IN TREATMENT: On Needles and Pins (Literally)

Everyone’s first experience in the hospital, almost immediately, is that someone sticks you – an injection, an IV, a catheter, — it doesn’t matter.

February 21, 2014
3 min read
peters-nurse

peters-nurseEveryone’s first experience in the hospital, almost immediately, is that someone sticks you – an injection, an IV, a catheter, — it doesn’t matter.

By Peter Jovanovich

peters-nurse

Everyone’s first experience in the hospital, almost immediately, is that someone sticks you – an injection, an IV, a catheter, — it doesn’t matter. It’s as if the doctors and nurses are dying to say, before good morning or how are you feeling, “Just a little pinch.”

My first experience was virtual. My father had suffered a heart attack and was recovering at Columbia-Presbyterian. A freshman at Princeton, I walked into his room to hear him shout: “You G—D — Princetonians! You talk a good game, but can’t accomplish anything practical.”

Actually, I was rather proud of my newfound ability to talk about just everything without really knowing anything; but, to the problem at-hand, my father’s arms were covered with blood. I learned that an intern, and a fellow Princetonian, had failed multiple times to insert at an IV – a painful ordeal.

“What happened to the intern?” I asked.

“I sent for the Oriental nurse on 7. They’re good with needles.” (Political correctness was invented for people like my father.)

To be fair, threading a needle isn’t easy. The best nurses tell you they do it by feel: find the best vein, and then sense by touch how to insert it. In my experience, the IV award of the century goes to Rye/Port Chester EMS. While the ambulance was rocking back and forth, and the patient was frantic because of lack of oxygen, an EMS tech grasped my arm and in one try, stuck it in perfectly. (Our local EMS is terrific and deserves all of our support).

Of course, things can go pear-shaped. One night, after over a week in the hospital, I woke up and realized that my IV had infiltrated.  That means that the solution was no longer going through my veins, but was spilling out with attendant blood and some pain. I rang for the nurse.

As it was 1:30 a.m., I feared it might take a while, but soon a young nurse came to my aide.

“I think this is my tenth infiltration, so far, (I actually kept score and the final number was unlucky 13), so we’ll have to find another vein.”

“Don’t worry,” she replied as she laid out the chucks, bandages, and needles. “But you should know something. This is my second.”

“You mean second tonight?”

“No, I mean second time ever,” she replied sweetly.

The first attempt was not even close – just pure pain. The second wasn’t much better.

“You know, I think I’m getting a bit nervous, which isn’t good,” the nurse admitted. Of course, I wasn’t nervous: just bathed in sweat and holding on to the guardrails for dear life.

As she reached for her third needle, I said in a mousy voice: “Isn’t there something about not trying again if you miss after two times?”

“The other nurse is busy, so let’s get this done.”

Third time, she hit a gusher. Blood all over the arm. Undaunted, as she reached for the fourth needle, I was mentally screaming: Don’t they give morphine for IV’s? But with great care, working now on the other arm, she failed again.

My inner father finally arose: “Nurse, I think you need to call your supervisor.” She agreed, almost in tears about the failure. The supervisor arrived, from Jamaica as it happened, who did it in one try.

Let me assure you – as someone who has become a pincushion for the advancement of medicine — it nearly always works out well. Nurses – beware of interns! – are pretty comfortable inserting needles, etc.; and they aren’t afraid to ask for help if they fail after two times.

So, here are my three rules as doctors or nurses start sticking needles or bigger things into you:

Don’t look. You just make yourself nervous.

If a nurse or doctor fails after two tries, ask for someone else.

Remember to ask: “By the way, you didn’t go to Princeton, did you?”

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