Saturday, October 09, 2004

Procedures and Complications

For the most part, the most exciting time for a medical resident is when he/she has to perform a procedure. It’s the time when the medicine residents can pretend to be surgeons who actually know how to read an EKG. So when a fellow resident’s intern approached me to supervise her Central line placement I had no trouble with it. Her resident was supposedly not certified as of yet and so could not yet supervise her. What she forgot to tell me (“forgot” is a relative term) is that she never told her resident that she was placing the line.
A bit of hospital politics: Since all residents have to perform a number of central line procedures to be certified and since all have a three year residency, the general rule is, senior gets the procedure, unless resident is already done enough procedures. It’s a dog war out there.
To make a long story short: Intern scrubs in, Intern preps area, Intern breathes deeply and begins to hyperventilate, sticks in BIG ass needle, pokes around for a really annoyingly long time. It gets interesting: Resident (Her own) happens to walk by, storms into room yelling that he is the one supposed to do procedure, Intern gets flustered and yells at her resident calling him “Big Baby”, Resident and intern continue to yell at each other (Patient not under general anesthesia and is now threatened by BIG ASS needle in PISSED OFF intern’s inexperienced hands), and me watching everything. Intern stops procedure and storms out of room, panic ensues (my own!), Resident storms out to continue yelling at Intern, I do my best to finish procedure, I keep my name out of patient’s chart to avoid impending law suit. A quick lesson: Procedures have complications, even those we would never think about