A year at U of R

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Wednesday, August 09, 2006

Giving injections

Today was my first day giving medications. We are closely supervised as students when giving meds. Each of my clinical group of 8 students is assigned to a different day to give meds. I was scheduled for the first day, along with one classmate.

Yesterday, I stopped by the the unit to pick up my patient assignment for the next day's clinicals. Low and behold, my patient was scheduled for no fewer than 12 different meds given every two hours, including a subcutaneous heparin injection. I read this and panicked. That same morning I had just attended the lab where we learned how to give injections. The next day, without any further practice, I was going to have to actually inject someone. To make matters worse, my patient was fully awake and alert. Couldn't they be comatose just this once???

I did not feel prepared. I'd read a chapter on injections, watched a 20 minute video on the subject, listened to an hour lecture, and given five injections of different types to a plastic dummy in lab. However injecting a piece of plastic didn't inspire confidence. Anyone can jab plastic. What about the real thing? What about flesh?

I dashed home, and spent the rest of the afternoon researching and writing notes on all of the 12 drugs I'd be giving. Then I reread the chapter on injections. I poked at myself with a ball-point pen periodically throughout the evening to practice technique. I went to bed with ink-dots all over my stomach.

In actuality the injection was very easy. It was over and done in a few seconds, and I'm happy to report I didn't feel any pain at all. Thankfully, my patient reported no pain either. However, it is the little things they don't mention in class that trip you up in clinicals.

What no one warned me about was packaging. Each individual pill comes from the pharmacy specially wrapped up in a little packet. For safety, these packets each get opened at the patient's bedside, and the pills are all dropped into one medicine cup.

So there I found myself, nervous as anything at the patient's bedside, with eight tiny packets to open. My instructor, the patient, and the patient's whole family were watching me expectantly. I picked up the first plastic packet, and tried to tear it. It wouldn't give. It was like your worst nightmare of trying to open an unyeilding bag of Doritos, and knowing that if you use too much force, the Doritos will end up all over the floor. I wasn't about to try using my teeth. Finally, my instructor gingerly took the packet from me, and tore it easily in the other direction. How humiliating. Instead of practicing injections tonight, I'm going to get some candy and lipton's instant soup, and work on opening packets.