The IV

One of the most basic medical procedures is the placement of the intravenous line. Nearly everyone who comes into the emergency department, hospital, or operating room gets an IV for administration of medications and blood tests. Every nurse and medical student learns how to start one. But doctors don't do it often. In fact, I didn't start any IVs last year as a medicine intern. In an institution like Stanford with plentiful ancillary services, physicians simply don't need to put in IVs. We only get contacted when several nurses have tried and failed. And in that case, there's no way I would get one when practitioners far better have tried.

But then I started anesthesiology. Anesthesiologists are the physicians who probably put in the most IVs since we're responsible for them for every operation. Indeed, we are often the last resort when no one else can get an IV. My first week, I had more failed IVs than successful ones. I was really grateful for my patients' and attendings' patience. But after practice and watching more experienced practitioners, the process clicked. Today, I managed to start a couple difficult IVs on my first try, including one on a patient over 350lbs and an elderly woman with transparent paper-thin skin. It felt good. IVs can be one of the most frustrating and yet satisfying procedures even though it is one of the most basic things health care practitioners do.

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