Saturday, November 19, 2011

Becoming a statistic

Monday, 3 weeks into my surgery rotation, I became a statistic.  I stuck myself with a suture needle in the OR while attempting to close the patient.  There was a moment of silence in the OR.  The scrub nurse and my attending glared at my with wide eyes while their masks concealed their facial expressions.  Were they smirking?  Were they frowning?  The sound track of "shit! f#@k! Damn! I screwed everything up!" echoed in my head. 

As per the scrub nurse's orders, I placed the needle on a non-sterile field and pulled off my glove to have my hand inspected by the circulating nurse.  There, on the palm on my left hand was a small little speck of blood, signifying that I broke skin.  The circulating nurse's response was "shit!... well, I guess you need to go to the ER now."

What did I do?  I went to the sink and washed my hands with soap & water for a good long time.  I looked through the patient's medical chart weighing my options.  Then, in one of my less proud moments, I decided to forgo the OR in trade for going home.  I had been at work 11+ hours for the last 8 days.  I was exhausted, and embarrassed, and not wanting to make a stick of something with such a low risk. I didn't want to be put on HIV prophylaxis as I'm sure it'd screw up my diabetes big time.  There isn't anything that can be done for Hep C...  Plus, since being on surgery I've heard so many attendings tell war stories of being stuck and mocking the whole contact precaution protocol. 

"Researchers surveyed surgery residents at 17 medical centers and, of 699 respondents, 415 (or 59 percent) said they had sustained a needlestick injury as a medical student. Many said they were stuck more than once. Of the surgeons-in-training whose most recent needlestick occurred in medical school, nearly half of them did not report their injury to an employee health office, thereby avoiding an evaluation as to whether they needed treatment to prevent HIV or hepatitis C." -Medical Students Regularly Stuck By Needles, Often Fail To Report Injuries 

The story doesn't end there though.  I fixated on the needle stick, kept contemplating my decision, weighing my options.  I talked to my girlfriend, a few other medical students and a few residents whose opinions I trust.  Then, on wednesday, I made the mistake of mentioning the stick to my program site director & the surgery clerkship director.  That was it.  Wheels started turning leading me to employee health.  Phone calls were made.  Documents were filled out, papers were faxed, and emails were sent.  4 tubes of blood were drawn and plans were discussed to report back in 6 weeks, 3 months and 6 months.  

Nearly a week after the initial stick, I still feel like an idiot.  My dexterity is clumsy when it comes to using a needle driver, as was pointed out in my mid-block evaluation yesterday.  It did prove to be a lot of hoopla for a little event, a tiny tiny stick.  But you know what?  Wednesday night I went to bed with a clear conscious that I was doing the right thing.  Yesterday I breathed an even deeper sigh of relief in learning that I'm currently HIV and Hep C negative and Hep B immune.


Solitary Diner said...

It happens to all of it. I had the dubious distinction of getting a needle stick on my very first night of call ever. The senior resident was not impressed with me for taking time off to go to the ED to be evaluated. Glad to hear that all the testing has been negative thus far - as low-risk as a needle stick may be, it can still be pretty anxiety-provoking.

MacKenzie said...

I'm sorry, that sucks. But it does happen to the best of us. I've been stuck once, and had an exposure secondary to being cut on a rapid trauma assessment on a patient who went through the windshield. No fun.