Just Another Day at Work

I am just not a morning person! Getting out of bed this morning at 5:30am felt much like the work of Atlas carrying Earth up the hill. Only with the fear of facing turtle-speed traffic to Dallas and showing up late in the ER, did I drag myself through the morning routine of getting ready. While in the car, I was still feeling groggy-brained and resentful. Then, I thought, "I don't want to start my day like this. I have 12 hours ahead of me." I made a little prayer in the car, "God, please make today matter, make it worthwhile for getting so early out of my comfy bed. I want to learn something today that would be of value to my future patients." I felt much more positive and energetic after that.

Today was my first day working with a PA in the fast-track section of the ER. That means mid-levels practioners who see "colds and minor cuts" type of stuff as well as pediatric and OB/Gyn patients. Well, there was nothing boring with any of that. Our first patient of the day was diagnosed with appendicitis (lesson to self: have a high suspicion for acute appendicitis, the pt won't always look as much in pain as you think they should). As a plus, I loved working with the PA, she was young, not any older than me and have be working for less than a year. She was easy-going and carried herself with aplomb and voiced herself with authority. After suturing a wound (dog bite) with her, she asked me if I'd be comfortable sewing up the next patient's laceration by myself. I said "sure" although I was so nervous I nearly took my answer back. To the experienced, this was as commonplace as tying your shoe, but to me, the novice, it was an much skilled endeavor.

I gathered all my stuff: sterile saline with betadine mixture, needle syringe with 1% Lidocaine, Prolene 5-0, suture kit, sterile gloves, etc. The patient, who was there with his wife, had sustained a small laceration to his arm from hitting a jagged pole. The wife said to me, "Can I watch you? You won't believe how I'd like to watch this kinda of stuff!" Oh no, I thought, not only am I nervous and inexperienced, the wife of the patient is going to watch! I begain be injecting the wound area with Lidocaine, this is the most painful part for the patient. Then I irrigated the wound with the saline + betadine solution. I felt like it took me forever to to do the first two sutures. I just didn't quite have the wrist coordination to smoothly maneuver the needle driver and suture needle.

"What is that suture technique called?", asked the wife.

"Umm, it's called 'interrupted sutures.'" The only type I knew. I was just glad she didn't ask how many times have you done this?

"The way you tie it, that's how I crochet!" she exclaimed.

"Oh really? I've never done crocheting. If one day I get better at suturing, maybe I can crochet!" I said.

Some brisk bleeding, pressure applied with gauze and two more sutures later, I was done! I went to get the PA to check out the "handiwork" as she likes to call it. She said I did just fine.

I thanked the patient and his wife for being so patient with me.

"Oh, you did a beautiful job. Soon, you'll be suturing like the rest of 'em!" the wife said to me.

I thanked her again. Secretly, I was fearing that maybe the sutures were too tight and the skin would turn black and necrose. . .or a large hematoma would form inside the suture because I didn't use the lidocaine with epinepherine, or maybe the patient would get compartment syndrome and need emergent surgery. . .

Seriously, I'm so grateful to have gotten the opportunity to practice suturing AND to have done it with a very wonderful couple. While the PA had offered me the opportunity, the patient's wife had given me the encouragement I so needed. That was an answer to my prayer this morning. Thank you, God!