Have the best day ever!

August 19, 2014

After  a summer that seemed far too short, WE ARE BACK!!!! Back and excited about the start of a new school year.   HealthOU had the opportunity to connect with some of the incoming Biology / Biomedical Sciences majors and it was fun to see the excitement and anticipation. Wishing you all a great first  day of classes!  Hope its one of the best days of your life 🙂


1.  Start strong.

2.  Study everyday!  Yup, you read that right.  STUDY EVERYDAY!  It will make life immensely easier come test time, if you build daily upon what you learned the day before.  Review everyday after class for your core classes ( at the very least).

3. Don’t forget to have fun!

Next week, after things settle down a bit, we’ll post our fall timelines for each classification, so you’ll know what you should be doing to stay in the game and on track for working towards your goal of professional school.



Believe in Yourself

January 23, 2014

Hey Pre-Health Students!  Welcome back from your holiday break.  HealthOU hasn’t forgotten you.  Look out for the spring timeline for freshman – seniors in the next week.  Until then, remember:




Have a great weekend!


p.s.  As HealthOU preps content for this upcoming semester, we would love your input / questions regarding specific aspects of the application process, and life as a prehealth student so we can provide the best advice / content tailored to your needs.  Leave us a comment, or email us at healthou.org@gmail.com!  Hope to hear from you.

You Can Do It!

December 5, 2013
source: planetminecraft.com

source: planetminecraft.com

Feeling overwhelmed as finals approach, interviews loom, applications for summer programs and secondaries flood your inbox.  Take a breath and remember: You Can Do It! How do I know?  Because these guys did! Nothing to give you a little reminder that you can make it like seeing those like who have gone before! Be inspired!

Oakwood alumni Dr. Jaysson Brooks, (Orthopedic surgery) and   Dr. Carlin Williams, (General Surgeon)

Oakwood alumni Dr. Jaysson Brooks, (Orthopedic surgery) and Dr. Carlin Williams, (General Surgery)

Oakwood alumni, Dr. Stephen Gray (Transplant Surgery) and Dr. Colin Martin Sr (Pediatric Surgery)

Oakwood alum: Dr. Stephen Gray (Transplant Surgery) and Dr. Colin Martin Sr (Pediatric Surgery)

*Photos used with permission from Dr.Brooks and Dr. Martin Sr.

When Plans Don’t Pan Out

April 7, 2013

“For I know the plans I have for you,” declares the LORD, “plans to prosper you and not to harm you, plans to give you hope and a future.” Jeremiah 29:11safari.elephants.africa

I am very fortunate as to how my whole medical school journey panned out, although there was a time when I didn’t consider it as such .  Offshore medical school wasn’t what I originally planned while a Biology major at Oakwood. In fact, when I first heard of such medical schools, I told myself I would never allow myself to go there.  My plan was to go to Oakwood, get my B.S in Biology (which I did), then go to Loma Linda, get my M.D (which I didn’t), then get a residency at Florida Hospital in Orlando (which is still in the air).

Long story short, after my graduation from Oakwood, I went to Miami to pursue my Masters in Biomedical Science for two years.  Then, I went to South Korea to teach English for 26 months.  And then, I ended up at the American University of the Caribbean School of Medicine in St. Maarten.  WOW! This allowed me to literally complete medical school in 4 different continents: 2 years in St. Maarten, 1 year in England, five weeks in Africa, and my final year in the States.  I don’t regret a second of it.  God knows me so well, that He knew my passion for traveling, learning, and new cultures can only be fulfilled by the route I have taken.  I started medical school 5 years after my original plan, and yet, I know I am a better medical student for it.  I’m not afraid to push the limit and delve into unknown territory.   My adventures during my travels (close to 30 countries in 6 years) has given me so much courage, that I became a much more confident student in every way, allowing me to be in the top 12% of my class, and having the honor to address the new medical students during my Honor Society Induction ceremony.

