My hand was shoved down, awkwardly positioned between the folds of trousers and half-pulled down underwear, in the man's groin crease, trying to palpate his testicles without pulling any of his pubic hair. Something didn't feel right, but it wasn't his testicles.
I was in my final surgical OSCE's and it was my first station, where the adrenalin was flowing and my mind was racing faster than my running commentary...
...and I would be checking to see if there were any hard lumps in the scrotum, or if I could not get above the swelling...
I had only just recovered from initially describing my landmarking for the deep inguinal ring as the "midpoint between the pubic trochanter and the anterior superior iliac spine" which caused my examiner to hover his pencil over the marking pad as I searched for the correct word that started with a "T".
TUBERCLE. Tubercle. Tubercle. Tubercle. Dammit.
Check.
Initially I hadn't been too flustered. It was a groin exam for a lump, which is pretty standard on a surgical final. But I didn't think that we'd be expected to actually tackle the tackle in the exam. I said the usual "Ideally I would like to expose the patient fully and perform a genital exam to complete my hernia assessment" and waited the beat for the examiner to butt in, rescuing the patient from a succession of 32 fumbling medical students.
Silence.
Maybe he hadn't heard me.
Ideally I would like to EXPOSE the patient fully and perform a genital exam...
Still nothing. So I went for it. Which is how I found myself rolling this 70 year old man's testicles around in my hand at 0905h on my last day of medical school, wondering WHAT it was that didn't seem right.
It wasn't until my rest station a few stops later that I saw, between a one inch crack in the curtain, a colleague pulling on a pair of gloves.
OH FUCK!
That was what felt weird. I have been a nurse for 5 years and a medical student for 4. I put on gloves when I hear the ambulance bay doors open, even before I see the patient. So WHAT THE HELL WAS I THINKING DOING THE EXAM BARE HANDED?!?!? What felt weird was the fact that I didn't have a nice latex barrier between myself and that poor man's private parts.
I started wondering if maybe my mistake had been a red flag (i.e. cause for failure of my surgical OSCE's as a whole). When one of the emerg docs walked by and asked how I was doing during a later rest station I told her, "Well, pretty good for starting the day by ball handling without gloves, how's your day going? Do you think I red flagged???"
She said she couldn't be sure but told me not to worry as once during her emergency medicine exams she put in a chest tube without gloves (I'll point out that this involves sticking a FINGER INTO THE CHEST after you've made an incision in the rib cage). She did make me feel better.
Afterwards with some of my classmates during our postmortem on the exam I confessed to my ridiculous oversight. The color drained from one girl's face as she suddenly realized that she had done the same. Ohmygodohmygodohmygod. She seemed to be quite disturbed by this realization. It wasn't until much later in the evening when she had consumed a few celebratory pints that she approached me at the bar and confessed.
You know how freaked I got about not wearing gloves? Well...I couldn't tell you at the time because I was so mortified....but mostly the reason I was so upset was that when you said that I realised that right after that station I had EATEN A SCONE!!!!!
I was in my final surgical OSCE's and it was my first station, where the adrenalin was flowing and my mind was racing faster than my running commentary...
...and I would be checking to see if there were any hard lumps in the scrotum, or if I could not get above the swelling...
I had only just recovered from initially describing my landmarking for the deep inguinal ring as the "midpoint between the pubic trochanter and the anterior superior iliac spine" which caused my examiner to hover his pencil over the marking pad as I searched for the correct word that started with a "T".
TUBERCLE. Tubercle. Tubercle. Tubercle. Dammit.
Check.
Initially I hadn't been too flustered. It was a groin exam for a lump, which is pretty standard on a surgical final. But I didn't think that we'd be expected to actually tackle the tackle in the exam. I said the usual "Ideally I would like to expose the patient fully and perform a genital exam to complete my hernia assessment" and waited the beat for the examiner to butt in, rescuing the patient from a succession of 32 fumbling medical students.
Silence.
Maybe he hadn't heard me.
Ideally I would like to EXPOSE the patient fully and perform a genital exam...
Still nothing. So I went for it. Which is how I found myself rolling this 70 year old man's testicles around in my hand at 0905h on my last day of medical school, wondering WHAT it was that didn't seem right.
It wasn't until my rest station a few stops later that I saw, between a one inch crack in the curtain, a colleague pulling on a pair of gloves.
OH FUCK!
That was what felt weird. I have been a nurse for 5 years and a medical student for 4. I put on gloves when I hear the ambulance bay doors open, even before I see the patient. So WHAT THE HELL WAS I THINKING DOING THE EXAM BARE HANDED?!?!? What felt weird was the fact that I didn't have a nice latex barrier between myself and that poor man's private parts.
I started wondering if maybe my mistake had been a red flag (i.e. cause for failure of my surgical OSCE's as a whole). When one of the emerg docs walked by and asked how I was doing during a later rest station I told her, "Well, pretty good for starting the day by ball handling without gloves, how's your day going? Do you think I red flagged???"
She said she couldn't be sure but told me not to worry as once during her emergency medicine exams she put in a chest tube without gloves (I'll point out that this involves sticking a FINGER INTO THE CHEST after you've made an incision in the rib cage). She did make me feel better.
Afterwards with some of my classmates during our postmortem on the exam I confessed to my ridiculous oversight. The color drained from one girl's face as she suddenly realized that she had done the same. Ohmygodohmygodohmygod. She seemed to be quite disturbed by this realization. It wasn't until much later in the evening when she had consumed a few celebratory pints that she approached me at the bar and confessed.
You know how freaked I got about not wearing gloves? Well...I couldn't tell you at the time because I was so mortified....but mostly the reason I was so upset was that when you said that I realised that right after that station I had EATEN A SCONE!!!!!
9 comments:
Oh wow! That must have been an unpleasant realisation! I'm sure it's not the end of the world! Just remember to look for all the possible equipment before you stock your hand down someone's trousers next time ;)
Hilarious!
Love it! I was being tested on catheter insertion on a male. It was really just rubbery male bits and not a real person, but half way through I realised I forgot to put gloves on, and talked to instructor about it, she laughed and said "you would never make that mistake in real life." Maybe she was wrong lol.
@AB--Well they didn't fail me so...heh. Poor guy. How gross.
@K--hilarious now, now that I haven't been invited for repeats in August! hahah
@Andrea--Ugh I HATE those fake cath kits. They should make them more real. GIANT testicles with an impossible to find penis hiding in the folds of pannus. :) And yes...anything is possible! hahah
I just spit tea all over the keyboard. Awesome story. Probably made the guys day.
Is it bad that Tool is the word for robot confirmation...
I will never look at scones the same again. Thank you.
Oh no. OH NO. That's awful. I have a CS OSCE tomorrow. Will remember the gloves.
Even worse, my associate applied Condylox to the patient's genital warts and then gently blew air over it to help it 'speed dry'! She was so embarrassed!
Post a Comment