The other day I was working with my preceptor at the University emergency department when a maroon-vested undergraduate volunteer took to following me around. I happily answered several of his questions then referred him to this blog.
Later that evening, we were both watching a resident sew up a laceration. Even though the resident had already taken the patient's history, I asked the patient simple questions like how and when, as much for my own curiosity as for distracting her from the discomfort.
As I stood there watching the resident put in one simple interrupted stitch and then another, I realized that this kid standing next to me had little or no context and probably had absolutely no idea what was going on. So I decided to teach.
"The reason why I asked how it happened is because it could give me a clue as to how dirty that wound is and what possible organisms could be in there."
"I asked her when it happened because we don't typically close wounds on the extremities if they happened more than 8 hours ago. It could cause an anaerobic bacterial infection."
These are things that I take for granted now but that he likely didn't know.
The resident heard me teaching the volunteer and asked me if I wanted to finish up. Sure! As I put in the last three sutures, I verbalized everything: grip the needle in the middle of the curve using the tip of the needle drivers for better control, needle perpendicular to the skin, roll my wrist because the needle is curved, take an even bite on either side of the wound, don't tie the knot too tightly to avoid strangulating the skin, etc...
It felt good to be on the other end of information exchange for once. Teaching felt natural.
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