Family Medicine – Day 15

My hands were full. An mL of Kenalog, a nearly empty vial of lidocaine, its fresh replacement, a 5 mL syringe and both a 18 and 22 gauge needle. I followed my attending around hoping that she would pick up on my hesitancy to do this injection and decide to hold me hand through the process. She told me I could draw up the medications in the office out of the sight of the patient because she “always feels awkward doing it in front of them,” while she went to quickly check up on another patient.

Ok that helped take some of the pressure off. I could have some space to breathe as I did this relatively simple task for the first time for a real patient. I couldn’t just pretend to draw up the lidocaine from an empty bottle and make highly inaccurate sound effects to emphasize that I was indeed drawing up imaginary liquids. I actually had to think about which needle to use when. When to clean what with the alcohol prep pads. And I had to get it right. After several pauses and second guesses, the injection was ready for the patient.

I went to find my attending and we went in to see the patient together. It was showtime. Project confidence. Don’t let them know this is your first time putting a needle in someone’s knee (ok not true, but at this point it was the first time I was choosing the spot and doing pretty much everything). Keep it smooth. Lucky for me, and probably for the patient’s peace-of-mind, she was Spanish-speaking so my attending did all the talking and my nerves wouldn’t be revealed by any shakiness in my voice. Just like we practiced. Mark the spot. Clean the site. Pokey poke. Pull. Push. Oops forgot to have a 4×4 and band-aid ready. Ask attending to open them for me. Pull. Hold. Cap. Band-Aid. It was done. Not sure what all the fuss was about. It was easy and the patient was so gracious about everything. When do I get to do a shoulder?

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