(As you can see, I clearly have no future writing movie scripts, so let's hope this whole becoming-a-physician thing pans out for me.)
But based on the title of this post, you can hazard the guess that my first needlestick injury categorically did not occur in as awesome and badass a manner as I hoped it would. What actually happened is probably better described with words like "laughable" and "pathetic" and "Oh my God, I cannot believe this girl is going to be allowed to handle sharp objects like scalpels and loaded syringes. Someone take those away from her before she hurts herself!"
Like most things, it started off innocently enough. Our class was expected to attend a special skills session in the anatomy lab where we would practice inserting IVs and performing venipuncture. Excited at the prospect of doing something hands-on, I arrived at the lab early to check out what was set up for us. Laid out on a table were packages of alcohol swabs, tourniquets, IV catheters, tubing, butterfly needles, and two massive mannequin arms connected to bags of what looked like red food coloring. As I looked over all the equipment, a girl from my class joined me by the table and we started making small talk to pass the time. "I'm really excited to try this out," I told her. "Although knowing my luck, I'll probably be the first person in the class to get a needlestick injury doing this." (Hint: this is a little technique that them writer folk like to call foreshadowing.)
She laughed and replied that she was sure I'd be fine (if I'd known what was going to happen, I would've bet money against her wonderfully idealistic prediction). Shortly after, the rest of our classmates in our group started filing into the room, followed by our preceptor, an anesthesiology resident. He went through a handout that we'd been given on IV insertion and venipuncture, then gathered us around the table to demonstrate what we'd be doing. It all seemed simple enough - apply tourniquet to distend vein, disinfect site, insert needle, then either advance catheter and attach tubing (IV insertion) or attach other end of butterfly needle into collection tube (venipuncture). There was no possible way to screw that up, right? (Another bit of foreshadowing: there was totally a way to screw that up, and guess who discovered it?)
We were instructed to take turns practicing inserting an IV and drawing blood (well, red food coloring) from the mannequin arms. When my turn came, I decided to try venipuncture first, since it was the easier of the two techniques. To my credit, I started out like a seasoned veteran. Apply tourniquet? Check. Locate suitable vein? Check. Disinfect area around said vein with alcohol swab? Check. Now for the fun sharp stuff.
I removed a sterile butterfly needle from its packaging and carefully inserted it into one of the mannequin's veins. A moment later I was rewarded with a flashback of red food coloring into the hub of the needle - I was in the vein. As I held the needle in place with my right hand, I ran my left hand down the length of the attached tubing until I reached the second needle at the end of it. Now, this second needle is meant to be inserted into a blood collection tube. Since these tubes are under negative pressure, poking through it with the needle will draw blood out from the patient's vein, through the tubing, and ultimately into the collection tube. I'm sure anyone reading this has probably had blood drawn before and can hopefully visualize what I'm saying, but I included a picture below for reference.
To get back to the story, we're at the part where I'm holding the needle that I'm supposed to insert into the collection tube. And as I looked at the needle, I realized that it was covered with a rubber sheath (which I have marked on the diagram with my piss-poor attempt to draw an angry face using MS Paint - more foreshadowing!). Thinking that the rubber sheath was supposed to be removed prior to inserting the needle into the tube (look at the size of that sheath! Could you blame me for thinking that I wouldn't be able to just ram the whole thing through the top of the tube?), I started tugging at it with my left hand.
The fact that the sheath was tightly wrapped around the needle and difficult to remove should have led me to the very sensible conclusion that maybe it wasn't supposed to be removed at all. Unfortunately, brawn won out over brains, and I gave the sheath one last, forceful yank. What happened next was a bit of a blur since it all took place in the space of about a second, but I'll outline it as best I can.
The sheath snapped off and the now uncovered needle shot toward me like a rubber band. I reflexively jerked my head back to avoid getting hit in the face, but the rest of my body didn't respond as quickly. I felt something stab into the index finger of my left hand, and I looked down in time to see giant drops of blood fall from my fingertip onto the table, mixing in with some red food coloring that the mannequin arm had leaked out during another student's failed attempt at inserting an IV.
