My hospital is a remote DGH with a tiny staff. This is a good thing. The compensation for going to the arse end of nowhere is that this is where you’ll find hospitals with fewer students, better teaching, and much more opportunity for getting stuck into things. I was told before I came that at this hospital, I would be able to do practical stuff and improve my clinical skills.
I clerked in my first patients. I learned how to scrub in. I relearned how to take bloods. I stopped trembling when I had to sign patients’ notes, and pretended I wasn’t when I had to hold down a toddler for a blood draw.
At least twice a day, someone asked, “Are you a medical student? Do you put venflons in?” I always told them that I was a medical student but that I’d only ever done a venflon on a plastic arm (and that in my OSCE, I had failed to do even that — but I didn’t say that part), and they always balked and went to find someone else. Eventually, my FY2 found a man with excellent veins and herded me in to his room… and I gave up after the fourth attempt. It happened again on the next three patients. The patient who ended up being my first successful venflon got me because it was the middle of the night and the ward nurse thought that my burgundy scrubs indicated some sort of competence.
The patient didn’t ask if I’d done this before, and thank God for that. I’d not slept. I might have blurted out the thing about the plastic arm.
Although if someone’s putting in a venflon and they can’t work out the venflon dressing, it’s a pretty good indicator that they’ve never done this before.
I cleaned up the blood that I’d got all over her and apologised profusely to the nurses for the blood that I’d got all over her sheets, and I scuttled back to the doctors’ room with my heart still doing triple time. They beamed at me. “Oh, we knew you could do it. You just needed to be left alone to get on with it!” Well, I suppose. Yes. I feel better about them now — getting one in in the mostly dark at five o’clock in the morning does wonders for confidence, even if it doesn’t do much for actual technique. Still, I’d not have wanted to be that patient.
I’ve still not worked out how to get them in without spurting blood absolutely everywhere.