Itchy Fingers

I work in a teaching hospital 80% of the time. Despite the fact that I love to teach and convey my knowledge to our residents, there is one aspect of teaching that really grates me.

Anaesthetists are not really perceived as being great procedural doctors. Most of our day consists of putting up IV lines and injecting stuff through them. Yes, we regularly insert endotracheal tubes but that to me is not a procedure - it is more like breathing or, to put an aeronautical spin on it - more like raising the undercarriage on an aircraft after takeoff. It is part of the process.

However, occasionally, we do get to do procedures. I am talking about things like epidural catheters, central lines, nerve blocks and procedures specifically aimed at control of chronic pain. This is where I have my great difficulty.

You see, I have very itchy fingers. I find it really difficult to watch a trainee do a procedure. It always seems to take forever if I don’t have the needle in my own hand. What they are doing never looks right - and as a result, I tend to want to jump in and get my hands on. NOW. Often, this is the only way to actually help. In many procedures, the way the needle feels as it passes through tissues is crucial to safely placing the catheter. And until someone figures out a way so gauge feel by simply looking at someone manipulating a needle, I will continue to pace, get agitated, and then shove on a pair of gloves and take over.

Does this make me a bad teacher? Probably. But that is simply the only way I know how to do it. Perhaps a daily supratherapeutic dose of Patience will help......