Amazingly, with hardly even more than what felt like a little pressure, blood flashes into the needle. He got it on the first try, and I barely felt it. Donating blood was a lot whole lot worse. He lets just a little blood run into the vial, unties the tie, puts a gauze on the needle stick site, and withdraws the needle. It spurts droplets of blood over my arm as he safeties the needle - not something I've ever seen a nurse do - but aside from that, no big deal.
* * *
One of the school clubs run by fourth years allows first year medical students a chance to practice their clinical skills. The very first meeting is on doing blood draws. Our fourth year is currently applying for orthopedic surgery residencies, but he claims that he actually has quite a lot of time. He has us tie off each others' arms at the bicep with a rubber strap to allow the blood to collect in the veins - surprisingly more difficult than it appeared. Then he demos a blood "draw" on a pack of gauze with a butterfly needle. It has an angled point, and it should be injected with the pointy side down, as the top part has the hole for blood collection.
"And make sure you have good technique to deal with needles," he tells us, "because if you don't, you will get stuck. Right now, you think you'll be careful and all that. But you need to have good technique, because it really sucks to get stuck." (They handed us all a double-sided sheet of procedures and preventative treatments in case we did get a needlestick.)
* * *
There are three of us in the group: myself, another petite girl with veins hardly in evidence, and a very tall, muscular guy with veins popping out. My arm is already tingling from the rubber tie, and to my surprise, my veins are actually in pretty good evidence. I volunteer to be the first guinea pig, as I'm pretty used to getting stuck and know I'll probably mind less than most people to have someone digging around in my arm with a needle. Also, it's a way to make sure I don't have to be the first to stick someone. I'd rather have someone poke me than poke him or her unsuccessfully.
* * *
The first guy's successful blood draw on me makes us all relax a little. If this guy can do it on me - a person with notoriously bad veins - it can't be that hard.
The girl and I look at each other. I look at her arms, no veins in evidence, and think to myself, "It's just not going to happen." She also doesn't seem too crazy about getting practiced on, or slapping her arm lightly with two fingers to make the veins stand out. (I thought that was standard procedure because that's what they always do on me, but apparently not. The slapping supposedly releases histamine, which dilates the veins and makes the blood draw easier.) We both look at the guy, and before we can even ask, he generously offers to let both of us practice on him.
The other girl got her venipuncture on the first try, and then it was my turn. I swabbed my partner's arm down with alcohol, opened up the packet of gauze, and pulled out a vial for the butterfly needle. I definitely had been anxious about it in the few hours leading up to the workshop, but after seeing both my partners succeed on the first try, I'm a lot less worried.
I swab the guy's arm, then fumble with the vial and needle - somehow I'm supposed to hold both of those in my left hand and simultaneously use my thumb to hold down the vein. I am happy to see that his veins appear 2 mm wide or so, a large and inviting target. "You can't miss," the fourth-year tells me. I visualize the procedure, hold down the vein with my left thumb, and jab the needle in.
At first I thought I've failed, but then I see that blood has flashed into the needle up to the butterfly. With my left hand, I push the vial in. It has vacuum inside, and that draws the blood through the tubing from the needle. I almost pull the needle out, but they remind me to untie the rubber strap first - otherwise blood could go spurting everywhere. I put a piece of gauze over the tip of the needle and withdraw it, then awkwardly pull on the tubing to "safety" the needle.
"Be careful," the fourth year reminds us. "Don't wave the needle around or you or your patient will get stuck. Don't move that hand at all. Safety the needle before you do anything else."
I put a bandaid on my partner's arm, feeling rather happy. He reassures both me and the other girl that he barely felt it. We all thought it was better than our experiences with blood donation or nurses, though it could be that the needle was a very fine gauge.
* * *
The fourth year shows us how to do IV's, but everyone agrees we've been stuck enough and would rather wait for another day to do it. We all walk out of the room, feeling good, and with perhaps a false confidence. If only all patients could work out, have zero body fat, and prominent veins, life would be easy. Not going to happen, of cours - but we all have a bit more swagger to our steps (for those of us that swagger), feeling like we've just begun to earn that white coat.
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