5 | Weakness

"So you'll be taking care of this lady, huh? Good luck."

Exhibit A: something you don't want to hear from the day shift nurse before she leaves you with the patient in question.

"...I guess she basically screamed at the night nurse. She was okay for me, but I think she can sense if you're insecure. Just don't show your weakness and you should be fine." 

My weakness. 

As a green nurse in my first year of acute care, weakness is a constant companion. I doubt myself. I question my judgments. I ask questions until I stretch everyone's patience, and after that I fly by the seat of my scrubs. I come perilously close to making it up sometimes.  How on earth am I supposed to hide my weakness? Is it even safe to do that?

I draw in a breath as we enter the room, turning broadside to face the woman enthroned on her chair and holding court with a tired-looking family member. I give her a genuine smile. 

"We're doing shift change, I'm Kristen, and I'll be your nurse until 11 tonight. How are you feeling?"

She sizes me up. 

Hit me with your best shot. I've got my game face on. 

* * *

IVs have an uncanny ability to sense shift change. They work complacently all through the day, but the minute they smell shift change, they go bananas and start leaking, beeping, infiltrating, and bleeding their merry little hearts out. They really can be villains. 

I had actually hit it off to a good start with my patient. I liked her dry humor, she liked my Chuck Taylors, and the day shift nurse helpfully talked me up with nonsense about how patients love me. But five minutes later, I got a call from my tech. 

"Hey, can you come in here for a minute? Her arm's swelled up. I think the IV blew."

Of course it did. It's shift change. 

I briefly consider asking my charge nurse to restart the IV. She could do it effortlessly, and I wouldn't have to risk face with my patient over a messy IV attempt. But I will never improve if I don't try. So I pile my IV start equipment on the bedside table and chat nonchalantly to keep her mind off the needle. Or maybe it's to keep my mind off the needle. 

"So." she nods in the direction of my supplies. "Are you any good?" 

Shot through the heart. I never know how to respond to this. 

"Oh, don't worry. We do this a lot up here. Everyone needs an IV or five." She laughs at this. Good. I don't mention that I missed my last three IV sticks.

"Deep breath for me, little pinch..." I slide the IV into her left antecubital vein. Instant blood flash. Easy stage over: I flick the catheter gently with my fingertip to advance it and recognize that I've already resigned myself to blowing this one. 

My catheter meets resistance. I shift the angle slightly and nudge again. Resistance. Another degree. Resistance. I'm painfully aware of how many seconds have passed: another nurse would have finished this by now. 

Suddenly, the blissful release of catheter sliding into vein. It's in. I throw on a J-loop and flush the line; it works like a dream. I mask my relief with a business-as-usual expression and compliment her on her cooperative vein. 

"It's in?" She looks as surprised as I feel. "Wow, I barely felt it. You're good."

Cue theme song. 

* * * 

The high from that small success gave me the audacity to try an IV that my charge nurse missed. Miraculously, that one went in too. The cranky 83-year-old lady with dementia didn't pull her hand away, so I don't think I hurt her badly, either. 

Maybe in twenty years I won't fear IVs. Maybe I'll be a veteran who throws in hard sticks without hesitating.

But I have a lot of IVs to blow before then.

My deepest apologies to the owners of those veins to come. I will give you my best and sometimes that won't be good enough. I'm a human, and humans learn through experience... which looks a lot like practice. I'll try to make it up to you. 

All I can promise is to be better than I was yesterday.