I’ve always believed in the “sisterhood”. Not in a way that excludes men, but that in all walks of personal and professional life, a band of females can support each other and be each other’s cheer squad. That rather than feel threatened by each other, or even stomp on each other in order to elevate ourselves, we can prop each other up and be stronger together.
Something happened recently that tangibly demonstrated to me why this sisterhood is so important, and why it has a unique advantage over a regular support network.
About a month ago, I messed up. I’d like to think that it wasn’t my fault – and, believe me, I spent a few moments trying to divert blame away from me – but I couldn’t escape the reality that I was accountable and that I needed to own my error. As the story unfolded, I was desperate for someone – anyone – to rescue me: to minimise my failure, and to make me feel better.
What I learned was that, sometimes, only another female knows exactly what it is you need. Here’s what happened:
I was back at work after a few weeks off and was working the weekend evening shifts. They start at 1730h and finish around midnight – if you’re lucky and are able to leave the night shift staff to get on with the task of running the Emergency Department overnight. On Sunday night, I was on call for emergencies until 0730h the following day.
I woke up the next morning around 0600h and checked my phone to make sure that I hadn’t missed any calls – even though I am a very light sleeper and the sound of a feather falling on carpet would normally wake me.
The screen was clear and I thought “Wow – that’s a lucky on-call”. Indeed I felt quite refreshed. I got out of bed to get ready for a non-clinical shift and put my phone on charger. It was an ageing phone and was now on Low Battery.
I picked up my phone again as I was leaving home around 0730h and noticed that it had switched off. Likely the charger cable hadn’t made a connection with the phone and the battery had died. So I plugged it in again and powered it up.
“2 missed calls”
I thought it was probably my mum kindly checking that my weekend had been okay and I absently checked messages.
“Hi Shahina. It’s Sandra from work. We have a patient in Resus who is very unstable and is deteriorating rapidly. Can you please come in?”
My heart felt like it stopped beating as I checked time of message: 0655h.
The vasovagal response was swift: I felt the blood drain from my face and my mouth go dry. My sympathetic drive followed quickly: sweaty palms, racing heart, a buzzing in my brain.
What to do now? It was 0735h – 40 minutes later. Morning handover would have started, the early team (including consultants) would have arrived. Almost certainly the clinical situation will have been resolved, one way or another. There was nothing to gain by me driving in at speed now.
The nurse who phoned me would have handed over and gone home. The Night Registrar, Caitlyn, would now be occupied in the medical handover. Likely, an early shift team would have taken over care of the patient. Figuring that it would be untimely (and unhelpful) for me to phone the Caitlyn now, I texted her: I’m so sorry I missed the call. What can I do now?
As I was working out whom I might call for an update, I received a text from my colleague who had worked with me the previous evening: Are you okay? They were trying to phone you for a Resus this morning.
I phoned him immediately. “Jack, I’m so sorry. I am absolutely mortified. My phone switched off and I only got the message now. Do you know what happened to the patient?”
“Oh that’s okay. They managed to get hold of me and by the time I arrived, Rowan had come in early for his shift, and we sorted out the patient”.
“Gosh. I’m so grateful you were both there. I feel absolutely awful. Thanks for dealing with it. I promise I’ll sort out my phone”.
“That’s okay”.
What I most wanted to do next was to dig a big hole in my yard, crawl into it, and not come out for two or three days.
I guess what I was most feeling was shame: that I had been so unreliable, that I had let down the night shift team (despite my parting words: “Please don’t hesitate to call – it doesn’t have to be a big reason – I know sometimes you just need a friend”), and mostly that I had potentially compromised the care of a patient.
However I got into my car and drove in to work. My initial thought was “Who can I call that will make me feel better?” But I felt too overwhelmed even for this. I considered switching on the radio at loud volume to help distract me.
Thankfully, I remembered the mindfulness practice that I am supposed to be championing.
I recognised that I simply had to own what I was feeling in that moment: the shame, the feeling of being lost and not having an answer, indeed (despite the dramatics) the horror of what this all felt like for that period of time.
I desperately wanted to fast-forward two or three days, so that I could regain some perspective, and so that the ugliness of that moment would be diminished.
However, I recognised that I simply had to immerse myself into all of the negative emotions: to acknowledge them and label them for what they were. I discovered, once I did this, that I stopped fighting them and trying to make them go away – and that brought with it an odd sense of relief.
