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Wednesday, October 22, 2003

Taking shots

Who would have guessed that you could trigger hemolytic anemia, induce tonic-clonic seizures and rupture someone's appendix just by giving a flu shot?

Of course, I'm kidding.

Yesterday I successfully administered 5 influenza shots, 1 vitamin B-12 injection (hey, it really IS red), and a Prevnar shot (to a 2 year old) without having to call 911. Alas, I was not so successful giving a PPD, as it did not raise a wheal as it should. So the nurse had to give it again, while I apologized to the patient who must have thought I was a resident. It's harder than it looks.

The hardest part is doing everything in one sequence. Uncap needle with prefilled syringe . . . tear open alcohol swab . . . wipe deltoid with alcohol swab. . . . pinch skin . . . insert needle intramuscularly . . . draw out for any blood return . . . inject vaccine . . . pull out needle . . . deposit syringe in sharps box . . . get band-aid . . . open band-aid . . . find injection site . . . apply band-aid . . . breathe sigh of relief! I kept putting the needle and syringe on the counter after I did the injection, but luckily no one got an unintended needle stick. The nurses do this all day. I imagine I will become as proficient as them if I keep doing it over and over.

I'm getting a little worried about my startup cost projections. Others in the Practice Improvement email group mention starting their practices with as little as $7500. Originally, I thought I'd need just $10,000, but lately it's been going up, and now I'm thinking $20,000 is what I should borrow from my 401k. Although I should only take out what I need, I am also worried that I won't take out enough, and have to take a cash advance off my credit card. Even though there are 0% credit cards, they are only for a short time, then a high interest rates kicks in. I figure I'm better off taking out more than I need (at 5% interest), rather than having to take a cash advance at 15-19% interest later.

Then there's always Plan Z: buying a Lotto ticket. I see the jackpot is up to $98 million. It's worth taking a shot, right?

Speaking of shots, I'll be getting stuck tomorrow morning by a technician coming out to draw blood for my AAFP Disability Insurance application. Hopefully his needling skills far surpass mine.

Countdown: 75 days until target start date.