making himself look bad. Who would want to work with someone on their team who's always pointing out other people's mistakes?

 

[Rendar5]

"I'd appreciate it if you stopped repeatedly reminding me and everyone else about my mistake, I already feel bad enough about it" for the next time they bring it up.
And for the future, don't pull inflated things out against resistance. If you feel resistance, try to deflate more until nothing further comes back. And you shoudln't let the nurse tell everyone about it, it's your procedure and you needed to inform the team anyway, so he didn't throw you under the bus, he was just a complete dick.

 

[han14tra]

"I'd appreciate it if you stopped repeatedly reminding me and everyone else about my mistake, I already feel bad enough about it" for the next time they bring it up.
And for the future, don't pull inflated things out against resistance. If you feel resistance, try to deflate more until nothing further comes back. And you shoudln't let the nurse tell everyone about it, it's your procedure and you needed to inform the team anyway, so he didn't throw you under the bus, he was just a complete dick.

I know this for next time. I wasn't sure how much resistance there was suppose to be. The nurse told me I wasn't pulling hard enough so I thought there was suppose to be some resistance with the larger adult foleys. And, I just thought 10cc of air was the standard amount that you put in when you inflate the foley. So, I only sucked out 10cc. I didn't know I had to keep reattaching the syringe to suck out more air

 

[Guillemot]

Its unfortunate if your 4th year is not very good. A good 4th year can be very helpful. Part of their job as a subi is to help the 3rd years. I guess that means the 4th year was doing a poor job.

 

[Rendar5]

I know this for next time. I wasn't sure how much resistance there was suppose to be. The nurse told me I wasn't pulling hard enough so I thought there was suppose to be some resistance with the larger adult foleys. And, I just thought 10cc of air was the standard amount that you put in when you inflate the foley. So, I only sucked out 10cc. I didn't know I had to keep reattaching the syringe to suck out more air

Some foleys take 30cc's. There is usually something printed on the insufflator section which says the size of the tube (18Fr, e.g.), and the amount of water insufflated. However, you have to assume imcompetence on the person who inserted it, so any resistance just play it safe, recheck. I had to go back 3 times on a 18Fr 10cc foley because whoever inserted it had put in 25cc's total. One tip is that when you can't take anymore fluid/air out, the balloon side of the foley will collapse on further attempts at aspiration.

 

[Valadi]

Welcome to med school politics. Residents notice this kind of behavior. The m4 is not going to look better for trying to make you look bad.

You're allowed to mess up. Now your job is to gun out like never before, come early, leave late, always have a paper at your disposal, etc. Since he's not helping you out you need to buddy up to the residents and make sure they directly see you performing well. One maneuver is to tell a resident you've been reading up on X and ask if they could go over it with you whenever they're free. Be honest, stay on top of your patients (eg if you're awaiting test results check the computer every hour and text your resident when they get back), be absolutely well-read and prepared for your cases, and you'll do fine.

Your best bet is to work around the m4, not against him. There's always fall-out after a confrontation and that tends to land on the person at the bottom of the hill.

 

[drizzt3117]

I don't think he was being nice but I don't necessarily think he was backstabbing you, just was prob wtf about you pulling a foley on someone when it was inflated, it's feb after all, no need to impress anyone.

 

[235009]

it goes without saying that this subI was being a total douche by pointing out your mistake over and over.

is this your first rotation of third year? if not then you should've known better (sorry). this is a lesson though that not all nurses are created equal and you should always be using your common sense and if you feel anything is even slightly off you should immediately stop and get your superior (ex: a resident). also you should NEVER EVER do any procedure "hard and fast" ...except chest compressions.

 

[han14tra]

it goes without saying that this subI was being a total douche by pointing out your mistake over and over.

is this your first rotation of third year? if not then you should've known better (sorry). this is a lesson though that not all nurses are created equal and you should always be using your common sense and if you feel anything is even slightly off you should immediately stop and get your superior (ex: a resident). also you should NEVER EVER do any procedure "hard and fast" ...except chest compressions.

