I've learned to take on big challenges the same way you eat an elephant: one bite at a time. I've walked confidently in every adventure I've undertaken, especially in the OR. Unfortunately, that attitude hasn't always prevented me from occasionally ordering up a big slice of humble pie. Especially in the OR.

It always happens the same way. Things are going smoothly. I'm thinking, "Damn, I'm good." Then I fall on my backside and it's 28 years of cool — yes, I've been an OR nurse for that long — down the drain. I'm not the only one who sometimes feels less than sure of myself, but when you foul up as described below, you're on that stage all by your lonesome.

• The fall. You're efficient and light on your feet as you hurry around the room, then you're not. When you fall, it's either before you realize what happened or it's in super-slow-motion. You'd like to think you look like a cat landing on its feet, unruffled. Instead, you're another four-legged creature, grazing. You ask yourself, "How many people saw that? Can I salvage my dignity? Did I break anything? Can I get a day off out of this?"
• The errant pass. Sometimes you're passing instruments on a case you've never scrubbed in for, or even seen, before. What's more, the surgeon you're working with has actually operated on you. Naturally, you want to do a good job. And you do — until you inadvertently slap the wrong end of an open towel clip into his hand. Slowly the surgeon turns to you, the towel clip hanging from his palm, and asks, "Have I done something to you? Did I fail to give you enough pain meds after your surgery?" Where's a good sinkhole when you need it?
• The brain drain. There's nothing like precepting a student or new employee, impressing them with your skills and knowledge as you serve the surgeon's and the patient's needs. It's all good until the surgeon asks for the autotransfusing drain and you hand him the big sterile roll, which certainly looked like the drain from across the room. As you hustle out of the room to get the drain, you explain to the newcomer that the circulator should always check for the drain in advance, and should of course be able to tell the difference between a roll of cotton and a rolled-up, packaged drain.
• The flash. Circulating for an all-male total joint team, you're feeling like the only girl on the football team. The surgeon, a man of very few words, is waiting for you to finish the prep and tie up his gown. As you turn to discard the prep trash, the OR table snags your scrub top, unsnapping it all the way down, and you pretty much flash the surgical team. In that moment, the only sound is the anesthesia machine. You are thankful that you started wearing camisoles beneath your scrubs, that there were no cat calls and that the case went on as though nothing happened. Afterwards, the surgeon begins to leave, then turns back. "Every once in a while it's nice to see a good, healthy shade of pink," he says. "Thanks for a good day."

Sometimes I can't pronounce the words. Sometimes I forget the one thing the surgeon loves for a case. Sometimes malfunctioning equipment drives me to a rage, particularly when the problem involves the on/off switch. I'm not the perfect circulator, but I am human, taking care of other humans, and still loving it.