Dealing with Stress in the Workplace

I have been working my current hospital job as an ultrasound tech for about four months now. Ten if you count my time as a student employee! My confidence and speed have significantly improved. But I’m not sure anything could have prepared me for what went down a couple of weeks ago. I typically work second shift with at least one other person. Now my manager had me scheduled to work three consecutive overnight shifts alone! Talk about being intimidated.

My first night I scanned eleven patients in my ten-hour shift. That may not seem like a lot to some, but it is when you consider that you have to look up the patient’s medical history; either go to the patient or bring the patient to you; get the machine and patient set up; perform the scan; return the patient; clean up the room; write up your impression sheet, scan it in, and complete the exam. And let that patient have COVID. There is even more of a process to go through upon entering and exiting the patient’s room in this case.

That was a lot, but it was the second night that shook me. I think I scanned eleven patients that night as well. Like the previous night, I didn’t sit down. But unlike the first night, everybody who had ordered an ultrasound exam was looking for me. They needed me to be in three places at once.

I was in the middle of performing a stat transvaginal exam on a COVID patient when someone from the radiology core knocked on the door, cracked it, and let me know that labor and delivery was calling because they needed me stat. She proceeded to ask me when I could get up there, to which I responded, “It depends on what other stats have printed.” She let me know that this patient in labor and delivery was a super stat. And I’m thinking, “Oh God, I’m not done with this patient, and when I do get done, I’ve still got to clean my machine and write up my impression sheet before I can look up the next patient and get upstairs. And who knows what else has been ordered. Help!”

I finally make it to labor and delivery after what feels like forever. The baby has no heartbeat. But they knew that – that’s why they ordered the exam. So was it super stat? I don’t know. I finish that exam as quickly yet thoroughly as I can so that I can get to my next stat exam – another OB – but this one was less than 14 weeks along. She was in a lot of pain. As soon as I put the probe down, I knew we had a problem: That baby was coming out. What I didn’t know is that the baby would come out on my watch. Shortly after I had the patient empty her bladder for the next part of the exam, fluid started leaking. I knew I had to get the patient’s ER nurse ASAP. The ER called the rapid response team. My patient was stable, so in retrospect, I should have made it clear that there was no need for a rapid when I got help.

But alas, I did not. So my manager heard about it – of course. Once the patient was out of my care, the same person who had coming knocking on the door earlier that night knocked on the door to the ultrasound department. I opened it, and the first thing she said was, “Do you need a hug?” YES! She had never met me, so she asked if I was new and then proceeded to tell me that I am only one person and to take those patients one at a time. Do the super stats first and then go from there. She also said that she had to use this as a teaching moment: Call for the rapid response team. I apologized and told her that I didn’t know that that was what I should have done in the case of a miscarriage. So I learned: When in doubt, call a rapid!

The following night was much better. I only scanned eight patients, and the board was clear by the time the day shift person got there. When I returned to my regular second shift schedule, my manager did talk with me about the night I failed to call a rapid. She told me some things that I could have done differently. In the end, it was okay. I’m still learning and I was all alone. But now I know what to do if and when something like that happens again.

I was so much harder on myself than anyone else was on me. I am still learning to be gentle with myself, and even though everyone expects me to come NOW, the reality is that I just cannot do that. Everyone has to wait their turn and trust that I am doing my best and that I will be there as soon as I can get there. The key is to keep pushing through it even when you feel like giving up. If you need to call your on-call, do that. Even if it is 3 o’clock in the morning. And remember to breathe. You WILL clock out.

Signed,

Lai