ScienceisAmazin Posted June 17, 2012 Author Share Posted June 17, 2012 I am pre-PA, applying this fall, and my biggest obstacle is overcoming vasovagal syncope. I recognize my symptoms (feeling overheated, sweaty, nauseated, tunnel vision) before fainting and excuse myself for a drink of water in the hallway before returning. I have identified my trigger is seeing patients in pain from fractures, lacerations, or IVs. (This has occurred, embarassingly enough, through shadowing.) I am a former teacher and my instinct is to empathize with patients. I believe the best way of overcoming this obstacle is to view patients as puzzles to be solved and treat their pain as a symptom, instead of identifying with them and trying to "make them feel better". Does anyone else here have a similar story and has overcome this? Are there techniques to (this sounds terrible) "de-humanizing" patients? Link to comment Share on other sites More sharing options...
ScienceisAmazin Posted June 17, 2012 Share Posted June 17, 2012 I am pre-PA, applying this fall, and my biggest obstacle is overcoming vasovagal syncope. I recognize my symptoms (feeling overheated, sweaty, nauseated, tunnel vision) before fainting and excuse myself for a drink of water in the hallway before returning. I have identified my trigger is seeing patients in pain from fractures, lacerations, or IVs. (This has occurred, embarassingly enough, through shadowing.) I am a former teacher and my instinct is to empathize with patients. I believe the best way of overcoming this obstacle is to view patients as puzzles to be solved and treat their pain as a symptom, instead of identifying with them and trying to "make them feel better". Does anyone else here have a similar story and has overcome this? Are there techniques to (this sounds terrible) "de-humanizing" patients? Link to comment Share on other sites More sharing options...
jmj11 Posted June 17, 2012 Share Posted June 17, 2012 I had one panic attack as a student when I quickly went from talking to a patient to holding his beating heart in my hand on my first day of surgery rotation. I didn't pass out (thanks in part to my face mask forcing me to re-breath). I would assume that the best way to over come this, like with all forms of anxiety, is through gradual exposure combined with self-talk and relaxation. Exposure opens the world, avoidance closes the world. Don't let this side track you. It because a vicious cycle where you become fearful of the event (passing out) so it isn't the trigger that's the problem anymore but the fear of repeating the response (passing out). You can take lemons and make lemonade by using this extreme empathy in a positive way with your patients. Link to comment Share on other sites More sharing options...
jmj11 Posted June 17, 2012 Share Posted June 17, 2012 I had one panic attack as a student when I quickly went from talking to a patient to holding his beating heart in my hand on my first day of surgery rotation. I didn't pass out (thanks in part to my face mask forcing me to re-breath). I would assume that the best way to over come this, like with all forms of anxiety, is through gradual exposure combined with self-talk and relaxation. Exposure opens the world, avoidance closes the world. Don't let this side track you. It because a vicious cycle where you become fearful of the event (passing out) so it isn't the trigger that's the problem anymore but the fear of repeating the response (passing out). You can take lemons and make lemonade by using this extreme empathy in a positive way with your patients. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted June 17, 2012 Moderator Share Posted June 17, 2012 Practice. Got woozy first time I saw few surgeries. Seeing a person's hand inside someone else got me. Got over it by repeated exposure. Eventually it was no different than watching someone skin a deer. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted June 17, 2012 Moderator Share Posted June 17, 2012 Practice. Got woozy first time I saw few surgeries. Seeing a person's hand inside someone else got me. Got over it by repeated exposure. Eventually it was no different than watching someone skin a deer. Link to comment Share on other sites More sharing options...
Joelseff Posted June 17, 2012 Share Posted June 17, 2012 Practice. Got woozy first time I saw few surgeries. Seeing a person's hand inside someone else got me. Got over it by repeated exposure. Eventually it was no different than watching someone skin a deer. I agree, exposure is the key so it will take time. I have absolutely no problem with traumas or human blood gore etc, but the smell of vomit, the smell of necrotic flesh like from a diabetic in desperate need of a BKA and ANY animal carcass gets me woozy. Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Joelseff Posted June 17, 2012 Share Posted June 17, 2012 Practice. Got woozy first time I saw few surgeries. Seeing a person's hand inside someone else got me. Got over it by repeated exposure. Eventually it was no different than watching someone skin a deer. I agree, exposure is the key so it will take time. I have absolutely no problem with traumas or human blood gore etc, but the smell of vomit, the smell of necrotic flesh like from a diabetic in desperate need of a BKA and ANY animal carcass gets me woozy. Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
ScienceisAmazin Posted June 17, 2012 Author Share Posted June 17, 2012 Exposure opens the world, avoidance closes the world. What an excellent quote! I plan to expose myself as much as possible. I believe self-talk, reaffirming that what I'm doing is HELPING the patient, despite the pain, will help. And deep breaths will help for sure. Link to comment Share on other sites More sharing options...
