Again, TINS, TIWFDASL in some other ER, in some other little town. The night of THIS story, I had a patient assignment, and one of my patients was the subject of a an order that he receive an IV (infusion of sterile fluid) and a blood draw. Typically, these are performed simultaneously, as very few folks really enjoy a second needle stick in order to obtain the blood that you did not obtain the first time you subjected them to a needle stick, to start the IV. I thought, Easy-Peasy, no problem, I can do this, just like the thousand and twelve other times I had done this very thing.
I gathered the supplies I would require, and approached the patient, launching in to my stock spiel. “Hello, sir, I’m Reltney McFee, one of the nurses, and I here to start an IV and draw some blood. Please, say your name.”
He said his name, the name I was expecting, and asked, “What’s an IV?”
I explained, “Well, sir, I stick a small needle into your vein right here on your forearm, and slide it out, leaving a small plastic tube in the vein. I connect this here tubing to the hub of that plastic tube, and administer sterile fluid to help you feel better. You should feel the benefits in under a half an hour.”
“Will it hurt?”
My internal dialogue, effective squelched by my functioning thought/speech filter, ran along the lines of either “I’m fixing to stick you with this here pointy thing, and you wonder if it’ll hurt? Naw, hell naw, I won’t feel a thing!”, or “Yep. Hurt like a motherfucker. I don’t think you will completely pass out, but, just in case, I’ll get some towels when your bowels and bladder release from the pain, OK?”. Due to that filtering, I said, “Sort of, for a minute.”
He then asked me, “Doc, hurry up!”
I corrected him. Not every male with a stethoscope is a physician. “Sir, I’m a nurse, not a doctor. I’ll be as gentle as I can be.”
He was not listening, it appeared. “Oh, doc, doc, doc! Hurry up!”
I set my stuff down, and faced him. “Ok, here is how this works. I can, if you wish, do this really fast. Or, as an alternative, I can do this once, correctly. Which of these sounds better to you?”
“Uhhh, once sounds better!”
“Very good choice. Now, maybe you would allow me to do this, just like I’ve done it several thousand times before, OK?”
“Uh, OK.” And he stuck out his arm.
So, I applied the venous tourniquet, prepped the site, set up my blood draw tubes, readied my adapter, tore my tape and prepared my site dressing, one puncture, blood flash, and steadied the hub as I withdrew the needle. Attach adapter, obtain blood, remove adapter, attach tubing, secure tubing connection, tape hub, apply site dressing, create and tape down “tug loop” in IV tubing, set IV drip rate, and collect my trash and blood and off I go. Send blood, chart IV start, done.
Like I said, Easy-Peasy!