How exactly would I have learned? My school spends 0 hours teaching us foleys on mannequins, and I haven't had surgery. On OB, they wouldn't let med students do foleys. That leaves psych, family (outpt) and peds (outpt). I only removed 1 foley before (from a kid), and I've never placed one. At 3rd year orientation, they told us "don't worry. Someone will be supervising you doing procedures. They help you, and make sure you don't do it wrong." I thought I was safe with a nurse on the urology floor teaching me.

 

[SouthernSurgeon]

NEVER EVER do any procedure "hard and fast" ...except chest compressions.

pulling chest tubes

 

[Rendar5]

pulling chest tubes

AFTER removing the stitches, lol.

 

[Top Gun]

I wouldn't worry about it. Your sub-I was being a douche, and pointing out your mistake to make himself look good. Most residents and attendings can see right through this, and will not be impressed. As far as matching at that program, assuming that was his goal, your sub-I screwed himself over by failing to show himself as a team player.

That said, next time you pull a Foley, don't keep pulling on it if you feel a lot of resistance. Deflate the balloon until nothing comes out, and if there is still a lot of resistance, call your resident for assistance. And also, when you're putting in Foleys, don't keep pushing it in if there is a lot of resistance. Sometimes, there might be a stricture, and then urology has to be called.

 

[Bacchus]

AFTER removing the stitches, lol.

This just made my skin crawl. Moreso than thinking of when I'd removed JP drains. *Shudder*

 

[2012mdc]

How exactly would I have learned? My school spends 0 hours teaching us foleys on mannequins, and I haven't had surgery. On OB, they wouldn't let med students do foleys. That leaves psych, family (outpt) and peds (outpt). I only removed 1 foley before (from a kid), and I've never placed one. At 3rd year orientation, they told us "don't worry. Someone will be supervising you doing procedures. They help you, and make sure you don't do it wrong." I thought I was safe with a nurse on the urology floor teaching me.

No disrespect to any nurses or other staff but if I was doing a procedure, no matter how "simple", I was new to or not comfortable with I always made sure to do it under the supervision of someone in the chain of command on my team. This way I made sure to do it the exact way the team wanted it. People can have variations on things as simple as a dressing change and I always liked to learn the team/attending way first.

 

[jcu]

Out of curiosity, was this patient assigned primarily to you or the douche-i? Why are three medical students following one patient? In my opinion, the person most at fault here is the resident for not supervising. At the very least, your sub-i should have been there guiding you. 4th years who delegate for the sake of delegating absolutely infuriate me ... and I'm a 4th year. If I were you OP, I'd deal with this person by not dealing with him at all. He has absolutely no say in your evals. If he approaches you with other procedures or asks you to do anything you're not comfortable with (especially if it's not your primary patient), tell him no thanks and walk away.

 

[amaprez]

I'm trying to imagine how awkward & funny it'd be if the Sub-I in question finds this thread

 

[han14tra]

The pt was initially mine. I picked him up because I was didn't have enough to do with only 2 pts (both simple cases) and no one else wanted to follow him because the pt was a very eccentric man. That gave me 3 pts, the other 3rd year 2 pts, and the subI 2 pts. As I was reading all about the pt, the other 3rd year's pt left AMA. So, I said, "I haven't gone to see Mr. X yet, but I've read all about him. Why don't I tell you about him and then we can go see him together. After that, he's yours to follow." She was happy with that. But, then the case got more interesting and the sub-I decided he wanted to follow him and so he basically took him off the other 3rd year. Because we all knew the pt, the sub-I kept asking us if we wanted to see him together. That's how I ended up pulling the foley.

The Sub-I never told the team that he delegated the task to me or that he asked the nurse to teach me, so it made me look like I went off on my own and pulled a foley on a pt I wasn't even following.

