My Second Needlestick Injury (Now with 50% less badass!)

I was originally going to start this entry with a thrilling yet entirely made-up narrative of how I'd received my second needlestick injury, (i.e., I'd gotten jabbed while trying to inject epinephrine into a patient in cardiac arrest, with special emphasis on how I looked so sexy doing this that the handsome trauma resident working with me continuously shot me "Come hither" looks as he did chest compressions). But then I realized that my extensive fan base (all 2 of you) would immediately see right through this and probably call me out on my BS. So I grudgingly decided to be forthcoming and truthful about my second needlestick injury, even at the risk of sounding completely incompetent and far less awesome than I fancy myself to be. (Feel free to thank me for my honesty.)

What really happened is that I recently attended a workshop in which medical students could practice a number of different skills (IV insertion, intubation, injections, etc.) under the watch of a physician, nurse, or clerk. Since my last attempt at IV insertion and venipuncture was nothing short of a disaster, I deliberately signed up for this session to improve my skills and show that damned butterfly needle who's boss. Now, one of the main reasons why I'd gotten stuck with a needle during my last venipuncture attempt (aside from my general lack of know-how) was that I was unsupervised as I tried it, resulting in no one stopping me from doing something stupid like pulling the rubber casing off of the needle. However, in the workshop session I signed up for, there were going to be 3 preceptors minding only 6 students, and I figured that as long as I did everything under the watchful eye of someone who knew their stuff, nothing could possibly go wrong.

Clearly the fact that I'm even writing this suggests that something went wrong.

The session started out deceptively well, probably because life likes screwing around with me in that sort of way. I tried doing an IV insertion first, making sure that one of the nurses running the session gave me the green light for each move. In retrospect, this probably annoyed her to no end ("Okay, so do I advance the catheter now?", "Should I pull out the needle now?", "I apply a strip of tape here, right?"), but I was hellbent on not getting hurt. My irritating diligence did pay off in the end, as I managed to insert the IV without sticking myself, although the mannequin arm I was practicing on lost a decent amount of fake blood. (I may have been a bit slow in doing things like staunching blood flow and actually hooking the damn IV up, but we take victories wherever we can get them, right?)

Successfully inserting the IV gave me the boost of confidence I needed to try my hand at venipuncture. After taking out the IV from the mannequin arm and applying a tourniquet to it, I gathered the equipment I would need for a venipuncture: a collection tube, a vacutainer, and of course, the dreaded butterfly needle. As you may recall, my first needlestick injury was from this type of needle - more specifically, the end of the it that is supposed to be inserted into the collection tube. With this in mind, I was understandably more careful when handling this portion of the needle. Rather than trying to tug the rubber sheath off of it, I screwed it into the vacutainer as the nurse instructed me to do. To my delight I realized that the vacutainer would not only hold the end of the needle in place when it came time to attach the collection tube, but it would also act as a barrier between the needle's sharp tip and my hands. (To help you visualize this, I included one of my MS Paint-modified pictures below.)



So there was some nice, thick plastic separating the rubber encased needle from my fingers. If you guessed that that prevented me from getting the same sort of needlestick injury I got before, you are absolutely right. However, if you look at the picture a little more closely, you will see that the other end of the needle is not surrounded by a similar protective barrier, but is rather ensheathed in a tight, thin plastic covering that is really difficult to take off.



To my credit, I do learn from my mistakes to an extent. I figured that if the plastic covering was as tightly wrapped around this end of the needle as the rubber sheath on the opposite end, yanking it off would cause the needle to shoot unpredictably in my general direction and stab me in the process. Armed with this bit of foresight, I turned to the nurse and asked, "Is there a safe way to take this off?"

She said to hold the base of the needle steady and slowly ease off the covering, which sounded about right. Grasping the base of the needle with my right hand, I used the thumb and index finger of my left hand to gently pull at the thin plastic sheath. The sheath didn't budge.

I pulled a bit harder. Still nothing.

I pulled slightly harder, and that's when shit happened, as shit is wont to do.

The plastic sheath instantly slid off the needle, much like the rubber sheath did when I got jabbed the first time. But since my right hand was holding the needle in place, it didn't fly towards me. Rather, my left hand recoiled and jerked towards the needle. If you want to see this for yourself, find a pen with a cap that's too tight to fit properly and try pulling the two apart. Unless your hands are incredibly steady, they'll probably snap toward each other once you pull the pen and the cap apart. (Or if not, there's always the possibility that I just have the manual dexterity of a cabbage and should never, ever handle sharp objects like needles.)

So my left hand jerked towards the needle. I felt the stab of pain before I had time to fully process what was happening, and I looked down to see a drop of blood welling on the tip of my left index finger. A moment later I heard someone next to me gasp. It was none other than the same girl who had been in my group during the very first IV insertion and venipuncture session we had, the girl I had made small talk with.

I'd gotten stuck with the exact same type of needle, in the exact same finger, doing the exact same procedure, in front of the exact same girl as before. You have got to be kidding me, I thought. You have got to be fucking kidding me.

The only point to the good was that I didn't get the same apathetic reaction from everyone else as I did the first time around. After the nurse realized what had happened, she quickly handed me a piece of gauze and said, "Oh no! Would you like me to try to find you a band-aid?"

You still don't have bandages on hand in the anatomy lab? What is wrong with this school? went my inner monologue.

Outwardly I flashed her an embarrassed smile, wrapped the gauze around my finger, and told her that no, she needn't bother since I probably had a band-aid in my purse. She then asked if I was all right, and I assured her that yes, I was fine, and that I was used to being poked with needles, oftentimes willingly.

The uncomfortable look that crossed her face suggested that what I'd just said could probably be grossly misinterpreted (e.g., intravenous drug user!). I quickly flipped back my hair and gestured to the four piercings I had in each ear, which was I had meant when I said that I was used to being willingly poked with needles. Then, being the old pro that I was in dealing with needlestick injuries, I excused myself from the session, trudged over to the sink to wash the wound with soap and water, and retrieved a band-aid from my purse. I was also shouting a string of obscenities in my mind the entire time, being such a good multitasker and all.

And that is the story of my second needlestick injury. I know that I'm probably expected to have slip-ups like these so early on in my medical training, but this is just getting embarrassing. I mean, I come from a family of people who have displayed insane levels of badassery in the face of injury - my father took a freaking chainsaw to the throat (work-related accident), my brother managed to work out in the gym for 2 weeks before noticing that he had a pneumothorax, and my mother gave birth to both my brother and I without epidurals. And here I am, getting repeatedly jabbed by needles without even a cool backstory to show for it.

Ah, screw it. Stay tuned for my next needlestick injury (you know it's going to happen eventually), same Bat-time, same Bat-channel.