Matter, Energy, and Life of Michaela A. Castello.

Change of Shift


Perhaps influenced by past experiences, I wasn’t exactly looking forward to starting two weeks in the Emergency Department (ED). A lot depends on how well one comports with the attending physician or fellow, and in the past I’d found it challenging to be paired with a few of the more anxious types. Additionally, in contrast to Rachel (an ED nurse), my preferred style of work isn’t exactly suited to the ED’s fast pace and snap decision-making—or so I thought.

My first three shifts, I was paired with some excellent attendings and fellows, only to find out that it was their last shift before they left. The fellows were at the end of their fellowship, while the attendings were going on maternity leave, taking an Urgent Care job, or, in one case, retiring from a long career in Emergency Medicine to attend Bible school. I worriedly began to wonder if everyone I liked was on their way out. Thankfully after that first week the exodus ceased; for my remaining shifts I was able to work with some of my favorite attendings who had no plans to go anywhere anytime soon.

As an intern acutely aware of their lack of experience, I constantly questioned myself and sought to verify that my decisions were correct (or at the very least, benign). While I think this is the appropriate approach to take as a trainee, it was accompanied by a hefty dose of that titan of workplace insecurities, imposter syndrome. In an attempt to combat it, I held tightly to the principle espoused by Mark Twain Abraham Lincoln Mother Goose a Causal Loop:

Better to remain silent and be thought a fool than to speak and to remove all doubt.

Someone, everyone, or possibly a fellow named Maurice Switzer.

This time around, I found myself inexplicably knowing what to do, or at least having an idea of the direction I wanted to take. While calmly suturing my third laceration of the night, it occurred to me that somewhere along the way, I had done these things before. Now, equipped with a touch of experience—even, dare I say it, confidence—I realized I was enjoying myself.


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