 

[st0w]

Sorry to hear about the experience, but as others have said, this reflects more poorly on the AI than on you. His behavior in repeatedly bringing it up and placing blame on you was an incredibly unprofessional way to handle the situation, and although they may not say it, residents and attendings do see right through that kind of behavior. He'll be seen as not a team player, and that's a big red flag when it comes to residency applications.

At every level in the hierarchy, people need to have the attitude that the buck stops with them. If someone delegates a task to a subordinate, it's their responsibility to make sure the subordinate has all the resources and skills required and that the task is completed appropriately. Blaming somebody below oneself is rarely ever an acceptable response in medicine. Medicine is a team sport, more than ever in this day and age of increased patient handoff, and I feel greatful that thus far, I have not seen anybody thrown under the bus by a classmate or peer.

Everybody makes mistakes. The true measure of someone's character isn't the mistakes they make, but how they react and respond. Your AI is an assclown, and I really wouldn't worry about this if I were you. It sucks to make mistakes, but we're students, that's what we're there for.

 

[Nelcovp]

This thread caught my attention and I had to look up what a Foley was.

http://en.wikipedia.org/wiki/Foley_catheter

The photo on the bottom right will cause nightmares for years to come. All I can say is that has got to be the most miserable experience one could go through. I hope this patient was put into a medically induced coma for this.

 

[Valadi]

This thread caught my attention and I had to look up what a Foley was.

http://en.wikipedia.org/wiki/Foley_catheter

The photo on the bottom right will cause nightmares for years to come. All I can say is that has got to be the most miserable experience one could go through. I hope this patient was put into a medically induced coma for this.

Haha! Yeah it's pretty weird when you're not used to seeing it. Good thing you chose pharm!

 

[Rendar5]

honestly, it's not usually that bad. Just ask them to use urojet (viscous lidocaine designed to numb the urethra, and then have them wait 1 minute.

 

[DeadCactus]

How exactly would I have learned? My school spends 0 hours teaching us foleys on mannequins, and I haven't had surgery. On OB, they wouldn't let med students do foleys. That leaves psych, family (outpt) and peds (outpt). I only removed 1 foley before (from a kid), and I've never placed one. At 3rd year orientation, they told us "don't worry. Someone will be supervising you doing procedures. They help you, and make sure you don't do it wrong." I thought I was safe with a nurse on the urology floor teaching me.

It's easy to drop your guard on a procedure as seemingly uneventful as a Foley and I can't say I wouldn't have done the same, but I think it's a good idea to set a policy of reading about any new procedure before trying it. Ideally, just take a few minutes to read up on the indications, contraindications, technique(s), and complications. It's the ideal and I can't argue that it's always practical or that I meet my own goal 100% of the time, but it's worth aiming for and even more important if you don't feel comfortable with the technique.

One of the most valuable lessons to learn as early as possible is that everyone is full of s--t. Nurses, medical students, attendings, and fellows will all mislead and misinform you though some are obviously more reliable than others. Procedures are one of the the first times a student has any actual responsibility for a patient's well being so they represent a good opportunity for getting in the habit of not being dependent on someone else's knowledge base...

 

[sirenomelia]

I'm a 3rd year and today the subI told us to follow him and he'd teach us stuff. This is my 3rd day of the rotation. He took us to see a pt with a foley in. The pt needed the foley removed and so he asked, "would you like to remove the foley?" I said sure, and he went and asked the nurse to teach me how to remove the foley. I've only done it once before and it was on a kid not an adult. I told the nurse that, and she said she'd be happy to teach me. So, I go in and she tells me to deflate the balloon with a 10cc syringe, and then tells me to "pull it out fast, and pull harder". I told her there was a lot of resistance and she checks it, and realizes there's still some air in it so she sucks that out. Then, she tells me to pull it again. I pull it out still with a lot of resistance and find out that the bulb was still inflated partially.