"Son of a bitch!" I snapped under my breath, as I frantically tried to think of what to do next. My right hand was still holding the opposite end of the butterfly needle in the mannequin's vein, so I yanked it out and chucked the whole thing into the sharps container. I then walked up to the anesthesiology resident, who was fiddling with his pager in the corner of the room, showed him my finger, and said, "I had a bit of an accident while trying to do a venipuncture." Completely unsupervised by you, I wanted to add, but I figured that I should probably first address the issue of how I was technically turning the lab into a biohazard by dripping blood onto the floor.
His reaction pissed me off. His eyes widened as he took a step back (what, did he think I was planning on bleeding onto his expensive-looking shoes?) and said, "Oh. Wow. That's not good. Um. Wow. You need to, uh, wash that out. Yeah, go wash it with soap and water."
Okay, so cleaning the wound was good advice, but this guy made no attempt to try to find a first aid kit, glance at the injury for more than 2 seconds, or even ask how exactly I'd gotten hurt. Realizing that I wasn't going to get any help from him whatsoever, I stalked out of the room to find the sink near the entrance to the anatomy lab, trying to ignore the stares of my classmates who had clued in to what had happened.
Once at the sink, I pumped a crapload of soap onto my hands and started rinsing the blood off my finger. It hurt like hell but I was still able to move it normally, so I figured that the needle hadn't jabbed in deep enough to do any major damage. As I left my hand under the running water for a minute, I glanced around at what everyone else was doing, wondering if anyone would come over and ask what was I was up to. I freely admit that I can be a mass of contradictions - while I didn't want to call attention to the fact that I'd been the class idiot and gotten stuck with a needle, it would've been nice to have someone show an iota of concern. Especially the tall, muscular, and incredibly sexy guy in my class that I'd been sneaking looks at during lecture for the past few weeks.
I ended up getting my wish in some sort of fashion, or at least I thought so at the time. As I was drying my hands and wrapping a paper towel around my finger to stop the bleeding (still no first aid kit in sight - shouldn't a medical school be rolling in enough money to have these on hand in rooms containing sharp objects?), I heard someone come up behind me and ask, "Hey, you still bleeding?"
I turned and saw one of the students from my group, a guy wearing a hoodie with a baseball cap pulled down almost entirely over his eyes. Figuring that the resident had sent him to check on me and pleased at the fact that at least one person was thinking of my well-being, I replied, "Well, just a little. I don't think the needle went in that deep. Did the resident ask you to see how I was doing?"
"Anesthesia Guy? No, he didn't say anything," the student said. "In fact, I'm just on my out to use the bathroom. Oh man, the lunch I had today - I really gotta take a dump. Never should've had that second enchilada."
I forced myself to smile politely and repress the I-cannot-believe-we-are-having-this-conversation look that was dying to replace my benign expression. As the guy gave me a parting nod and walked out of the anatomy lab to presumably face the wrath of those enchiladas, I went back to rejoin the group and finish the session with whatever dignity I could scrape together. I hadn't tried inserting an IV yet, and I was required to make at least a halfhearted attempt to do so in order to get full marks for the session.
I won't bother going into the details of how the IV insertion went. One point to the good was that I didn't stick myself with the stylet, thus leaving open the possibility that my second needlestick injury may be totally epic and badass. One point to the bad, however, was that the stylet actually ended up ripping through the mannequin's fake vein and overlying skin, which I could only imagine would've been incredibly painful had I been practicing on a real patient (thank God I wasn't). So I have quite a ways to go when it comes to learning how to properly insert IVs and draw blood from patients without a) stabbing myself with the tools of the trade and b) looking like a moron.
So there you have it - my first needlestick injury. All in all, things could've been a lot worse. For example, the offending needle could've come straight out of a patient infected with HIV or Hepatitis C, which I'm sure has happened to at least a few unfortunate health care workers in the past. However, I can also see how things could've gone a lot better. Namely I could've gotten jabbed in my middle finger instead of my index finger, thus giving me an excuse to flip people off for the rest of the day, under the guise of "Hey, look what happened to me at school today!"
...I'll have to keep that idea on the back burner.
(Pictured: Another idea I am keeping on the back burner. 3 cheers for wasting health care resources!)