This is not a boast, in the least.  It is a testament that God’s purpose in our lives will be fulfilled for our own good.  I say this is not a boast, because the years that I wasn’t in medical school, I screamed in anguish as to how my Lord can take away the dream that he placed in my heart!  I was angry, sad, and bitter.  That is until I stepped into my own “newfoundland.”  For once, I allowed myself to not think of medicine and just enjoy life. I am in my 20s, and this is the time to enjoy my life and cultivate my other interests and talents.  In that, I was able to discover other talents that I’d never known I had.  I was able to see myself as completely well-rounded.  I was able to live a life of no regrets.  I am still flabbergasted as to all the jaw-dropping, heart-wrenching moments I’ve experienced in the different corners of this world.  And that, no one can take away from me.  In fact, taking time off before pursuing one’s career is customary in Australia and England.  This is called Gap Year.  In many of my travels, I met many Aussies who’d been traveling for months! I was very envious of them.  They take the time out to enjoy life, discover their talents, take a break in the best decade of their lives, while their responsibilities are low to nil.  Once you start working and starting a family, taking a year off is near impossible.


So, fortunately for me, I started medical school in January 2010.  This meant that I would have lots of time off before my fourth year, and I will have lots of time off before residency.  I took advantage of that and did a 5 week elective in Tanzania, East Africa.  My dream of being in Africa finally came true.  I spent Christmas, New Years and my birthday in this foreign land.

I will say this.  In those five weeks, for the first time in all my travels, I wanted to go home during my second week.  In fact, my plane ticket was bought.  But why? Something major must have happened!  Thankfully, I didn’t go home early, and the weeks that followed more than made up for the reason I wanted to get out of Africa.

In my next post, I shall discuss my adventure as a medical student in Africa!

But do remember,  when plans don’t pan out as you would hope, it is not the end of the world.  Don’t lose sight of your original goals.  Keep pushing, but use the time “off” to cultivate your other talents.  We are all more than just medical students or future doctors.  What else do you love to do?  It helps to take time out to do something completely non-medical.  When you do come back to medicine, you will be refreshed.  You may even be a better medical student!  My fear that I have been out of school for too long when I started medical school catapulted me to study THAT much harder and more effectively, and it definitely paid off!

Good Luck!


Being A Patient!

February 25, 2013


“Humble yourselves, therefore, under God’s mighty hand, and he may lift you up in due time.  Cast all your anxiety on him because He cares for you.” 1 Peter 5: 6-7

Today, the roles of my everyday life was reversed for the first time.  On this day, I became a patient.

To make matters more interesting, I was a patient in the exact same hospital in which I’m a medical student.
I was scheduled to have both upper and lower molar wisdom teeth extracted under general anesthesia, due to recurrent infections (occupational hazard of a healthcare professional). I waited three months for this moment, and the time has finally arrived.
What i didn’t know, however, was that I would be admitted into the day surgery unit, and be dressed in hospital gown. I thought I would be in and out as an outpatient.
As I sat in my hospital bed, being consulted by the dentist,doctor, nurse and anesthetist, I couldn’t help feeling vulnerable and thinking, “this is what it’s like to be a patient.”
Ironically enough, just the day before, whilst in my usual role as medical student, I visited the same ward I was in, to check up on gynecological patients,who’ve recently had surgery. The irony goes even further than that, as the day lolls along.
Most of the staff who looked after me somehow knew that I was a medical student…some of them referring to me as doctor. Everything they explained was followed by:  “but you know that already.”  They were very kind and extremely thorough. I was amazed, as this was my first time ever as an inpatient in a hospital.
One caveat of being a patient who is also a medical professional, is that you know too much. As I’ve never before been under general  anesthesia in my life, I was rightfully very nervous. I have control issues, and for the life of me, it disturbed me to think that I would  medically be induced to sleep, where whatever happened during that time, I would never know.  Such a violation, I kept thinking. But more worrisome for me were the rare complications of general anesthesia that I remembered studying in Pharmacology. These complications include Malignant Hyperthermia, Locked-in Syndrome, Mendelson Syndrome, allergies to the anesthetic drugs,  just to name a few.
Sure, I knew that without known family history of the Autosomal Dominant gene that predisposes to Malignant Hyperthermia ( pyrexia, convulsions, myoglobinuria, arrhythmias, tachycardia, etc),there is a very slim chance I would be affected. Also, all the other complications were rare as well. Still, I asked for an anti- anxiety medication to calm my nerves.
When I was finally rolled into the operating theater, the second coincidence was that my anesthetist for the day was also the anesthetist who I worked with just the day before, for a patient due to have a Dilation & Suction for retained products of conception.  That patient hardly spoke English, so all the information had to be relaid in elementary, laymen words and very slowly.