When we meet up with the resident, intern and attending later, the sub I says "Tell them what you did with the foley" without giving me any warning. I was just going to let the nurse take care of it because she said she'd call urology for recommendations because they placed the foley. I didn't find the blame game necessary. In fact, when I told my team what happened, I took full responsibility for it because I didn't want to blame the nurse. So then, they bladder scan the guy, and the subI keeps saying repeatedly "we're bladder scanning because Han14tra pulled out the foley while it was still inflated." I already felt bad that this happened to the pt. I about cried everytime he said that. Then, later in the day, the Resident says "Strong work on Mr. X" to the subI and the other med student, but not to me even though I was following the pt as well. The subI responds by saying "Yeah, Han14tra was actually the one who pulled the inflated foley." Was it really necessary to remind them of that and repeatedly make me feel horrible for what was obviously an accident? Even the other med student was shocked at how the subI was treating me.

Advice? How do I deal with this person for the next 4 weeks?

Seriously, why did he have to say "Tell them what you did." If I was in his shoes, I would've said, "Hi resident, there was an issue with the foley and it accidently was pulled with air still in it. They're going to bladder scan the guy to make sure everything's ok."

I would have said with the whole team there that you would have been better with manipulating the catheter if you had the chance to practice using one on the sub-I but they dont make foleys that small. Guaranteed you would get a grade of A and the MS4 would STFU for life.

 

[jcu]

I would have said with the whole team there that you would have been better with manipulating the catheter if you had the chance to practice using one on the sub-I but they dont make foleys that small. Guaranteed you would get a grade of A and the MS4 would STFU for life.

Can we be best friends?

 

[cpants]

A little more education on Foleys for you. First of all, they are inflated with sterile water (or in a pinch saline) not air. Secondly, when you hear that a Foley was placed by urology, big bells and whistles should be going off in your head about removing it. Why was it placed by uro? Does it need to stay? Should we contact them before removing? Also Foleys placed by uro often have atypical characteristics as they may have placed for different indications than you are used to.

Which brings me to my next point...the amount of fluid in the Foley balloon. The number printed on the balloon port is meaningless. They can be and often are overfilled for various reasons. A 10cc foley balloon can easily hold 3x that amount. Urology often uses 30cc balloons in certain situations. You can see where I'm going with this.

The safe and appropriate way to remove a foley catheter is to deflate with a syringe, and to keep attempting to deflate until nothing else comes out and you see the balloon lumen collapsing on itself. This is how you know it is empty. Even in that case, the balloon is not necessarily empty. Saline can crystalize in the lumen preventing you from deflating appropriately (hence H2O as the preferred fluid for inflation). The lumen and port can also malfunction in various ways. So, if you encounter any resistance pulling a foley, the balloon is up until proven otherwise. Stop what you are doing. Fix it if you know how. Call someone who does if you don't. But never pull against resistance.

You messed up, but the real screw up is on the part of your resident and to a lesser extent your sub I for not providing appropriate training and supervision for you. I'm sure your resident caught hell for this situation if it makes you feel any better. Put it behind you, move on, and learn from this. Many seemingly innocuous procedures have the potential to cause significant harm to patients. You owe it to them to make sure you have a good idea what you are doing before you do it. If you don't, just ask (and I don't mean the nurse).

 

[han14tra]

A little more education on Foleys for you. First of all, they are inflated with sterile water (or in a pinch saline) not air. Secondly, when you hear that a Foley was placed by urology, big bells and whistles should be going off in your head about removing it. Why was it placed by uro? Does it need to stay? Should we contact them before removing? Also Foleys placed by uro often have atypical characteristics as they may have placed for different indications than you are used to.

Which brings me to my next point...the amount of fluid in the Foley balloon. The number printed on the balloon port is meaningless. They can be and often are overfilled for various reasons. A 10cc foley balloon can easily hold 3x that amount. Urology often uses 30cc balloons in certain situations. You can see where I'm going with this.

