FT: Shay Montgomery
She forgot the drug bag.
Fresh off orientation as a flight nurse. Scene call. 80% TBSA burn victim who needed an airway immediately.
No paralytics. No drugs. Nothing.
Shay Montgomery, flight nurse and educator, sat with the shame of that moment for a long time before she could actually learn from it.
Then she started researching. And this is what she found.
THE MISTAKE WASN’T JUST CARELESSNESS.
Your brain creates task brackets — automated sequences of small actions bundled together so you don’t have to think about each one. That’s how experienced providers make complex calls look effortless. They’ve got a deep library of brackets built through thousands of repetitions.
But it takes 30-45 days of daily repetition to build a single bracket. Until you have them, you’re improvising. And improvising under chaos is where mistakes live.
THREE THINGS THAT ACTUALLY HELP:
- Change the question on your checklist.
“Do I have everything?” → your brain says yes. Automatically. Even when you’re wrong.
“Where are the things I need?” → forces your brain off autopilot. Physically locate and point to each item. - Get the first habit right.
The first version of a habit is permanently wired in. You can build on top of it. You can suppress it. But it never disappears. Under enough stress, it comes back. Get it right early. - When someone makes a mistake — support them.
The knowledge of the error is already punishing enough. What they need is peer support and a system fix. Punishment doesn’t prevent the next error. It just traumatizes the provider.
This week’s episode is one of my favorites because Shay is honest in a way that most clinicians aren’t, and the science behind what she shares is directly applicable to your next shift.
Build habits. Get 1% better each day. Focus on the process not the outcome.
