Why it is good to share our vulnerabilities .

Dr Anne Stephenson GP in Torquay , Victoria . She is also the GP liaison officer at Epworth Geelong Private Hospital , Victoria .

HAVE many faults , but when I use the last skerrick of toilet paper , I put another roll on .

Admittedly , this was not always the case .

Many moons ago , in my early 20s and queasy post-party , I was hanging out with some uni classmates at a friend ’ s kitchen table when the friend ’ s burly father unexpectedly burst in .

“ Who left this ?” he growled , brandishing the empty toilet roll . A deathly silence ensued . Red-faced , I meekly admitted that it was indeed me who had left the offending roll on the holder .

In this case , it was probably no coincidence that my friend ’ s father was an esteemed surgeon and was accustomed to throwing his weight around .

Sadly , feeling ashamed for making a mistake is commonplace in medicine . Just last week , the empty toilet roll memory came flooding back . I gave an immunisation that was meant to be administered subcutaneously , and I had given it intramuscularly .

The poor woman got a nasty local reaction , which was vividly photographed , recorded in her notes and shown to me by one of our practice nurses .

“ Surely , Anne , you didn ’ t give it intramuscularly ?” the nurse said incredulously . “ You wouldn ’ t have done that ; would you ?”

I felt like crawling under a rock ,

desperately not wanting to own up .

I have a perpetual low-grade fever of self-doubt that lies dormant most of the time , but when I make a mistake , the fever flares into a roaring sepsis .

There are the weeks of waking in the middle of the night with Pythonesque

images of horror .

Nightmares of blackened , scarred limbs ; emergency doctors shaking their heads at the incompetence ; and newspaper headlines of ‘ Doctor misses obvious diagnosis with dire consequences ’.

Despite most doctors being conscientious , we are also highly

neurotic about making mistakes .

Many young doctors are particularly vulnerable to this , and when something goes wrong , they believe their incompetence or inexperience is to blame .

It does not help that the wider community expects perfection from

My perpetual low-grade fever of self-doubt flares into a roaring sepsis when I make a mistake .

the medical system , and it is not shy to share stories of another doctor ’ s perceived incompetence .

Mistakes are part of life and help human beings to learn . Usually , when you do make an error , you do not make it again .

Every time I am faced with an empty toilet roll , I flash back to

PICTURE CREDIT

that moment in my friend ’ s kitchen and go out of my way to replace the empty roll .

To fully learn from mistakes , it helps to explore what happened . But doctors worry about openly sharing mistakes .

We fear being embarrassed and losing face in front of our peers . Subconsciously , we believe making a mistake reflects a failure of our entire being and that we have failed to live up to what is expected of us .

Openly discussing adverse events in a safe place can provide enormous relief for medical professionals . Done well , these discussions can prevent us from being too hard on ourselves .

By unpacking all the factors that contributed to the error , we are likely to find that systemic factors also played a large part in what happened .

I recently rewatched Professor Brené Brown ’ s fabulous TED Talk , The Power of Vulnerability .

Professor Brown , now a household name , shares her personal journey of studying vulnerability .

She begins by acknowledging that vulnerability is often seen as a weakness , something to be avoided or hidden , and she shares her own struggle with perfectionism .

But through her research , she has discovered that vulnerability is actually the birthplace of courage , creativity and connection .

She defines vulnerability as “ uncertainty , risk and emotional exposure ” and emphasises that it is an essential part of living a wholehearted and fulfilling life .

In my opinion , Professor Brown ’ s TED Talk should be compulsory viewing for all doctors .

Can we change the way we think about making mistakes by doing less shaming of individuals and more normalising and learning ?

Here are a few suggestions :

• Create an environment where people feel comfortable discussing their mistakes without fear of judgement or retribution .

• Openly share your own mistakes , especially as senior doctors , and what you have learnt from them with your team . By being vulnerable and showing that mistakes are a natural part of life , you can help normalise the experience for others .

• When someone makes a mistake , focus on providing constructive feedback rather than solely pointing out the error . Importantly , also give positive feedback whenever you can .

• Incorporate mistake-making into education and training for trainee doctors . Teach them how to learn from their mistakes , develop resilience and bounce back stronger .

It is time to unlearn perfectionism in medicine .

Let ’ s be kind to ourselves and others when mistakes happen .

And then work on what we can do to prevent the error happening again .

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