My first patient for the day complained of pain where there were scar tissues on his internal organs. He had ‘severe pain’ but looked very comfortable when he didn't realise I was watching him. Some investigating later and it turns out he had been a very frequent flyer in our ED as of last month and had also been 'doctor shopping' - getting restricted medications prescribed to him by various new doctors. It soon became clear that he was only after one thing - more drug prescriptions.
In emergency, it's a norm to present most, if not all cases to our consultant in charge. Depending on the consultant who's on, they may or may not decide to see the patient with you too.
The consultant who was on with me that shift was one I had worked with many times before in the past and who I got along with quite well.
I was hoping he would stand up to this patient for me, you know, what with him being older and tougher-looking than little pipsqueak me and all.. but, he didn't. He listened to my story, taught me how to approach the situation sternly while remaining professional, and sent me to do the deed on my own.
I was fearful no doubt, but I took a deep breath and faced him to sternly say no.
And just like that, his pain was 'miraculously all better' and he left without too much of a fuss, even thanking me for looking after him.
...
Later that shift, my 7-week-old chubby baby boy of a patient needed to have his bloods taken. I was advised to try a heel prick first and massage it out if possible, but two attempts proved futile. Taking bloods from young babies is something I am still not very confident about - nothing says pressure like crying parents and a screaming baby.
My consultant held this screaming baby's hand for me and guided me to go for a tiny vein in his hand. One attempt - unsuccessful.
"Try again with a smaller needle."
Second attempt - unsuccessful.
By this time, I am ready to give up and let him take over but he looks at me and instructs me - "there's a vein higher up here. Feel it, and try again."
Did I mention PRESSURE is directly proportional to length of time spent doing deed and number of failed attempts?
I feel it, calm myself, and try again. I have to move the needle a bit, but eventually I see the flashback of blood going into my needle, and manage to draw up all the blood I needed.
"You did a good job Candice," came the reassurance from my teacher.
I smiled with relief, and thanked him for his patience with me.
...
Yet another elderly woman comes in later who needed a surgery to save her leg, and she required bloods and a cannula in. She and her daughter-in-law warned me that her veins were very difficult and that I might have trouble with them.
"I hope you're good," they laughed.
"Ooh.. well I don't usually like to brag until after the deed is done," I joked.
I set up my tray, got into a good position and inserted the cannula in within a matter of seconds with no trouble.
"You got it in first go?? Oh wow, you're really good! You can come take my blood any time!" She laughed heartily and gratefully.
Relieved, I reassure her that I've seen my fair share of failures before being able to do them as well as I do now.
...
There's a saying in medicine - "see one, do one, teach one."
In reality for me it's more like see ten before you do, and do fifty before you dare to teach one.
As I packed up to leave for the day after my shift, I reflected on the day that had just gone. I thought of how fear will always be a companion, but that I no longer have the luxury of succumbing to it. Preparing to become a registrar is an insanely scary thing - to have to take on more responsibilities and be confident in not just doing but teaching as well.
But I keep pressing forwards with a hope, and a faith.. that one day, I'll learn those things too. And I'm hopeful too that this time next year there will be a new set of challenges that scare me while the ones that used to in the past become but a polished skill to keep under my wing.
In emergency, it's a norm to present most, if not all cases to our consultant in charge. Depending on the consultant who's on, they may or may not decide to see the patient with you too.
The consultant who was on with me that shift was one I had worked with many times before in the past and who I got along with quite well.
I was hoping he would stand up to this patient for me, you know, what with him being older and tougher-looking than little pipsqueak me and all.. but, he didn't. He listened to my story, taught me how to approach the situation sternly while remaining professional, and sent me to do the deed on my own.
I was fearful no doubt, but I took a deep breath and faced him to sternly say no.
And just like that, his pain was 'miraculously all better' and he left without too much of a fuss, even thanking me for looking after him.
...
Later that shift, my 7-week-old chubby baby boy of a patient needed to have his bloods taken. I was advised to try a heel prick first and massage it out if possible, but two attempts proved futile. Taking bloods from young babies is something I am still not very confident about - nothing says pressure like crying parents and a screaming baby.
My consultant held this screaming baby's hand for me and guided me to go for a tiny vein in his hand. One attempt - unsuccessful.
"Try again with a smaller needle."
Second attempt - unsuccessful.
By this time, I am ready to give up and let him take over but he looks at me and instructs me - "there's a vein higher up here. Feel it, and try again."
Did I mention PRESSURE is directly proportional to length of time spent doing deed and number of failed attempts?
I feel it, calm myself, and try again. I have to move the needle a bit, but eventually I see the flashback of blood going into my needle, and manage to draw up all the blood I needed.
"You did a good job Candice," came the reassurance from my teacher.
I smiled with relief, and thanked him for his patience with me.
...
Yet another elderly woman comes in later who needed a surgery to save her leg, and she required bloods and a cannula in. She and her daughter-in-law warned me that her veins were very difficult and that I might have trouble with them.
"I hope you're good," they laughed.
"Ooh.. well I don't usually like to brag until after the deed is done," I joked.
I set up my tray, got into a good position and inserted the cannula in within a matter of seconds with no trouble.
"You got it in first go?? Oh wow, you're really good! You can come take my blood any time!" She laughed heartily and gratefully.
Relieved, I reassure her that I've seen my fair share of failures before being able to do them as well as I do now.
...
There's a saying in medicine - "see one, do one, teach one."
In reality for me it's more like see ten before you do, and do fifty before you dare to teach one.
As I packed up to leave for the day after my shift, I reflected on the day that had just gone. I thought of how fear will always be a companion, but that I no longer have the luxury of succumbing to it. Preparing to become a registrar is an insanely scary thing - to have to take on more responsibilities and be confident in not just doing but teaching as well.
But I keep pressing forwards with a hope, and a faith.. that one day, I'll learn those things too. And I'm hopeful too that this time next year there will be a new set of challenges that scare me while the ones that used to in the past become but a polished skill to keep under my wing.
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