Cannulas and cars

I don't like cannulas (drips for the non-medicos)

After a quiet inital 4 days it's been on relatively smooth sailing tonight except for the fact that I haven't been able to get 2 cannulas into 2 old people.

The first guy is getting a PICC line inserted tomorrow which means he probably has shoddy veins anyway but the old cannula decided to die tonight so I tried and tried but couldn't get that little plastic tube into his arm. I looked all over his arms for a palpable vein but just could not find anything resembling a bump on his arm. So I witheld his IV antibiotics till the morning.

The second old lady I think has a chest infection from aspirating and so I needed to give her some IV meds and her wrist was seriously 3cm in diameter (I'm not kidding - I've seen newborns with bigger wrists). I had 4 goes on her and used all the 22 gauge cannulas in the ward. But again she had not a bump in sight for me to stick the tube into.

I feel quite bummed about it now. Like I even went to ICU to ask the RMO there for help but she was asleep and is only a locum (so very unlikely to give a fig about the plight of a poor newbie on his overtime shift).

I've always sucked at cannulas. I'd never even got one in successfully until AFTER I graduated from med school. I dread having to be asked to put one in. I get so angry at myself when I miss. I was even using my beloved Introcan passive safety Cannula (I reckon they are amazing to use).

Why am I so uncoordinated/unable to get these darn tubes in?

I feel like I am so not preparred to be an intern from our med school. I somehow managed to avoid ever seeing an IDC/NG tube ever being put in and so this week of nights I've asked the nurses if I can watch whillst they do it. If you aksed me how to do it I could quote you a textbook answer, but having never seen one done until this week I was pretty useless.

And that's how I feel right now... useless.

The enitre hospital is depending on me right now to get these people some venous access and I just can't do it.

And to be honest I dunno how I'm gonna improve... short of asking an anaesthtist to follow me round 24/7 to comment on my technique I think it's just gonna suck indefinitely.

It's times like these I get frustrated.

I know I'm not the world's best doctor. I'm awful with ECG's... not brilliant with Xrays and my practical techniques are non-existent.

But I used to at least think I was competent. But even that is now in dispute in my mind.

I really don't think I'm cut out for this at times. Like I could never be a med or surg registrar. I'm just not that smart to do so (even if I DID want to). To be honest, GP-land would be the only real option for me (or maybe psych?) cos then I wouldn't be expected to know much and I wouldn't have any real procedural stuff to deal with.

As much as I like to pretend it's about lifestyle, it's really about me realising my limitations... and realising I am just not good enough/competent enough to do anything else.

In many ways I've been so relieved that my nights have been quiet becasue if they were more busy I fear that my inadequacies would be more evident.

I'm kinda worried about doing Urology next becasue that will involve lots of cannuals and catheters (both of which I am not good at). Doing psychiatry has been fun and a nice gentle introduction to working life... but has been useless for preparring me procedurally for the skills needeed for internship. I think the next 10 weeks after Whoop Whoop will be another steep learning curve.

Today I washed my car. I realised that my baby has not been washed EVER and the build up of dirt was starting to show. But after a 20 minute run at the local car wash she's looking nice and shiny. Like the sleek blue machine that I fell in love with oh so many months ago.

Like seriously... cars are so much better than girls.
You don't have to talk to your car if you don't want to.
She always goes wherever you want to go with her.
Her CD player always has good music.
When it's hot she cools me down and warms me when its not.
She only costs about $40 a week to keep maintained.
She doesn't mind if other people tag along with us.
She doesn't expect phone calls.
She only takes 20 minutes to look clean and attractive.
She smells really nice.
She doesn't care if she looks fat.
She doesn't get 'that time of the month'
She doesn't send 'signals'

I'm smitten with my car... sigh