So, I almost took blood from my first real patient today. Almost, being the key word.
It was the scariest thing to happen to me on the wards to date.
I was on the morning ward round and the patient the team was seeing was hyponatraemic, tachypnoeic, with a history of brain tumour, and so they needed bloods. D-dimer to rule out pulmonary embolism as the cause of her tachypnoea, thyroid function tests, cortisol and blood osmolality to explore the causes of her hyponatraemia, possibly SIADH.
And so, the consultant asks if I can do venepuncture. And I respond- sure.
And so I take ages to get the tray ready because I don’t know where anything is in the stockroom and the nurse that most probably feels sorry for me kindly helps me to find everything.
Then, I explain everything to the woman I am going to take blood from and name my first child after (see previous post) and she consents. And I do all the prep, clean the area, put on the tourniquet etc. She is elderly and the veins on her wrist are visible, so I’m going in. Needle comes out. Sharp scratch coming up. Needle in. I missed it. There was no flashback, which is a sign that you’re in the vein. So, I pulled the needle out to try again. And there was blood squirting out of her wrist. Oh ****.
Gauze, gauze. I need some gauze. Why won’t this packet open. Oh, I’m so so sorry. Oh look it opened. I’m so sorry.
It turns out I had gotten into the vein. There is not always flashback in the needle. If I had just attached the collection bottles I would have been victorious.
I tried once more at the wrist and then in the arm but was unsuccessful and decided to give the poor lady a break and let someone more experienced take it.
If I had just filled the bottles that first time.
Fortunately, she was very nice about it. She was one of those tough elderly ladies that feels no pain, which was lucky for me.
Lesson: you don’t always get flashback
Bright side: I don’t have to name my first child after a British monarch
Post script: on this same disastrous day I attempted to take a history from a patient and ended up spilling her entire jug of water over her table. I made her a cup of tea to apologise and managed not to spill that.