Medical mistakes—how to heal guilt, shame, and self-blame →

Late last night I got this email: “Hello I am a nurse struggling with a medical error that may have led to a patient death and I need support.”

I texted her:

I called her just after midnight.

I asked how she found me. She said I was the only one offering support groups for medical mistakes. She gave me permission to publish this in hopes of helping others.

Three years into her nursing career working in a busy US urban hospital, she had just come on shift when one man who had been up in bed eating breakfast and speaking with her 30 minutes prior suddenly died. His code was a dramatic, gruesome scene.

Afterwards, the doctor told her she did nothing wrong. Yet ten years later she still blames herself for his death.

“Did I kill him?”

“Is it my fault?”

“Should I contact the hospital CEO?”

She still has so many questions.

Why?

All unexpected deaths require debriefing ideally within 24 hours.

Without peer support, we’re left in professional confusion and emotional isolation.

Knowing the cause of his death would have allowed her to (1) make sense of the situation; (2) learn how to help similar patients in the future; and (3) prevent a decade of intrusive thoughts.

This nurse needs closure.

Like a movie ending in a “cliffhanger,” the viewer leaves with unresolved questions. Without a sequel, viewers feel forever frustrated.

Suppressing feelings and sensations (subconsciously gnawing away at her) does not resolve suffering as buried memories continue to resurface.

Patient death PTSD happens when the visceral experience of witnessing a death is stored in your body. Sights, smells, and sensations take you back to the death scene instantly without warning.

Who is to blame?

Not the nurse.

Hazardous hospital conditions with understaffing lead to overwork, poor supervision, communication breakdown, and medical mistakes.

Unexpected patient deaths are not always caused by mistakes.

This nurse couldn’t have averted his death. She just happened be on shift as a witness.

Without a confirmed cause of death, perfectionists default into self-doubt, self-blame, and self-harm that may end in suicide.

Perfectionist people pleasers with savior complex often develop in childhood as parentified children trying to help parents with health issues. As a child, this nurse desperately tried to help her parents’ mental health issues. Her career motivation began with the desire to save her loved ones. Being unable to save this patient may trigger her deep-seated pain of being unable to save her parents as a child.

On a spiritual note . . .

Survivors of near-death-experiences report a state of bliss on the other side. Most don’t want to return to the pain of human life. So this man is now a free spirit.

“The most generous thing you can do now is to allow him to be free by not using him to punish yourself.”

“Doesn’t he want revenge?” she asked.

“No. He wants you to be free of your suffering.”

We spoke for one hour and 25 minutes.

By the end of our call, she felt she could finally sleep.

After ten years of dark thoughts, she can now rest in peace—without dying.

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Hospital fines doctors for keeping patients healthy →

Hospital taxes doctors for keeping patients healthy.

To care for patients in the hospital, docs have to be on staff and pay yearly dues. I was paying $300/year. Then I got a bill for $700. Why? I only had one patient in the hospital last year. Docs admitting more than 25 patients/year still paid $300. I got fined because my patients were too healthy.

Same thing with my friend in his residency program. He helped his patients quit smoking, lose weight, reverse their diabetes. His program director called him into his office. He thought he was getting an award. Instead he was reprimanded for not generating enough money for the hospital with cardiac caths and other expensive tests. He got punished for keeping patients healthy.

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Can’t pay your hospital bills? Call 1-800-U-R-FUCKED (Seriously) →

Can’t pay your hospital bills?

Call 1-800-U-R-FUCKED (1-800-873-8253).

Seriously.

This is my Catholic hospital.

“Thank you for calling PeaceHealth Patient Financial Services. To make a payment, request an itemized bill, hear your last payment, or check your balance, press one . . .”

The nuns would never approve.

To work here, we had to memorize and recite this mission statement: “We carry on the healing mission of Jesus Christ by promoting personal and community health, relieving pain and suffering, and treating each person in a loving and caring way.”

Problem with MBAs running nonprofit hospitals is I had to see so many patients per day I couldn’t fulfill that beautiful mission.

The hypocrisy made me physically sick.

So I quit and opened a community clinic where I’ve never turned anyone away for lack of money—to finally provide the love and care people deserve from their doctor.

Pamela Wible, M.D., has helped hundreds of doctors launch ideal medical clinics in their communities. Want to break free from assembly-line medicine? Contact Dr. Wible.

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Doctor uses marijuana for menstrual cramps loses medical license →

Sign petition to stop PHP abuse

In a state where marijuana is fully legal, a doctor uses marijuana tincture 3 times per month in evenings after work around time of her menses. She was working part time at a hospital. Was asked by hospital to work full time. She said okay.

They said, “You’ll have to do an employee physical and that will include a drug test.”

She said, “Just so you know I’m using marijuana tincture 3 times per month around my menses after work, never at work.”

They say no problem whatsoever. Just go do the test. Test comes back positive for THC.

Hospital lawyer is like ummm . . . “Just go get cleared by the PHP.”

She just sort of blindly submits (and this unfortunately happens all the time that people who have no knowledge of PHPs through no fault of their own they just don’t know anything about them). Then what happens is what happened to this woman. PHP says she’s got to go out of state for a 4-day evaluation at a cost of $6,000.

She says, “What? Wait a second.” Then (realizing she’ll lose her career if she refuses) agrees to go.

I read the records so this is not second hand. They did a hair sample which showed no THC (hair samples provide a 90-day window), diagnosed her with severe marijuana dependence, and said you need to stay here for 60 days at a cost of $60,000.”

She said, “I can’t do that. I’m the first person in my family who has gone to med school. I’m 3 years out of training. I can’t afford that.”

They said, “Isn’t your career worth it?”

She said, “I’m going to think about it.”

The second she started to walk away, that program called her PHP and said she was noncompliant. PHP called the board of medicine in her state and said she’s noncompliant. Board forced her to sign a “voluntary” agreement not to practice. She did that. She hasn’t worked as a doctor in the last 7 or 8 years.

Per J. Wesley Boyd, MD, PhD, Psychiatrist, Director of Education in the Center of Bioethics at Harvard Medical School.

View full podcast interview here.

Have you been harmed by a PHP? Contact Dr. Wible for free help.

Sign petition to stop PHP abuse.

Doctor loses license for using marijuana for menstrual cramps

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Physician “Health” Programs: Complex Problems & Solutions →

THE COMPLEX PROBLEM OF PHYSICIAN HEALTH PROGRAMS.

Livestream Q & A Saturday 4/27/24 @ 10 am PT (1 pm ET). Watch replay above.

Are physicians being extorted? Livelihoods threatened and doctors coerced into expensive hospitalizations for minor issues while facing threats of polygraphs and drug testing as a weaponized part of their treatment plans? Join physicians, J. Wesley Boyd, MD, Professor of Medical Ethics and Psychiatry at Baylor College of Medicine. Pamela Wible, MD, who runs the only physician suicide helpline in the country and Kernan Manion, MD, the founder and Director of The Center for Physician Rights. As we explore the issues with these three physician leaders as we do a deep dive into the Complex Problem of Physician Health Programs. You can sign up on LinkedIn, Facebook, and YouTube. If you ask questions during the livestream, and we will do our best to answer them on the air.

 

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