However, for me, they hardly explained much at all.  I am a medical student after all, and I just observed the exact same procedure the day before, I’m sure they thought.  We used the time right before I was induced to sleep to joke around.
The irony of it all was not lost on me.

They were very gentle, and once the mask came over me, I was gone within a few seconds.
My dream was so sweet, but for the first time in my life, I couldn’t remember it. It was a very deep sleep that I most certainly needed due to my lack of sleep the night before.
All of a sudden, I felt a nurse shaking me awake, ” Your surgery is done. You can wake up now.”
I was so confused. What’s going on, I thought. Where am I?
Why am I in a hospital bed?
Then, the pain in my mouth hit me at the same time as the sensation that I couldn’t feel the left side of my lips. A huge gauze was imbedded in my mouth, and I reoriented myself. I’ll never forget those first few moments.
I can’t believe that I didn’t feel or recall a thing in that OR. I never even met the dentist who did the surgery (being a replacement for my original).
I continued spitting blood, which was hard to do due to my numb mouth.
I had to stay in hospital to monitor my blood pressure and heart, due to the proneness of hypotension after general anesthesia.
All the staff continued to be very kind and during recovery, I got on with the other patients in my bay, actually giving them medical advice and opinion about their various day surgeries.
It was a very pleasant experience, overall…one I shall never forget.
To boot, the pain in my mouth was very minimal and I was out and about in no time.
I truly believe having a pleasant experience in hospital encourages faster recovery due to the endorphins doing its work.
It should be mandatory for all up and coming medical professionals to be a patient for a day, in order that they may empathize more with the patients they will one day care for.
I know I will.

Even the wind and the waves obey Him

February 4, 2013


“But the men marvelled, saying, what manner or man is this, that even the waves and the sea obey him”  Matthew 8:27

Jesus had just finished delivering the Sermon on the Mount (Matthew 5 – 7), where He spoke at length to the people delivering proverbs for practical living.  He taught the people how to pray, described the elements for a true fast, encouraged them to seek first the kingdom of God, etc.  As He finishes delivering one of his most profound sermons, He is likely exhausted, but His work is not done.  He is approached by a leper who seeks healing, and in His lovingkindness, He obliges him.  As He approaches Capernaum, He is met by a centurion who seeks a miracle for his servant; and as a result of the centurion’s  faith his servant is healed without even coming in contact with Jesus.  Finally,  Jesus enters into a boat with his disciples and the Bible recounts that a storm arises.  The disciples begin to panic, and fearful for their lives they cry out to Jesus:  “Master, save us for we perish”.  Jesus rebukes them for their lack of faith and calms the storm, and the scripture states, “they marveled that even the winds and waves obeyed Him”.

Why were they surprised at Jesus’ ability to calm the storm? They had seen him perform miracles before. They were there when he healed the leper.  They saw how with just a word, he healed the centurion’s servant.  So why were they surprised?  I have two theories :  One: Because the storm was personal. They were the ones in the storm, and oftentimes while we see God do great and marvellous thing in the lives of those around us, we somehow feel that He won’t do the same for us. Two:  Maybe, they felt that although Jesus had power to heal a leper and a centurion’s servant, He wasn’t big enough, powerful enough to calm a storm. They limited God’ ability based on what they were seeing and experiencing at that particular time.

They had witnessed the miracles he had done in the lives of others; yet they didn’t fully acknowledge or believe that He could deliver them.  Other’s yes, but surely not me, they must have thought. Well, Jesus proved them wrong.  He is concerned about ALL His children, and all aspects of our lives, from the seemingly mundane to the “life changing” decisions we face.

