when medical students practice drawing blood on each other…

Things are bound to go wrong. All I could hope for was that they would not go wrong when I was the guinea pig (but I sure did feel sorry for whoever my victim would be since I had very limited experience). So when it came time to pair up for this painful exercise (did I mention that I’m extremely squeamish when it comes to blood, especially my own?), I tried to pair up with a classmate who was well-versed in this skill (i.e., one who was very active in the free clinics). Well, I guess that was everyone else’s idea as well. I ended up with the oldest member in our class—I told myself that she would at least be super careful since she was so much older and wiser than me. Well, I went first. She turned out to be squeamish about blood draws too, which just made me all the more nervous. But I’m proud to say that it went off without a hitch. Yay! Pat on the back for me!

So then came my turn to be the victim. She was more nervous about it than I would have liked. Do you mean that you have really never drawn blood before?! I think I’m in trouble now. She eventually got to actually sticking the needle in, which I of course, could not and did not watch. So there’s the prick. Owie. Don’t be a wimp. Seems like everything’s going okay. I think I can look now. So I take a peek, expecting to see a needle sticking out of my arm with blood flowing neatly into the Vacutainer tube only to find that there’s blood everywhere! I still don’t really know what happened except for that she panicked for some reason (even though everything was okay) and pulled the needle out and then there was blood everywhere. I didn’t react as badly as I thought I would have (i.e., I didn’t faint dead away at the sight of all of my blood not in me or in the Vacutainer tube), but I was definitely not about to let her try again on my other arm (and she didn’t want to anyway).

And that should have been the end of my blood draw guinea pig experience. But curious med student that I was, I still wanted my blood drawn because the medical technologist trainees were going to run some tests on the blood and I (irrationally) wanted to see if anything was wrong with me. So, since I didn’t want to risk another botched attempt, I found a med tech (and not a trainee) who was supervising the whole ordeal to draw the sample. I wasn’t too apprehensive since these med techs are certified phlebotomists and should know what they’re doing (or so I thought). And this time I watched. Okay, good. No blood everywhere. Everything should be okay now. But it wasn’t. For some reason, instead of just leaving the needle in place once the blood started flowing out, this med tech (who must like making people suffer) just kept pushing the needle further and further in. Not further into the vessel but further down (as in, aren’t you going to go through the vessel?!). I kept my mouth shut because I didn’t want to risk any further blunders. Besides, a certified phlebotomist should know what she’s doing. Who am I, lowly med student that I am, to question someone who’s been certified to do this? But when it started hurting, I had to say something. She could have been stabbing a nerve and I really need my right arm! So I told her as nicely as I could that she had the needle in too far. She apologized and pulled it back a bit. And then she proceeded to start pushing it in again! I complained again and she pulled back again. And then she pushed it deeper again! Now I really just wanted this over with, so I just withstood the pain until she was done. But what was once a semi-healthy-not-so-bad fear of needles and blood draws has probably turned into a crippling one. I don’t know for sure since I haven’t had my blood drawn since. And my arm hurt for a good three months after that. I’m just lucky no permanent damage was done. This guy wasn’t so lucky.

A little awhile ago, I wrote about an imaging system that projects veins onto the skin, which aids in the identification of veins for venous access. Would it have helped in my case? No, not really. The problem wasn’t in finding the vein. The problem was in doing the procedure right. And that’s why it’s important that we practice, practice, practice even though it’s really not pleasant (for us or our victims) to be so inept at it. Nothing can really help us become not-so-inept except for experience. And experience involves making mistakes so that we don’t keep making them in the future. So, to all of those patients (and fellow med students) out there who put up with being stuck by med students: thank you.

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  1. blood draws made simple?While I was pretending to be productive at lab today, I came upon this article that describes an imaging system that projects veins onto the skin, which aids in the identification of veins for venous access. “What a neat idea!” I thought, almost jumping out of my chair to tell someone before remembering that I was supposed to be “working.” If only they had something like this device to guide us poor med students through our first clumsy-not-so-pleasant-for-our-poor-victims blood draws! Especially when our poor victims are each other. I know I haven’t seen my inflictor of pain (and emotional trauma) quite the same way ever since that fateful practice blood draw day. Maybe this device could have prevented that. Or maybe not. It costs $25,000!!! But it’s still super-neat to me! Oh, and it also gets bonus points for its other use as a method to verify identity (think fingerprinting and retinal scans)....
  2. ah, med students…They’re so amusing.  On Monday, I was driving to the lab early for once because of the fact that I had a clinical study to be at by 8:00.  Driving to the lab early is no fun because that’s when everyone else goes to work and it makes for a lot more traffic than I like.  After having finally navigated myself off of the freeway, I ended up in the long line of cars in the right turn lane for the street where the medical center is located.  This line takes forever because the stoplight never stays green long enough and because of the idiots who cut in at the last minute because they think they’re too good to wait in line like the rest of us.  So while I was waiting this morning, I noticed a black Prius stop behind me.  “Cool, a Prius!” I thought to myself (I wasn’t driving my new one yet at the time).  Upon further examination in my rearview mirror, I figured that the driver had to be a med student.  Why?  Well, because he was wearing a white coat.  Of course, he could have been a doctor.  But the dead giveaway was the fact that he was wearing his stethoscope around his neck.  While driving to the hospital?!  I understand that during the course of a busy day of seeing patient after patient, that you just might not have time to put your stethoscope into your white coat pocket (and that it gets...
  3. these experiments may not be a complete loss after allMaybe I've been inhaling too much waste isoflurane the last couple of days, but I seem to be deluding myself into believing that these failed experiments of mine are actually useful in the most minute way.  You see, I prepare all of the monitors, IVs, and catheters for these experiments, which has taught me how to do such things and what to check when I'm trying to explain an anomalous reading.  Not only that, but I've gotten plenty of experience with reading pressure curves to guide the placement of a Swan-Ganz catheter.  I also know what to watch out for when an animal is under anesthesia. But most importantly, I've learned how to not freak out and freeze when something goes wrong.  Not so long ago, I accidentally pulled a stopcock out on a pressure line and froze, letting blood ooze out from the line onto the ground until the surgeon fixed it for me.  Yesterday, I forgot to close a stopcock and blood started oozing back precipitously into the line.  But instead of panicking and freezing, I traced the problem to the stopcock and closed it myself, leaving no one the wiser.  And today, as I was helping the surgeon introduce a catheter into the external jugular vein, he turned away and the catheter popped out, resulting in a nice stream of blood shooting straight out (surprising considering it was a vein).  While he freaked out for a second, I merely pulled back on the ties around the vessel...

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