February 2, 2018

Proceduring.

By Lucinda Gruber

Proceduring [pruh-see-jer-ingv. To perform bedside procedures with great skill and aplomb.

Okay, so maybe it wasn't aplomb. Maybe a better word would be competence or capability...something a little less flashy than aplomb. Moral of the story, I didn't blog last week because I was proceduring. I worked with two of our interns, Ryan and Nikhil, and we covered the procedure service for the week. It's actually a pretty nice concept. We take consults from our two hospitals, St Marys and Rochester Methodist, which are located about 6 blocks apart. If you have a patient who needs a lumbar puncture, paracentesis, or joint aspiration and you don't have time to do it yourself, call us. We are happy to assist. Just don't forget to hold the enoxaparin. 🙂

Our week started out pretty quiet so we spent some time talking about lumbar punctures - the technique and anatomical markers, complications, how to interpret CSF results. We ultrasounded a few patients that day looking for sufficient ascitic fluid for a bedside paracentesis. By the end of the day, I think we were pretty comfortable with the ultrasound, and I would trust Ryan or Nikhil to do an LP on any family member. Except maybe my grandma...she's a little scrappy. As the week progressed, we did a couple procedures a day. It was nice to get back in the hospital, seeing and talking to patients and making them laugh. I was reminded of what I love most about medicine - helping another person through a difficult time, sometimes when time is coming up very short. One of the most surprising things about this experience was the overwhelming appreciation and warmth we received from patients, but also their providers. We performed a paracentesis on a delightful gentleman who quoted poetry and football scores while we were waiting for the Vacutainers to fill up. When we were done, he was genuinely touched that we had given him so much relief in such a short time. His hospitalist team was equally effusive with their thanks. I'll be honest...it was nice, but unexpected. It reminded me that we weren't simply draining fluid - we were bringing people comfort. And that can't fail to make you feel warm and fuzzy.

So, five days of proceduring later, I would say I have a different perspective than I did a week ago. I'm excitedly awaiting my procedure service assignment coming up later this month. It is fun to work with just a couple interns so you can do quick, impromptu teaching sessions. We can cover the basics and then get into the nitty-gritty of proceduring. And that time is capped off by knowing we can help our teammates and comrades in the hospital while trying to improve the well-being of a patient. That sounds like a pretty good use of a day to me.

As a side note, this week I went to the gym and saw EVERY MEMBER of the current procedure team there. It took all my restraint not to ask the DAHLC employees to announce "Stat paracentesis on Level 2" over the intercom. But, had we actually needed one, we would have been in good and capable hands. They would have handled it with great...dare I say it...aplomb.

Muneeb, Jas, and Dagny - "Proceduring" After Hours

Tags: #MayoProcedureService, #Proceduring, Around the Hospital