Monday, January 10, 2011

No Pressure

Part of being a PA working in the Emergency Room is doing procedures.  Since starting 6 week ago, I've had my fair share of them, including suturing, abscess incision & drainage, and lumbar punctures (aka spinal tap).

One of my first procedures was stitching up a little kid's eyebrow laceration.  It didn't go well for various reasons and after that I was a bit gun shy about doing any kind of procedures.  After several successful laceration repairs, my confidence was on the rise.

When I first started every procedure I performed was supervised by another practitioner, usually another PA or NP.  Now that I'm credentialed that is no longer necessary.  The first procedure I performed completely solo (with the exception of a tech holding the kiddo) was a bit nerve-wracking, but I did beautifully.  I've become much more comfortable doing lacerations and abscesses and actually look forward to them now.  Lumbar punctures are still a little anxiety inducing, but my most recent was super easy and I even was complimented by both my supervising NP and the tech.  That was a good day!

Well, last week, I'm getting ready to stitch up another patient's face (it seems like kids only cut open their faces, why is that?) and the parent starts snapping pictures with their camera.  Okay, no big deal, I've had that happen before.  We always tell them that its their child so they can take as many pictures as they'd like.  After getting my supplies set up and the wound thoroughly irrigated, I notice the dad is holding a video camera.  Whoa now...what's this?  I proceed to tell him that he is more than welcome to use it, but he probably won't see much because of the drape used to keep things sterile.  Unfortunately he didn't get the hint and kept recording.  Yikes!!  Talk about pressure!  My hands were shaking like never before.  It was worse than having to suture in front of my attending (which also sucks).  I successfully finished sewing up the face and made my way out of the room.  I don't think I've ever sweat so much during an easy, and pretty routine, procedure.

Afterward I tried to think of why I was so nervous.  I was going to do the same thing with the same amount of care and attention to detail whether the parents were video taping or if they weren't even there.  Honestly, I think it was a legal thing.  Now that I'm out on my own and practicing under my state license, I often find myself worrying about making a mistake and getting sued.  (I suppose this is a healthy fear because it makes me double check myself often.)  The video taping just made me more anxious about messing up and having it caught on tape.  

So, the moral of the story?  Please, if you take your kid to the ER, leave the camcorder at home!  Thanks in advance from your child's health care practitioner  :o)

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