Preparation

"Chance favors the prepared mind." - Louis Pasteur.

Today, I went to an open procedures lab at the UCSF simulation center which was really fun. I practiced lumbar puncture, intubation, IV lines, intraosseous lines, and umbilical catheterization on models (it's run by pediatric intensivists). Hands-on activities are always fun for medical students, but no matter what we're doing, we're cautioned that the most important part of the entire procedure and the main determinant of its success is the preparation. Does the patient understand what you're doing? Did you get consent? Do you have the help you need? Are your supplies ready? Do you have space? Do you have time or are you rushing through it to make it to lunch? Have you thought through all the steps? Have you confirmed the indications and contraindications?

Third year medical students are lucky; the resident takes care of all the hard stuff: the needle size is selected, the patient is positioned, the IV setup is within reach. But now I'm really beginning to appreciate the importance of the set-up. In the procedures skills lab, I spent more time reviewing the preparation for each procedure than practicing the procedure itself, but that's the way it should be. Even outside of procedures, this is important. Whether it is calling a consult, delivering bad news to family, or reviewing records prior to seeing someone, preparation is everything. Success favors the prepared mind.

Image of Louis Pasteur is in the public domain, taken from Wikipedia.