The safe and appropriate way to remove a foley catheter is to deflate with a syringe, and to keep attempting to deflate until nothing else comes out and you see the balloon lumen collapsing on itself. This is how you know it is empty. Even in that case, the balloon is not necessarily empty. Saline can crystalize in the lumen preventing you from deflating appropriately (hence H2O as the preferred fluid for inflation). The lumen and port can also malfunction in various ways. So, if you encounter any resistance pulling a foley, the balloon is up until proven otherwise. Stop what you are doing. Fix it if you know how. Call someone who does if you don't. But never pull against resistance.

You messed up, but the real screw up is on the part of your resident and to a lesser extent your sub I for not providing appropriate training and supervision for you. I'm sure your resident caught hell for this situation if it makes you feel any better. Put it behind you, move on, and learn from this. Many seemingly innocuous procedures have the potential to cause significant harm to patients. You owe it to them to make sure you have a good idea what you are doing before you do it. If you don't, just ask (and I don't mean the nurse).

I doubt the resident got into any trouble considering I don't think she knew I was going to do it. I shouldn't have let the Sub-I delegate the task to me. He acts like he's in charge of us, but then when something went wrong he completely abandoned me and took zero responsibility. So, he's dead to me. I'm not listening to anything he says for now on. In hindsight, I shouldn't have done it. My school tells us to "ask the nurses to teach you procedures (IVs, foleys, etc)" but that didn't work out so well. I'll learn how to put in my first foley, do my first IV, do my first rectal exam, draw blood for the first time, etc during residency, I guess?

 

[Top Gun]

I doubt the resident got into any trouble considering I don't think she knew I was going to do it. I shouldn't have let the Sub-I delegate the task to me. He acts like he's in charge of us, but then when something went wrong he completely abandoned me and took zero responsibility. So, he's dead to me. I'm not listening to anything he says for now on. In hindsight, I shouldn't have done it. My school tells us to "ask the nurses to teach you procedures (IVs, foleys, etc)" but that didn't work out so well. I'll learn how to put in my first foley, do my first IV, do my first rectal exam, draw blood for the first time, etc during residency, I guess?

No one is saying that you have to wait till residency to learn those skills. You can, and should, learn them as a third-year so that internship will be easier for you. You can't let a mistake doing a procedure undermine your confidence. Otherwise, you won't learn.

But its a good idea to learn the procedures from your intern or resident first before doing them on your own. Its really better to learn procedures from someone on your team first. If you didn't really feel comfortable removing the Foley, you should have paged your intern/resident and asked one of them to supervise you. Of course, I still stand by my statement that the Sub-I was being a douche, and it was basically a result of his, and the resident's, negligence that the error happened. If I were his attending, I would have tanked him on his eval for his lack of professionalism. I would also have had words with the resident for not providing adequate supervision. She probably originally assigned him the Foley removal. She should have been more aware of what was going on.

Anyway, what's done is done. What's important is that you learn from your mistake, and don't repeat it in the future. You're a third-year. You're expected to make mistakes. Just try not to repeat the same ones over and over.

 

[Rendar5]

I doubt the resident got into any trouble considering I don't think she knew I was going to do it. I shouldn't have let the Sub-I delegate the task to me. He acts like he's in charge of us, but then when something went wrong he completely abandoned me and took zero responsibility. So, he's dead to me. I'm not listening to anything he says for now on. In hindsight, I shouldn't have done it. My school tells us to "ask the nurses to teach you procedures (IVs, foleys, etc)" but that didn't work out so well. I'll learn how to put in my first foley, do my first IV, do my first rectal exam, draw blood for the first time, etc during residency, I guess?

sorry, but you better know how to place IV's, foley's, and perform DRE's before residency, you're expected to know those and be proficient in them. Nurses are fine for teaching foley's and IV's honestly, as long as it's within their scope of practice. Just don't do any around this sub-i.

 

[cpants]

sorry, but you better know how to place IV's, foley's, and perform DRE's before residency, you're expected to know those and be proficient in them. Nurses are fine for teaching foley's and IV's honestly, as long as it's within their scope of practice. Just don't do any around this sub-i.

Obviously not at this hospital:

So, I go in and she tells me to deflate the balloon with a 10cc syringe, and then tells me to "pull it out fast, and pull harder".