This time of year can be full of angst for pre-health students as they eagerly await acceptance letters, wonder if they’ll ever get off the waiting list, and start to question whether their life dream is in alignment with God’s purpose.  Can God help me get in?  Can God show me what direction to go next if the acceptance letter doesn’t come?  Oh ye of little faith!   Just like He did for the disciples; if you just believe, you will see that He not only can, but He will!  Be encouraged, He will never leave you or forsake you!

Happy Monday!

“My Calling Is Clear!”

August 30, 2012

 “For I know the plans I have for you,” declares the Lord, ” plans to prosper you and not to harm you, plans to give you hope and a future.”  Jeremiah 29:11

As I stepped out of the elevators and entered the double doors, I heard the familiar sounds of crying, objects clashing, and running feet. I looked around and saw the bright and colorful surroundings that felt like a reprieve from the rest of world. It was then that I knew I was “home.”

This “home” I refer to is the Pediatrics ward.  I have found my calling.  My interest in Pediatrics goes as far back as middle school.  I always knew this is what I wanted.  Furthermore, to confirm my desires, I interned in Florida Hospital’s Pediatrics and NICU ward for a semester during my senior year of high school.  I never stopped smiling!

However, when I started my eventual career in medicine and started learning about all the “cool” and interesting cases medicine has to offer, I started rethinking my path.  Maybe I should be an Internist, so that I would witness and diagnose these “cool” cases that mostly affect adults.  Suddenly, Pediatrics seemed a bit boring.  Aren’t most children relatively healthy?  Would I be bored with checkups, immunizations, school physicals, and the other mundane tasks of a pediatrician?  What about the paranoid, know-it-all, helicopter parents?  I would have to deal with them as well.  And babies?? They can’t tell you what’s wrong with them.  Will their incessant crying and irritability reduce me to a pile of frustration, as their parents look to me to tell them what’s wrong with their child? And let’s not forget the dark side of Pediatrics, which includes child abuse, depression, and other mental illnesses.  How will I keep my composure when I witness these unfairly treated adolescents and the consequences it brings?

I rotated in Internal Medicine from January to April.  I was sure that I would probably seek a residency in IM, due to the vast number of sub-specialties I could go into afterwards.  However, I couldn’t shake the boredom I felt most days of the week.  Surely it is interesting, however, it wasn’t for me.  My surgical rotation was quite interesting, and I will always be fascinated when one opens the body while the patient is asleep, repairs something inside, closes it up and the patient is better.  However, my interest in surgery is from afar.  But as soon as I started Pediatrics, the familiar smile that never left my lips in high school during my internship returned, even on my first day of rotations.  It was evident: I love kids!  And I can’t imagine a career without them.

As it turned out, Pediatrics ISN’T boring after all.  Children are so dynamic as they grow older, that many things change, including differential diagnoses and drug dosage, even with children only months apart.  Also, most attractive to me in Peds, is the fast turnover of the kids, with new kids on the ward everyday, unlike the adult ward, where a patient can be in there for months. Kids tend to get better faster, which increases a sense of accomplishment (important factor for me) and decreases boredom (also important)!

I found myself staying on the ward for longer hours, coming back to interview patients in the evenings (long after I settled in at home and had dinner) and just hanging out with the kids and their parents.  I realized that I could never do so willingly in Internal Medicine or Surgery.  Sure, I did a few overnight and weekend calls in Internal Medicine, but I was always aware of the hours passing by.

The most proud moment for me in Pediatrics, was when I spent some time with a mother and her 11 year old son who has Type 1 Diabetes that was poorly controlled.  It was common knowledge among the doctors and nurses, that due to a slight language and culture barrier, the mother seemed to not understand the importance of supporting her son in his tight blood glucose control to prevent the sequelae of a chronically high blood glucose, and would undermine the efforts of the doctors by feeding her son way too much sending his blood glucose spiraling upwards.  I spent the morning educating, in laymen terms, about diabetes to the mother.  The light seemed to emerge in her eyes, as she finally seemed to understand the pathophysiology of what was happening to her son.  She became tearful and was very grateful.

