Tourniquet. Cleany wipe. Safety needle. Blood bottles. Cotton wool. Tape. Gloves.
I wander over to the lady lying in the bed at the end of the ward, curled up in the sheets as if hiding from the world. I introduce myself, explain that I need to take some blood, and wash my hands. My fifth set of bloods that morning – the doctor I was shadowing had already thanked me multiple times for helping with the jobs. I was glad I could contribute after so many years of studying and shadowing, and taking blood was something I’d improved at a lot over the last year or so.
“She’s very difficult to bleed – I can help hold her arm if you like, she flinches a lot, ” the student nurse kindly offered. I gratefully accepted and we walked back to the bedside.
I found a vein, easy as anything, and slid the needle in. The lady flinched but the needle stayed true and felt that flicker of joy as the blood slowly wormed its way along the tube to the first blood bottle.
“You’re the first to manage that!” said the nurse, holding firmly onto the patient’s arm.
“Ah…you can’t jinx it!”
In a beautiful twist of defiance the blood screeched to a halt, tantalisingly close to the bottle. I pulled the needle back a little in an attempt to free up the flow but it wasn’t budging. I found my cotton wool and went to slide the needle out so I could try again, at which point the lady flinched, and my right hand swung just close enough to my left to let me feel the electric flick of the needle darting into my wrist, and out again, as if nothing.
That did not just happen.
I looked at my wrist as the ugly pearlescent globe of blood gradually ballooned out of the skin, confirming my mistake. At first I didn’t believe it. I couldn’t have. I’m so careful. I’ve done hundreds of these and never had a problem. Not me. I did all the online modules about safe venepuncture and got full marks. The needles are virtually idiot-proof, I’ve never been even close to sticking myself before.
But this time I did.
A surge of anger broiling with fear burst over me, sweat rolling down my back and my throat welling up. I wanted to scream. I hurriedly tidied up the equipment and left the nurse with the patient while I ran off to the nearest sink. The glove now had a film of blood smeared around its inner layer, as if mocking the futility of my situation.
Encourage the wound to bleed.
I stood there for what seemed like an hour with my hand under the hot tap, watching the thin trail of blood run off my wrist into the sink. I imagined millions of viruses pouring down the drain, praying that somehow they’d all be flushed out of my system. My mind went blank.
Shit shit shit shit shit.
HIV, Hepatitis B and C, CMV, Epstein Barr… all the possibilities ran through my head. How likely is it that she has HIV? Do I remember seeing it in her notes? How likely is it to have transmitted to? I was wearing gloves, the wound bled straight away – that’s good – shit shit shit.
I’d done everything right. That’s what hurt the most. I’d done nothing wrong, it was just an unfortunate coincidence that she happened to flinch right when my hands were nearest each other. A second later, or earlier, and there would have been no problem. The needle was still in her skin, for christ’s sake, what were the chances!?
I spent the rest of the afternoon in a daze as I plodded off to occupational health to be told just exactly how likely it is that I’ve given myself some nasty virus, before heading back to explain to my seniors. She was what is referred to as a ‘very low risk’ patient, with no history of blood borne viruses. One thing that was reassuring was the way everyone reacted – as if I’d got a parking ticket – it was one of those annoyances that happens more often than it should. There wasn’t the outright panic that I expected for some reason, and most people were even sympathetic! I gradually came round to the idea that I was actually incredibly lucky. I’ve taken blood many times from people with very nasty viruses that would have almost certainly have transmitted had I stuck myself when taking their blood, yet it was this time, on this patient, that it happened. It could have been so much worse. I also got a free Hepatitis B booster that I was overdue for anyway, and the lovely OH nurse demonstrated (on me) how to do it properly, as she took my blood for testing if needed later.
One day, three needles, and I was on the wrong end of all of them.
As I got home I put my bag down and shuffled in to the kitchen in search of food, bewildered and flustered by the day’s events. I promptly stubbed my toe on the fridge door and then burned my thumb on the frying pan.
Let’s try again tomorrow…