The Lesson I Learned the Hard Way

During my fourth year of Medical school, I completed an acting internship at a Veteran’s Administration hospital. Because VA hospitals were chronically short-staffed, medical students and interns were treated like slave labor; we were responsible for drawing all the blood and starting all the IVs. Thus, it wasn’t unusual to work a twenty-hour shift without a single break. After one particularly draining night, I crawled into bed at three in the morning, exhausted and cranky. I’d worked at a frenetic pace since seven the previous morning and hadn’t even had time to eat supper. My stomach grumbled in protest but if given a choice between sleep and food, even I, a food-aholic, chose sleep.

I had just reached that toasty, relaxed state where I was only seconds from catching an hour or two of much-needed sleep when my beeper went off. I glanced at my beeper and suppressed a curse—Nurse Ratchet at the “zoo.”

The zoo was the name we interns dubbed the poverty ward at the VA where a dozen beds were lined up in one large room like cribs in a Soviet orphanage. Nurse Ratchet was the name we dubbed for the battle-ax of a charge nurse who seemed to like medical students and interns even less than her patients. Other interns had warned me she took special delight in humiliating new interns over the tiniest of mistakes. Tonight was my first night to work with the old bat—lucky me.

I called with as pleasant a voice as I could muster and Nurse Ratchet informed me I needed to come start an IV on Horace Green. I dragged myself out of bed, stretched, and plodded toward the zoo. I dreaded my upcoming task, as I would no doubt have to poke and prod for thirty minutes before finally achieving a functioning IV. Meanwhile, I envisioned Nurse Ratchet standing over my shoulder sneering and snickering at my failed attempts. My hands would shake worse than an epileptic fit.

I trudged into the ward and located Mr. Green’s name at the bottom of his bed and then began the first of six attempts to start an IV. Both of his arms bore the splotchy, swollen, black, blue, green, and yellow evidence of previous incompetent medical student attempts to start an IV or draw blood. Every good vein—from his shoulders to his fingernails—had already been blown or butchered. Thankfully, Horace was so gorked out on pain and/or sleeping pills, he didn’t even flinch at my fumbling attempts. Finally, on the sixth try, I accomplished my goal--by pure luck and prayer--and connected the IV to a bag of saline. Thank goodness Nurse Ratchet was too busy stuffing her face with Doritos at the nursing station to hover at my elbow while tapping her foot and glaring at her watch melodramatically after each failed attempt.

I yawned, stretched my back--now aching from bending over Horace's bed for thirty minutes--and plodded to my call  room, praying I could get at least three hours of sleep before morning rounds. I had barely flopped my bedraggled body back onto the paper-thin, saggy mattress, however, before my pager beeped again. I wanted to fling the blasted beeper against the wall and clobber my cheapo mattress with a bat—but hadn't the strength or energy to do either. I glanced at my beeper and groaned—Nurse Ratchet. Again. WHAT DOES SHE WANT NOW? I called her back and she snapped, “I thought I told you to start an IV on Mr. Green. Why haven’t you done it yet—he needs his antibiotic.”

“I most certainly did start his IV,” I said, unable to suppress my indignant tone.

“Well, I’m standing right next to his bed and he has no IV.”

Had the old codger pulled out his IV already? If so, I’d ring his neck and he wouldn’t need another IV. (A twenty-hour workday with no supper and no sleep had done little to sweeten my mood or bedside manner.)

I stomped back to the ward cursing under my breath. But just as I’d said, Mr. Green lay in his bed with a fully functioning IV. What was her problem? Had that she-devil of a nurse paged me back up here just to be mean? I charged up to Nurse Ratchet at the nursing station. “Mr. Green’s IV is working perfectly.”

Hands on her ample hips and a condescending glint in her eyes, she said, “Afraid not.”

“I’ll prove it to you,” I said, annoyed at her priggish tone. I marched her to Mr. Green’s bed and pointed at his IV. “Voila, just like I said.”

Nurse Ratchet smirked. “You started an IV, alright—just not on Mr. Green. That’s Elmer Potts.”

My mouth dropped and the blood drained from my face. “What???” I pointed to the name posted in large letters at the bottom of his bed. “It says right there—Horace Green.”

She shook her head in disgust and with a patronizing tone said, “Don’t they teach you interns to check arm bands anymore? There are so many patients on this ward they just sleep in whatever bed is vacant. Elmer must have taken Horace’s bed so Horace is sleeping over there.” She pointed at another patient snoring in a nearby bed—without an IV.

I wanted to scream. “You mean I just wasted thirty minutes starting an IV on the wrong patient?”

She smirked again, unable to contain her glee. “Pretty much. And meanwhile, Mr. Green still needs an IV—just like I said.”

I wanted to cram the IV pole right down her cocky gullet. That cheeky nurse derived far too much pleasure from my mistake, especially at three in the morning. Her folded arms and “I-told-you-so” expression stuck in my craw like a chunk of spoiled scrod. But another intern had warned me to stay on Nurse Ratchet’s good side, or I would live to regret it. Since I had to work with the maddening shrew an entire month, I decided I’d better smooth things out between us. “Guess I learned that lesson the hard way,” I muttered, forcing myself to smile and chuckle in feigned humor.

Luckily, she accepted my olive branch and even offered to gather the IV supplies I needed to start an IV on the real Mr. Green.

On a positive note, never again did I perform a procedure on a patient without first checking the armband!