Further, it allowed me to recognise that this moment would run its course – for however long it needed to – and then it, too, would pass.
But, for now, I needed to own all of it.
Once I arrived at the hospital, I resolved that I would try to find Caitlyn, whom I had let down, in order to apologise and to check that she was okay now. And that I would then find my boss, own up to my error, and promise to be extra-careful about being contactable next time.
As I arrived into the department, I ran into another colleague. He stopped to kindly ask me how my holiday was. My response was abrupt, “Troy, it’s really nice of you to ask – and it was lovely – but I’m a bit distracted as I missed a Resus call early this morning and I want to go see what happened”.
“Oh yeah”, he replied, “I heard about that”.
Immediately my girl-brain checked through my “You failed” list:
- He had heard about the patient?
- He had heard about how the on-call consultant had been uncontactable?
- He had heard about how it was me that had let the whole night team down?
Dejectedly, I walked toward the Resus area and met Rowan.
“Rowan, thanks for being here to look after this patient. I’m really sorry I missed the call. I feel terrible”
“Oh, no problem. He was in a really bad way, but we sorted out a plan for him”.
“Is there anything that needs to be done for him or his family now?” I asked, desperate to still contribute somehow.
“No, he’s nearly ready to be moved to ICU. It’s all done”.
Finally, Caitlyn, the Night Registrar, had a chance to respond to my text with: Please don’t worry. Call me if you want.
So I did and I met with her in the Resus area.
“Caitlyn, I feel absolutely mortified. I am so sorry that I wasn’t available when you called me”.
She responded with: “Shahina, it’s completely fine. As it turned out, help came quickly and the patient is stable now. I know you would never just not come in.”
Then she continued, “Actually, I feel really bad that I had to call you at all. I’m at the end of my training and perhaps I shouldn’t even have needed help”.
So we sat down together and ran through the case. She described how the patient had been difficult to ventilate, and she had been through the algorithm to try to address this.
When the early shift consultant arrived, he directed that the endo-tracheal tube (ETT) be changed, but that as they were preparing to do this, some material was finally suctioned up via the ETT and ventilation improved.
She said it seemed the tube-change was suggested as if it had been an obvious and over-looked manoeuvre but that she had in fact considered it and decided to defer this: it had been a Grade 3 larynx, the platelet count was low and there was already bleeding in the airway, and the suction catheter had passed through the tube without obstruction.
But she chastised herself: “Perhaps I should have known to just change the tube?”
We discussed that she had rationalised her approach, and had actually made a reasonable decision, with a back up plan of proceeding with a potentially difficult tube-change (with ICU and Anaesthetic assistance) if the problem persisted. I assured her that she had acted at the level of a highly competent senior registrar/junior consultant, and that I was likely to have taken the same approach.
In that moment, I realised that she needed the reassuring conversation with me as much as I needed it with her.
You see, we just understood what we needed from each other. I needed to be reassured that I was a competent senior consultant, that I was considered to be reliable and supportive, and that this event would not tarnish my reputation for being so.
She needed to be assured that she was ready to take on a consultant role, that calling for help was not a sign of weakness or failure, and that her approach to the clinical challenge had been a good one.
I had to pass by three men (and perhaps she had too) before I found the one woman who would say the words I desperately needed to hear – and who would give me the opportunity to still contribute to the situation, simply by supporting her.
The men were not being unsupportive or insensitive. Really they were just saying “We got this – calm down”.
But, apart from being reassured that the patient was okay, I needed someone to hear that I was distressed and that – as needy and self-indulgent as it might be – I really just wanted to feel better about myself.
It is likely that my female colleagues and I are more sensitive to failure, or even a perception of failure. Our standards are high and our judgement of ourselves is harsh – we are simply not very kind to ourselves. For the record, I actually believe that men are equally vulnerable, and often just need to be given the invitation (and permission?) to open up.
So we all need to be incredibly kind to each other, and just be available for each other. But sometimes, only a gender-specific touch may offer exactly what’s needed.
We need to be courageous enough to share our vulnerability openly – to out ourselves as being imperfect, and to acknowledge that we are a little fragile sometimes – because by doing so, we strengthen and empower each other.
It is this reaching out with our own individual vulnerability that – in a strange way – allows us to be stronger together.
My colleagues’ names have been changed to protect their identity.
