“So,” said my tutor. “I’d like one of you to stay here and take morning clinic, and one of you to go to the treatment room.”
Oh, did I not mention that the learning curve between second year and third year is not dissimilar to Kilimanjaro?
I wasn’t too worried about taking clinic. This is a marked contrast to how I would have felt in the summer, when I spent some time sitting in on clinic with my old VS tutor and freaked out at her recording a patient’s BP in the notes without checking that I’d got it right. But my clinical partner and I have been assigned to this practice since October. We come in on one day a fortnight and we run the patient list together, and it’s not so scary as it once would have been (which isn’t to say that I didn’t flail horribly at my first attempt and again at my second attempt, or that I’m not enormously grateful for a GP who watches closely and steps in when we start to look hopelessly lost). I couldn’t say the same about going to the treatment room, a benign-sounding phrase that translates as, “I would like you to spend the morning doing bloods.”
I am not one of the growing number of medics who work as part-time phlebotomists. I’ve done two blood draws: one at the beginning of second year when an extraordinarily understanding FY1 offered himself up as a test subject, and one in the middle of last term when I was instructed to practice on a colleague and made a complete hash of things. I was despatched to the treatment room, and knocked on the door with shaky hands.
“Well, as long as she knows what she’s doing,” Patient 1 said, eyeing me dubiously.
“I think it might be better if I just observed this one,” I squeaked at the nurse. “If that’s OK.”
This is as close as you’ll ever get in medical school to shouting, “ARE YOU CRAZY? I DON’T HAVE A CLUE WHAT I’M DOING. IN FACT, I’M THINKING ABOUT RUNNING AWAY TO MEXICO.”
Patient 2 was trembling worse than me. “I don’t know. I’m not sure if I’m comfortable with a student doing that. It’s nothing personal, I’m just not that good with needles.”
I was fine with that. I got out of the way, and chatted to him about his new baby while the nurse took blood. I don’t know if I helped, giving him something to focus on other than the needle in his arm. Maybe.
Patient 3 set her bags down, took off her coat, and beamed at me.
“No, of course I don’t mind,” she said. “I’ve got good veins, and you’ve all got to learn!”
I’ll never forget this patient. I stumbled over putting my gloves on, I forgot how to use a tourniquet, I had to be helped with getting the sterile top off the needle, I realised far too late that I hadn’t got all my bits and pieces out before starting, and I couldn’t keep the needle from moving around inside her vein. I swore very loudly in my head and offered profuse thanks to the nurse who kept me from panicking too much. But when I was done, she gave me a big smile and thanked me for being so gentle. It was a lie. It kept me going.
As the clock ticked on to lunchtime, Patient 9 came in. I collected my tourniquet and needle and blood bottles and plaster and bit of cotton wool, and sat down on the stool that I’d appropriated from next door.
He shut his eyes.
I took a deep breath.
The needle went in. I pushed a vacutainer onto the end.
I popped the tourniquet off, got my bit of cotton wool, slipped the needle out, and breathed.
“Sir, can you just press down on the cotton wool?”
He looked enormously pleased. “Is that all? Am I done?”
“Yep, you’re done. I’ll just get your plaster. What are you up to for the rest of the day?”