You just get used to it, I guess.

The scariest time of my life was when I would go into the hospital to be the night house officer. It was July, I just graduated a few months prior after pretty much coasting the few months before that as a student. I'm alone, there's nobody else there... I could call the attending if I had to but I'd better damn well have a good reason to. Everyone's calling me "doctor" and I keep looking over my shoulder to see who their talking to before I realize that I'm that guy... They're asking me things like "can I give this medicine early" or "this guy's combative, what do you want to do" and "I think they're in a-fib now, what do you want to do?"... like I'm supposed to know. BECAUSE I'm supposed to know. I'd been taught all these things and on a multiple choice exam, I'm sure I could've gotten all the right answers. But now, I'm looking at someone's grandma throwing punches at nurses because she's delirious and I've never had to order Haldol for someone before. Is it safe to go IV? Will it even work IM? What are the contraindications for Haldol? What the hell dose of Haldol is reasonable and customary? Is there something I'm missing? Is she having an MI? A PE? Urinary retention? Abdominal catastrophe? But... you have to do something... everyone is looking at you, sizing you up, wondering if you're gonna be one of "those" residents, all while this poor lady is in her own living hell and you feel horrible for her. So you do what you've been trained to do and lo and behold... she's chilled out after 5mg of the good stuff.

Rinse, wash repeat for situation after situation. And sure, you'll screw up. Or something bad will happen that nobody thought could. I gave a patient a beta-lactam antibiotic one time after being reassured that she'd never had any allergies to meds and had taken penicillins before just fine. She went into anaphylaxis, wound up on a vent, had a bunch of horrible adverse outcomes... still lived and walked out of the hospital but I'll never forget that. Even still, I'd do it again. She had a bad reaction that nobody could've forseen. It would have been irresponsible to have given her a different med because beta-lactams are the drug of choice for her infection.

I guess... you just have to press through. You have no choice BUT to become comfortable with things. And the more you do them, the better you get. And you try not to ruin anyone's life, but at the end of the day, you do the best job you can. Leave it on the field and what happens, happens. You will screw up. Very likely, you will kill someone at some point in your career. We all take that with us. You just have to move on and be better next time. There's still the next patient who needs you.