i've been hanging around the ER trolling around for things to do and have been asking nurses to watch and potentially do an IV. well, after watching some, I was finally able to get a nurse to offer to let me do it and talk me through it. Ironically enough, i ended up doing it on a very familiar patient.
it was the 30-something year old that I admitted about 2 weeks ago. the one that put himself into heart failure and had diabetic retinopathy from her uncontrolled diabetes [he cant see shit and he only has himself to blame.] granted, he is a really nice guy, just doesnt take care of himself at all. its very sad actually.
so i went in with the nurse when he initially was brought into a room and i asked him if i could start his IV. he had no problem as he remembered me from taking care of him before. I pretended to be confident and i did it, got a flush on my first attempt and put in the IV catheter. i think the nurse was pleasantly surprised i didnt miss or infiltrate the needle. i was proud of myself.
needless to say, i ended up admitting this pt to the floor again as his blood glucose was around 500 and he has PNA.
after hanging out in the ER some more, i buddied up with the intern and went in to see a 'finger pain' patient. this 24 year old, uncontrolled diabetic, had a fat swollen finger that looked infected for sure. we presented to the attending and learned a ton from him about finger anatomy and injuries. then watched him do a finger digital block on the patient who was terrified of needles. the attending handled it so well and was hilarious while doing it, such good bedside manner, something i hope to be exactly like. so he numbed up the finger with lidocaine, cut a big slice at the end of his finger and squeezed and drained everything out. the infection was to far under his nail so we had to remove it too release the pressure. so i watched him tear off a perfectly normal fingernail which actually takes a good amount of force. it was gross and cool at the same time.
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