I presented the 11-year old patient to Grand Rounds, and later, during morning rounds, the patient’s mother kept saying to her doctor: “Natacha told me…”  I was a bit embarrassed that she kept mentioning my name, afraid that I may have said the wrong thing. I held my breath after each declaration.

The doctor followed with: “Natacha? The medical student, Natacha? You know she’s only a medical student. There is a difference.”

To which the mother replied, “I know, but I figured she studied about diabetes and knows something about it.”

Fortunately for both the both of us, the information I gave was correct, and the doctor subsequently praised my efforts.  It was at that moment that I, paradoxically, felt like a real physician.

“I can do this,” I thought.  “I CAN be a Pediatrician.”


I Almost Made It….

June 14, 2012

I almost made it through the day without crying.

Six years ago today, one of my dear friends and future colleague was tragically killed in a car accident. Truthfully,  I spent half the daywithout realizing that today was the “anniversary” of her death.  As I prepared for bed just mere minutes ago, I was led to have some sort of quiet time with God.  Shamefully, amidst a schedule that has me either on call or post call basically every other day, I’ve neglected my time with God this week. So, I went, as I was led.  I opted for a devotional book “Morning Rounds” – a compilation of devotionals written by Loma Linda School of Medicine students, alumni and faculty for its Centennial year a few years ago. I’ve had this book for almost a year, and I sometimes skip around and just read a random one.  Today, I opted to read the one for June 14. As I looked at the first words:  “I lost my best friend…”, I thought, “Oh wow, how ironic for me to read a thought on losing a friend, on THIS particular day”.  I read on, and realized that the thought was about MY friend, MY Hersha LaRissa King.  It was submitted by one of her classmates who despite the short time that he knew her, he had captured the essence of who she was.  I wasn’t a third of the way into the piece before my eyes bursted with tears.  I had almost made it through the day…almost.   And now, with tear soaked face, I will share his words with you…

“I lost my best friend, Hersha King, because of a car accident during our first year of medical school.  Being a very shy person, I am not good at making new friends.  However, now I have many friends in the class because of Hersha.  One day in my religion class, the instructor pointed at each student and then asked the other classmates to tell something they knew about that person.  Only a few students knew me, so I was worried what would happen when my turn came.  Fortunately, Hersha was in the class and she introduced me to the others.  *side bar*  This the part where I lost it, because it was so true, so representative of who she was. 

Hersha also understood my difficulty with English. When I could not understand a colloquial expression she always explained the term or the meaning of the sentence to me.  When I said something incorrectly in English, she kindly corrected me.

Hersha had such an open heart.  She was the only person I could feel free to talk to whenever I needed someone to talk with.  If I called her, she would always call me back and give me thoughtful advice, even when she was busy.  When I heard the new of her death, I looked at my cell phone’s calling history; her name popped up first.  It was difficult for me to accept the reality of her death at the time.

Because Hersha and I were in the biomedical science program, we worked together.  We shared the same goal, which was to become good doctors and serve according to God’s plan for us.  Although she did not have the opportunity to reach this goal, her spirit is always with me.

What I learned from Hersha are Christian traits that are very admirable.  She was not afraid to offer sound advice or be helpful, she was willing to listen, and she found time for our friendship.  By reaching out to me, she created a bond that I will forever cherish as I try to demonstrate her excellent qualities to others.  Perhaps people come into our lives, even if briefly,to show us how we  should live the Christian life. ”

John Kioka, LLUSM, class of 2009.

My dear friend was a truly amazing woman, amazing Christian, and had all the makings to be an amazing physician. Her biggest goal in life was to touch the lives of many through medicine.  Despite not having the opportunity to complete her medical degree, she did just that.  She is remembered by many for her willingness to help, her willingness to serve others in times of need, her incomparable ability to encourage others, and for the gift of friendship that she offered so indiscriminately.   I know I”m not alone when I say that because of knowing her, my life will never be the same.

Sleep well my friend, until I see you again.

