NYC
I look idly at the hand grasping the laundry basket. “That’s a beautiful vein,” I think. “Someone would be lucky to get to slip an IV into that.” And like everything that gets accidentally carried back from the hospital—venipuncture kits, 4cm x 4cm gauze (think: measures I am learning), alcohol swabs, tape, fecal occult blood cards and guiac solution, gloves—I have the materials to do it. But I’m not the one I would need practice on. It’s the patients with scarred veins (drugs, fistulas, too many hospital visits) or overloaded with fluid—the “vasculopaths”— that take skill. A patient with good veins is a good patient. Ones that don’t roll or slip away from you. Ones that leap to attention under tourniquets and alcohol.
I look idly at the hand grasping the laundry basket. “That’s a beautiful vein,” I think. “Someone would be lucky to get to slip an IV into that.” And like everything that gets accidentally carried back from the hospital—venipuncture kits, 4cm x 4cm gauze (think: measures I am learning), alcohol swabs, tape, fecal occult blood cards and guiac solution, gloves—I have the materials to do it. But I’m not the one I would need practice on. It’s the patients with scarred veins (drugs, fistulas, too many hospital visits) or overloaded with fluid—the “vasculopaths”— that take skill. A patient with good veins is a good patient. Ones that don’t roll or slip away from you. Ones that leap to attention under tourniquets and alcohol.
We are vampires not only at night.
It’s using your hands (not trusting your
head), taking ownership of each step of the process, delegating tasks (most)
that don’t take a medical degree to yourself.
I’ve caught myself thinking “I wish I had a
med student for this.” To get patients’ weights while standing (find the heavy
scale, wheel and weave it through the hallway, support the hesitant frame). To
get orthostatic vital signs (vital. Life. Here, to check the difference in how
fast and how hard the heart beats, how much the veins and arteries contract and
relax, when equilibrating between lying down and standing up). It takes
minutes. Five. Or more. I picture third year of med school, two hours per
patients, an afternoon to sit and talk…
Or carry blood.