Because I admitted this lady, and either I said she was cephalic or the nurse assumed she was cephalic because I didn't say. And either way I made a mistake. Because I don't know if she was the woman I remember or not, but at some time in that night I remember a tiny voice in the back of my head saying "hm, that's odd, that feels different" and I remember thinking it was just my inexperience. And I thought, O Best Beloved, I thought that I had asked the nurse to check after me on that one, but I must not have, and nobody noticed until I was gone, and I've never worked with the attending who had to deal with my mistake so all he knows is that I'm the intern who left him an unpleasant surprise, and my co-intern is the one who called him to help do an ultrasound when he wasn't sure of his positioning.
And it's not even my reputation I'm worried about, O Best Beloved, but I'm here in tears because suddenly I am terrified. And I had gotten out of the practice, a little bit, of asking nurses to check behind every initial exam, because they kept saying I was right. And I didn't stop and heed that tiny notion. And I left a surprise that could have been bad for mother and baby. And the fear is back: I'm not going to be a good doctor. I'm not going to do the little things that make the difference. Someone is going to get hurt because of me.
And we all make mistakes. But I'm so scared now.
Addendum: It's a silly thing, O Best Beloved, to sit at home alone and fret. I know it is, because I have told quinby this many many times. It's a silly thing that I am, nonetheless, very good at. But there's an e-mail client on our medical records that I can use to send in-house e-mails, and when I pulled up my charts for tomorrow's clinic I remembered it existed, so I e-mailed one of the staff doctors at the residency, a woman I admire and like a lot, who does OB in her practice. And I told her what happened, and how awful I felt, and I asked what I could do to ensure that it didn't happen again. And the response came back, flagged in red, high priority.
First of all, do NOT beat yourself up about this....it has happened to everyone including practicing Obstetricians. The outcome was fine.
Secondly, if you ever have the "thats odd" feeling, think to yourself why and figure out how to make it go away. There is an ultrasound machine in L&D and $staff_doctor will be talking about it use in L&D on Monday. So next time you'll just drag that sucker in and check AND the first couple of times you do, you may not feel all that comfortable deciding it is head on your own and that is ok too. Ask for help.
In the office, I usually drag the ultrasound machine in and do a quickie, confirm it is head down at 37ish weeks. But remember that even term babies flip! So whenever in doubt, check.
$OB_I_left_with_a_breech is one of the NICEST most polite MOST nonjudgemental of the group. He will NOT being thinking bad things about you. I think the next time you come across him if you explain how you felt and your plan to be vigilent, he'll be pleased by how much you care. If you recall, on July 1st we talked about that occasionally surprise breech deliveries happen in L&D. They don't always happen when a new intern is on. It happens to seasoned nurses and doctors.
Thanks for sharing. We can talk more when you aren't post call.
I hope it is ok with you, but we like for team leaders to know how their team members are doing. I'm going to share this with $team_leader so he can be supportive too.
And I think that nothing could have helped more. I'm feeling a little better, O Best Beloved, eating a late lunch around the lump in my throat, feeling my heart rate return to normal. Maybe I am going to make it.