I'm on my Emergency Medicine rotation right now and my lack of experience and confidence is biting me in the tail. Unlike our other rotations during third year, we are not assigned to a particular resident or attending physician who is to mentor, teach, and tell us what to do. I am completely on my own when I show up to the ER. I can do whatever I want whenever I want it. Freedom. Some thrive off of this (ie my husband). Others struggle (me). We have a list of things we have to get done during this short rotation, such as starting IVs, placing a foley and NG tube, doing a stint and laceration repair, etc. But there is no one there to make sure I get it done. It's up to me, which means I have to steal it away from one of the residents. I am not nearly aggressive enough to get in on the good stuff.
Confession: I am a third year medical student who has never put in an IV. We spend so much time book learning and do not get nearly enough hands on education.
Yesterday I decided I needed to "man" up and just do it. I went up to one of the EMS guys and asked him to show me how to place an IV on the next patient that comes in and then let me do it from then on. He was very accepting and was excited about teaching me, so after showing me on the first patient, he grabbed me to take me to the next room where it was my turn to try. I walked into a room with him to find a neurotic 45 year old man that had interesting views on life, and we were his audience for the moment. He explained to me how he doesn't trust MDs, only DOs. Army nurses are the only nurses that know how to place an IV because they are taught in stressful situations. He then told me how he never lets attractive doctors near him because they only got where they are because of their looks, not their brains. He then looks straight at me and says, "Yeah, so that means you better not touch me." Ummm, thanks for the complement, kind of.
I botched my next opportunity on a guy that was screaming bloody murder as I tried to stick him. Luckily the nurse messed up twice after me (well, luckily for my ego, not for the patient) and another nurse had to come in and give it a try. My confidence was down to zero at this point, but the EMS guys came to the rescue. They let me practice on them. Yes, that's right, they sacrificed their own bodies for a scared little med student who had no idea what she was doing. I am forever grateful.
Today I was assigned to Fire Station #1 in Lexington for an EMS ride-a-long. Once again, the paramedics were awesome and let me do whatever I wanted. I didn't get to stick the first patient we picked up because she was having seizures and was mentally handicapped plus had CP, so not the easiest thing in the world. But the second patient was perfect. A young, mostly healthy woman who was having abdominal pain. Easy stick opportunity. That is, until mama hopped in the back of the ambulance with us. When the medic explained to the patient that I was a medical student and would love to try to start the IV, she was cool about it. As I moved into position to start, the mom whispered to the Major on board, "She's suffering enough, I don't think we should make her suffer any more." "Huh?" he responds. "I'd really rather the medical student not touch my daughter." That wasn't awkward at all.
And then to end the day, the Chief of the station came up to me and started chit chatting. After about 5 minutes, he asks what program I am with. I tell him I'm a 3rd year medical student on my ER rotation, and he looks at me funny and says, "What? A medical student?! How old are you?" "26, sir. Why, how old did you think I am?" "19, tops." In some ways I guess that's a complement, but at the same time, I wish I looked a little more mature. No wonder people don't want me sticking them. I wouldn't want a 19 year old poking me with a needle either.