ScienceisAmazin Posted June 17, 2012 Author Share Posted June 17, 2012 Exposure opens the world, avoidance closes the world. What an excellent quote! I plan to expose myself as much as possible. I believe self-talk, reaffirming that what I'm doing is HELPING the patient, despite the pain, will help. And deep breaths will help for sure. Link to comment Share on other sites More sharing options...
ScienceisAmazin Posted June 17, 2012 Author Share Posted June 17, 2012 I have absolutely no problem with traumas or human blood gore etc, but the smell of vomit, the smell of necrotic flesh like from a diabetic in desperate need of a BKA and ANY animal carcass gets me woozy. How about I trade you my ability to deal with fecal extraction, vomit clean-up, and oozing sores for your ability to slice and dice without fainting? :) Link to comment Share on other sites More sharing options...
ScienceisAmazin Posted June 17, 2012 Author Share Posted June 17, 2012 I have absolutely no problem with traumas or human blood gore etc, but the smell of vomit, the smell of necrotic flesh like from a diabetic in desperate need of a BKA and ANY animal carcass gets me woozy. How about I trade you my ability to deal with fecal extraction, vomit clean-up, and oozing sores for your ability to slice and dice without fainting? :) Link to comment Share on other sites More sharing options...
Just Steve Posted June 18, 2012 Share Posted June 18, 2012 Teeth wig me the heck out. Loose teeth, mouth trauma, caries, you name it... if it's enamel, in the human mouth, I don't want to see it, deal with it, anything. So when forced to deal with them, such as in the course of my paramedic work, or being a dad to three kids who are going through their primary to adult teeth process I find that making myself cough will save me from hurling my guts out. Not a big coughing fit, but a dry, non productive, not a cough that requires me to cover my mouth, almost like a quick hack but with my lips closed, sometimes several per minute. My theory is that the cough increases my intra-thoracic pressure, keeping blood in my brain plus the thought process of coughing occupies just enough of my gray matter to keep things in control. I also use this technique for foul smells that make me want to wretch. Your notion of visualizing the patient as a puzzle is also very effective. I have done that many times during my work as a surgical tech, especially on big belly/chest cases. De humanizing? Sure.... but so is falling face first into the sterile field. Good luck :) Now go rent all the zombie flicks you can and watch them until you are desensitized. Link to comment Share on other sites More sharing options...
Just Steve Posted June 18, 2012 Share Posted June 18, 2012 Teeth wig me the heck out. Loose teeth, mouth trauma, caries, you name it... if it's enamel, in the human mouth, I don't want to see it, deal with it, anything. So when forced to deal with them, such as in the course of my paramedic work, or being a dad to three kids who are going through their primary to adult teeth process I find that making myself cough will save me from hurling my guts out. Not a big coughing fit, but a dry, non productive, not a cough that requires me to cover my mouth, almost like a quick hack but with my lips closed, sometimes several per minute. My theory is that the cough increases my intra-thoracic pressure, keeping blood in my brain plus the thought process of coughing occupies just enough of my gray matter to keep things in control. I also use this technique for foul smells that make me want to wretch. Your notion of visualizing the patient as a puzzle is also very effective. I have done that many times during my work as a surgical tech, especially on big belly/chest cases. De humanizing? Sure.... but so is falling face first into the sterile field. Good luck :) Now go rent all the zombie flicks you can and watch them until you are desensitized. Link to comment Share on other sites More sharing options...
Joelseff Posted June 18, 2012 Share Posted June 18, 2012 Teeth wig me the heck out. Loose teeth, mouth trauma, caries, you name it... if it's enamel, in the human mouth, I don't want to see it, deal with it, anything. So when forced to deal with them, such as in the course of my paramedic work, or being a dad to three kids who are going through their primary to adult teeth process I find that making myself cough will save me from hurling my guts out. Not a big coughing fit, but a dry, non productive, not a cough that requires me to cover my mouth, almost like a quick hack but with my lips closed, sometimes several per minute. My theory is that the cough increases my intra-thoracic pressure, keeping blood in my brain plus the thought process of coughing occupies just enough of my gray matter to keep things in control. I also use this technique for foul smells that make me want to wretch. Your notion of visualizing the patient as a puzzle is also very effective. I have done that many times during my work as a surgical tech, especially on big belly/chest cases. De humanizing? Sure.... but so is falling face first into the sterile field. Good luck :) Now go rent all the zombie flicks you can and watch them until you are desensitized. Lol, just like a fellow johnny janitor, worrying about the sterile field...I find I am still very anal about handwashing, cross-contamination, and strike through contamination. I guess STs will be STs. Also to cover up the smell of pts, I used to put a smear of vicks vaporub on my moustache under my mask Haha! To add to my animal carcass phobia, birds, Alive or dead freak me out! Lol. Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Joelseff Posted June 18, 2012 Share Posted June 18, 2012 Teeth wig me the heck out. Loose teeth, mouth trauma, caries, you name it... if it's enamel, in the human mouth, I don't want to see it, deal with it, anything. So when forced to deal with them, such as in the course of my paramedic work, or being a dad to three kids who are going through their primary to adult teeth process I find that making myself cough will save me from hurling my guts out. Not a big coughing fit, but a dry, non productive, not a cough that requires me to cover my mouth, almost like a quick hack but with my lips closed, sometimes several per minute. My theory is that the cough increases my intra-thoracic pressure, keeping blood in my brain plus the thought process of coughing occupies just enough of my gray matter to keep things in control. I also use this technique for foul smells that make me want to wretch. Your notion of visualizing the patient as a puzzle is also very effective. I have done that many times during my work as a surgical tech, especially on big belly/chest cases. De humanizing? Sure.... but so is falling face first into the sterile field. Good luck :) Now go rent all the zombie flicks you can and watch them until you are desensitized. Lol, just like a fellow johnny janitor, worrying about the sterile field...I find I am still very anal about handwashing, cross-contamination, and strike through contamination. I guess STs will be STs. Also to cover up the smell of pts, I used to put a smear of vicks vaporub on my moustache under my mask Haha! To add to my animal carcass phobia, birds, Alive or dead freak me out! Lol. Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
ScienceisAmazin Posted June 18, 2012 Author Share Posted June 18, 2012 ...I find that making myself cough will save me from hurling my guts out. Not a big coughing fit, but a dry, non productive, not a cough that requires me to cover my mouth, almost like a quick hack but with my lips closed, sometimes several per minute. My theory is that the cough increases my intra-thoracic pressure, keeping blood in my brain plus the thought process of coughing occupies just enough of my gray matter to keep things in control. Great idea! This is exactly the type of advice I'm seeking. Thank you! And, unfortunately, zombie movies don't do much for me because I know it's fake. It's when I know someone is actually in pain that I empathize so much. I'll still use it as an excuse to re-watch Shaun of the Dead, though. :) Link to comment Share on other sites More sharing options...
ScienceisAmazin Posted June 18, 2012 Author Share Posted June 18, 2012 ...I find that making myself cough will save me from hurling my guts out. Not a big coughing fit, but a dry, non productive, not a cough that requires me to cover my mouth, almost like a quick hack but with my lips closed, sometimes several per minute. My theory is that the cough increases my intra-thoracic pressure, keeping blood in my brain plus the thought process of coughing occupies just enough of my gray matter to keep things in control. Great idea! This is exactly the type of advice I'm seeking. Thank you! And, unfortunately, zombie movies don't do much for me because I know it's fake. It's when I know someone is actually in pain that I empathize so much. I'll still use it as an excuse to re-watch Shaun of the Dead, though. :) Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted June 18, 2012 Moderator Share Posted June 18, 2012 Don't lock your legs either. Move them around to prevent blood pooling. Takes out dozens of groomsmen every year. Seriously, keep moving. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted June 18, 2012 Moderator Share Posted June 18, 2012 Don't lock your legs either. Move them around to prevent blood pooling. Takes out dozens of groomsmen every year. Seriously, keep moving. Link to comment Share on other sites More sharing options...
ScienceisAmazin Posted June 18, 2012 Author Share Posted June 18, 2012 Don't lock your legs either. Move them around to prevent blood pooling. Takes out dozens of groomsmen every year. Seriously, keep moving. I am a former wedding coordinator and we've had a few close calls. Once they start rocking side-to-side, get ready to catch! Great point! Link to comment Share on other sites More sharing options...
ScienceisAmazin Posted June 18, 2012 Author Share Posted June 18, 2012 Don't lock your legs either. Move them around to prevent blood pooling. Takes out dozens of groomsmen every year. Seriously, keep moving. I am a former wedding coordinator and we've had a few close calls. Once they start rocking side-to-side, get ready to catch! Great point! Link to comment Share on other sites More sharing options...
mackjacks Posted June 18, 2012 Share Posted June 18, 2012 Move them around to prevent blood pooling. Takes out dozens of groomsmen every year. Seriously, keep moving. Skeletal muscle pump, keep it going! I definitely agree and @Just Steve teeth are the one thing that really gets me also. I will try the coughing technique. It was really horrible, but to help desensitize me I watched a video of a man being "curb stomped" several times and tried to think very pragmatic, medical thoughts about it. Terrible to view and the poor man, but I feel more confident that if something like that rolls in while I'm on an ER rotation I won't hit the floor. Link to comment Share on other sites More sharing options...
mackjacks Posted June 18, 2012 Share Posted June 18, 2012 Move them around to prevent blood pooling. Takes out dozens of groomsmen every year. Seriously, keep moving. Skeletal muscle pump, keep it going! I definitely agree and @Just Steve teeth are the one thing that really gets me also. I will try the coughing technique. It was really horrible, but to help desensitize me I watched a video of a man being "curb stomped" several times and tried to think very pragmatic, medical thoughts about it. Terrible to view and the poor man, but I feel more confident that if something like that rolls in while I'm on an ER rotation I won't hit the floor. Link to comment Share on other sites More sharing options...
ScienceisAmazin Posted June 18, 2012 Author Share Posted June 18, 2012 "curb stomped" :-_-:____________ Link to comment Share on other sites More sharing options...
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