How to Pack Your Bag Item 4: Fearlessness

April 30, 2012

***I hope you enjoyed and were blessed by the last post! A little about me: I am currently a first year med student at Loma Linda University (raises hands in praise). My journey to medical school has been exciting, difficult, fun, stressful, and character-building all at the same time. Along the way, I mentally picked up and developed tools I knew would help me be successful in medical school. Now as a medical student, I have already used these items packed away in my medical school bag. Each post I would like to share with you one item you need to pack your medical school bag with. Prayerfully, by the time you are accepted, you will already have everything you need to be successful in the next step of your journey. ***


Our deepest fear is not that we are inadequate.Our deepest fear is that we are powerful beyond measure.It is our light not our darkness that most frightens us.We ask ourselves, who am I to be brilliant, gorgeous,
talented and fabulous?

Actually, who are you not to be?You are a child of God.Your playing small does not serve the world.There’s nothing enlightened about shrinking so that otherpeople won’t feel insecure around you.

We were born to make manifest the glory of
God that is within us.

It’s not just in some of us; it’s in everyone.And as we let our own light shine,
we unconsciously give other people
 permission to do the same.

As we are liberated from our own fear,
Our presence automatically liberates others.


~ Marianne Williamson

A few weekends ago, from April 5th– 8th, I was able to attend the Student National Medical Association (SNMA) Annual Medical Education Conference in Atlanta, GA. It was a blessing to say the least. First and foremost, it was free! We received sponsorship through our school, Loma Linda University, to send four representatives. Second, it was incredibly enriching. I was able to attend several workshops about how to be come an excellent physician, student, mentor, and person. Lastly, it was encouraging. The best part was meeting so many students just like myself. Transitioning from a predominantly minority school to becoming the minority at my school has had both its benefits and challenges.  Thus, simply being surrounded by like-minded and dedicated individuals similar to me has been indescribably rewarding.

The theme of the conference was “Champions of Change”. Yet, the recurring theme in my heart was “Overcoming Fear.” As I interacted and conversed with several of the students there, I came across many who had unfortunately seemed to settle for being average. There was little extraordinary about their character, passion, or drive. They seemed unmotivated to grasp all they could from the opportunities that presented them there. But, in the midst of the mediocrity, there were some students who truly shined. Their enlightening passion and drive to become an excellent leader and, ultimately, physician was almost contagious. I saw within them qualities that I possess which yielded to the idea that I, too, could shine. Theses students had unconsciously given me permission to let my light shine and helped me to develop the fourth item in my medical school bag: fearlessness.

Having a mindset of fearlessness does not mean that we will never experience fear. On the contrary, as I ponder how I will handle school and extracurricular activities next year, I immediately experience the physical effects of fear and anxiety. The real test is how we handle the fearful moments, decisions, exams, and situations that we are bound to face in our lives. Marianne Williamson implies in her poem that our fear is precipitated when our thoughts teeter-totter on the line between success and failure – inadequacy and power. However, one important, scale-tipping factor remains evident: we are the children of God. 2 Timothy 1:7 tells us, “For God has not given us the spirit of fear; but of power, and of love, and of a sound mind.” As the children of God, we are equipped with the ability to be powerful beyond measure. Thus, it is in those moments when the MCAT score is lacking, when the “right” school must be chosen, when plans for next year must be solidified, and when opportunities arise that challenge our fearful hearts, we should discard fear and ask for the power and sound mind God has promised us. If we hold on to that God-given power, “we unconsciously give other people permission to do the same.”

As I looked around at the exceptional attendees of the conference, doubts of my powerful abilities arose. Challenged by the reality of failure, I asked myself the question, “Who am I to be fearless and powerful beyond measure?” You may be asking yourself a similar question. Who are you to be a competitive applicant, a leader in your school, a mentor to those under you, an exceptional medical student, and an outstanding physician? With knowledge that you are a child of God, I answer you back, “Who are you not to be?”

May God bless you and keep you as I know He will and may He give you a spirit of fearlessness and of power. If you have any questions, comments, concerns, or topics you would like to talk about- feel free to email me: k.titer@gmail. Also, if you’re new to the blog, take a look at previous posts by clicking on the tabs to the right.