Seriously though OP, you are assigning a lot of blame to others, but you should be looking at what you did wrong. You didn't know what you were doing and you didn't ask for help when you needed it. Next time do better.

 

[turkeyjerky]

Obviously not at this hospital:


Seriously though OP, you are assigning a lot of blame to others, but you should be looking at what you did wrong. You didn't know what you were doing and you didn't ask for help when you needed it. Next time do better.

Sounds like she did ask for help, from the nurse, and it backfired on her.

 

[Top Gun]

Seriously though OP, you are assigning a lot of blame to others, but you should be looking at what you did wrong. You didn't know what you were doing and you didn't ask for help when you needed it. Next time do better.

She does know she messed up. She took responsibility for the error in front of her resident and attending.

 

[Yellow Jacket]

Advice? How do I deal with this person for the next 4 weeks?

."

I am not a medical student (yet) but an engineer where we are heavily regulated by government agencies. We experience similar situations. You have done the right thing and took responsibility although I believe it was not your fault entirely. You should learn from this experience and come up with a mental procedure for these types of experiences and to prevent future similar occurrences. You should share your well thought precautionary measures with your boss and get their concurrence and seek their input/thoughts to perfect yourself.

 

[han14tra]

Obviously not at this hospital:


Seriously though OP, you are assigning a lot of blame to others, but you should be looking at what you did wrong. You didn't know what you were doing and you didn't ask for help when you needed it. Next time do better.

I agree that some of my posts do seem like I'm blaming the nurse, the subI, my school, etc. That's probably because I'm trying to process it mentally and make the mistake seem more acceptable in my mind so I'm not haunted by it forever. I believe the defense mechanism is called rationalization.

Rationalization - justifications, excuses or reasonings given to make a behavior that is unacceptable to oneself seem logical -- "A student fails the final he didn't study for and says... "I couldn't have passed it anyway - that teacher has it in for me."

The "blaming" you are observing is just me feeling guilty and you are seeing my mental process as I try to deal with it.

The point is, when I told the team, I didn't drag anyone down with me. If anyone on my team asked me again what happened, I'd say the same thing: That I made a mistake and pulled the foley while it was still inflated. As much as I hate to think about it, I know I messed up, and I absolutely hate that as a 3rd year medical student I've already done something that could've caused serious harm to my patient.

 

[235009]

As much as I hate to think about it, I know I messed up, and I absolutely hate that as a 3rd year medical student I've already done something that could've caused serious harm to my patient.

what ended up happening to the patient?

 

[han14tra]

nothing...they did a scan, which showed no damage and he was able to pee afterwards. He was discharged later that day.

 

[cpants]

nothing...they did a scan, which showed no damage and he was able to pee afterwards. He was discharged later that day.

No harm, no foul then. Keep you head up, because though this was the first time, it won't be the last. Believe me, I've made plenty of mistakes so far. You just have to give it your best and learn from it when it happens.

 

[Top Gun]

nothing...they did a scan, which showed no damage and he was able to pee afterwards. He was discharged later that day.

Excellent. But now you know, right? Never pull a Foley, or any other tube, out against resistance. And if you're not sure of what you're doing, ALWAYS ask for help.

Anyway, learn from your mistakes. You will make others as you go, no doubt. I've made my fair share. The important thing is to learn from them and avoid repeating them.

 

[Rendar5]

good judgment comes from experience.
experience comes from bad judgment.

 

[sirenomelia]

nothing...they did a scan, which showed no damage and he was able to pee afterwards. He was discharged later that day.

I remember old guys getting delerious and yanking them out at night all the time balloon and all. We only were called because the nurses wanted to leave them out and I never remember working up anything unless there were problems the next day.

 

[combatwombat]

This kind of thing happens all the time. Your case was not the first, nor will be the last. Anyone who has read the book House of God by Samuel Shem is familiar with the story of Dr. Potts (tl;dr- resident kills himself after being harangued over and over again for making a mistake).