~KeAndrea “Kiki” Titer

Fake It Till You Make It…

April 20, 2012

“Now this is the confidence that we have in Him,
that if we ask anything according to His will, He hears us.” 1 John 5:14 (NKJV)

Hello again! Today I want to talk to you about something that may seem in complete contradiction to what I wrote about last month. Last month, I talked about not being afraid to ask questions in the clinical setting, because not asking, in the worse case scenario, can be fatal. I also spoke about being aware of how much we don’t actually know once we start actually seeing patients.
However, there is an intimate balance between not knowing and asking questions and appearing as if you do know and being confident. The balance is extremely intimate in fact.
Just today, on my last day in my Internal Medicine rotation, I was with the “on call” team for the day and we were called in to see a 25-year old lady who came into Accident & Emergencies (A&E aka ER) hypotensive, tachycardic, and having passed out. On her bloods, it was shown that she was neutrophilic (high neutrophils on her white cell count) and acidotic (increased lactic acid). Basically, she had an infection. On further examination, it was determined to be a urinary tract infection/pyelonephritis.
Because she was acidotic, it was important for us to monitor her acid levels by taking some blood from her arteries, as venous blood can’t accurately tell us what’s going on with someone’s oxygen, carbon dioxide and bicarbonate levels. This is called an Arterial Blood Gas (ABG). Taking blood from an artery is more painful, as it requires us to go deeper into the skin. We usually do an ABG on the radial artery of the arm. Therefore, you must palpate the artery first to feel for a pulse. There are various techniques, and I have found one that has worked for me.
The registrar doctor I was with asked me to take the ABG. As soon as I walked in to take it, the patient was agitated. She didn’t like needles and kept asking if this was absolutely necessary. This wasn’t helped by the fact that her boyfriend was with her and kept asking why I couldn’t take venous blood (he’s a dentist, and had more medical knowledge then the average populace), and wanting the registrar to do it instead.
What do you do in this situation? First, let me tell you that I was seeing out of one eye, as I woke up that morning with a painful, pus-filled right eye, which was later diagnosed to be bacterial conjunctivitis, so contact lens were out. I had a headache as well. And I was hungry. So, what do I do at this point?
I carried on. I reassured the patient and her boyfriend that this was absolutely necessary. I warned her that it will be painful but hopefully it will be quick.
But guess what? I’ve attempted more than several ABG’s and only succeeded in one! At this point, I had to appear confident.
I prepared the ABG kit, cleaned the area, felt for a pulse, inserted the needle…and a loud YELP followed. No flash! Crap! That means I have to go fishing for the artery. I could feel the pulse underneath my finger, but I wasn’t in. I adjusted my needle and a greater YELP followed. At this point, disappointed, I removed my needle, and replaced it with a cotton ball. SIGH! I was not happy. Although I appeared confident, it didn’t work. The boyfriend beseeched me to let the registrar do it instead. I shamefully let the reg know that I couldn’t get it, and she should give it a go, because the patient was in pain.
Well, what do you know? The registrar gave it a go, and the SCREAM that followed was heard throughout the whole A&E. She couldn’t get it either. It’s terrible for me to say this, but I felt a slight twinge of satisfaction that it wasn’t just me. The patient’s fear of needles and low pain threshold combined with her overbearing dentist boyfriend made it impossible to get the ABG.
To the patient’s dismay, this meant that she had to stay in the hospital overnight, whilst getting I.V antibiotics and monitor her acidotic state.
This situation was a stark contrast to my last ABG, in which the older woman was also afraid of needles, and at that point, I hadn’t gotten a successful ABG yet. However, I appeared confident, and proceeded with the same steps. I was rewarded with a flash of beautiful bright red arterial blood – I WAS IN!!!
Moral of the story? Appearing confident is key. I have been called upon to perform several competencies that we are expected to know as physicians. It is very nerve wracking, especially for a shy girl such as myself. One must decide at this point should I carry on or ask for help. I believe asking for help is always the answer if there is a risk of patient injury. However, how can one learn if one doesn’t practice? As you get to the clinical setting, you will run into these scenarios time and time again, and you have to decide what the intimate balance is for appearing confident and asking for help. You may have to do both!
Today, I’m glad I attempted one more ABG in Internal Medicine. Now, on to Surgery!