problem: fainting during rotations

ok - so here is an odd question. i have a fear/phobia of needles and it has a tendency to make me pass out. i started my surgery rotation this week and yesterday we got called in because they had trouble startinga line in someone. as they were doing it, i started to feel faint, walked out into the hallway and fainted on the floor. i made it around the corner so my resident didn’tsee it. a nurse did but she asked me if i was just resting. kind of odd. anyhow, my question is this: does anyone know of a way to get over this fear? will it occur naturally or do i need to find relaxation techniques or what? also, how do i handle this with my resident? just come out and tell him my problem or try to hide it/get over it? i feel like such an idiot and i don’t want this to be a problem but i can’t seem to fight my way out of passing out. any suggestions would be welcomed…

One avenue might be anti-anxiety medication, another de-sensitization exercises. Arrange a psych consult to discuss what can be done about your fainting. I’m sure it is something that you can overcome. Good luck.

Hi Kelly,
I usually have two or three folks who faint in the OR or like you, when we are doing a procedure. It is nothing to worry about. First of all, if you are scrubbed and feel faint, announce that you have to step back from the table because you feel faint. The good thing is that you get a warning because you just don’t feel right. The circulating nurses are great about catching people before they hit the floor.
Second, make sure that you keep yourself hydrated. Almost every surgeon and most docs are walking around the hospital in a mild state of dehydration. If you have to get a small water bottle and keep it in your pocket, do so. Also, don’t forget to eat several small meals to keep your blood sugar constant. Avoid the Snickers bars (you get a rush and then a huge drop) to go for someting with good protein and complex carbs. I use to keep Crackling Oat bran in my pocket.
The best way to get you through your needle phobia is for you to start IVs and central lines. You would be my first student to nail one of these. I would first talk you through the procedure and then have you practice insertion on a roll of towels. Then you would place a perfect I.J. with me riding shotgun. By having you place the line, your attention get focused on the procedure and you are less likely to faint.
Finally, don’t worry about fainting. It happens so often. You might get teased a bit but a strong vasovagal is part of natures way of keeping you from throwing up! Most people who faint,don’t vomit as their first response to something distastful. Personally, I would rather faint than “hurl” but fainting could be hard on the head.
Keep yourself hydrated and avoid the very concentrated sweets. Warn the surgical team when you get that sense of impending faint coming on so the circulator can catch you. Be prepared to take some good-natured ribbing but hang in there, it’s not going to keep happening. Fainting at the OR table is a good way to keep the nasty attendings from pimping you!

So here I am, PostCallMary, better known as the mild-mannered Mary Renard but I used this login today because I’ve had two hours sleep in the last 40. But I will try to be nice. Anyway…
Kelly what you do NOT want to do is try to hide this or hope no one notices. As Nat said, this happens a LOT and OR folks are used to it. But everyone - attending, resident, scrub & circulating nurse - will be annoyed if you do NOT give fair warning as Natalie has described. Your safety (you could land on your head) and the patient’s safety (you could pull down drapes as you go down, for example) are paramount.
It’s been my experience that the folks who find this difficult at first quickly recover from it for a couple of reasons. First, I do think they’re desensitized. Secondly, they learn what Natalie’s talking about and they drink more water. Third, they remember that their mom was right and you must eat breakfast. It is hard to eat breakfast at 4:30 in the morning, which is what time I was heading in to pre-round during my surgery rotations in med school, but I got used to it. In fact, I ate a peanut butter and jelly sandwich with a glass of milk, and that kept me real nicely until a lunch break many hours later.
contemplating a holiday weekend - unexpected day off Monday, woo-hoo!

While I don’t have any advice to add to the as-usual-great-advice of Mary and Nat but I do want to add how common this is. Just last month, my pedi team was on rounds. We had a pre-med student rounding with us who looked particularly bored (like the rest of us) right up until she got a glazed look in her eyes and headed straight (and I do mean straight) for the floor. I managed to catch her with her face about an inch from the floor and me sitting on my arse.
Again, it is very common. Keep at it and good luck!
Take care,

Yeah, Jeff, I think that third year is when people realize that ya know, breakfast really is as important as it’s cracked up to be.
Reading my PCM comments from last night, I want to clarify something: I don’t mean ONLY that you should give warning if you feel like you are going to faint - obviously that is one thing you absolutely need to do.
But if you’re one of those strong vasovagal types who KNOWS that you have a needle thing, your resident needs to hear about it when you are NOT about to pass out. That way if you say, while scrubbed in, “I’m sorry, I’m going to have to step away for a moment,” s/he will know what it’s about and will facilitate your graceful departure, instead of wondering what the hell you are talking about. So Kelly, please do give your resident a heads-up.

Hi Kelly:
I too have a problem with needles. I worked for a vet for a while. Blood and scalpels I’m OK with, its the needles that I don’t like. I punctured my eye with a pin when I was six and that is where my anxiety stems from. I became nauseated by the smell of isopropyl alcohol until I was in my early teens. When I personally have had blood drawn or an injection, I freely admit this problem and take a lot a deep breaths. I don’t consider my issue a phobia, I just don’t like needles. Its seeing them enter and sit under the skin that gives me the willies. To get over this probelm I started to regularly donate blood. After a while I started watching them put the needle in my arm. As was stated in an earlier post, desensitizing myself. Blood donation is the end goal for those with needle phobias who seek professional assistance. If you can do that, you are over it. And some people who have needle phobias can’t even look at a photo of a syringe without passing out. Another thing that has assisted me is my cat was diagnosed as diabetic about a month ago. He needs insulin and I love him more and than I dislike needles. So I had to get over the issue of giving an injection a lot sooner than I anticipated. I feel for you. I would try to desensitize yourself. Get the help of a professional if you need to. You can do this. Don’t beat yourself up. Everyone is afraid of something. Good luck.

I agree, let people know. I DIDNT when a nursing student many moon ago, and got stuck in a very small room with 5-6 other nursing students, staff, the doc and a patient on a gurney about to undergo electroshock therapy. Well, I bounced off the gurney before hitting the floor. It wasn’t pretty. (I was first trimester BTW) Makes me laugh now though.

I had a similiar experience with my first trauma patient when I was a nursing student. I "grew out of that with time. Fourteen years later while on my surgery rotation, I had many near syncope episodes (I hate having all that gear on). When I shared my story with my sister she said to monitor what happenes the next time I was in the OR. The one thing that I did notice was,…I am a “breath holder.” When you notice “that funny feeling,” concentrate on your breathing (also move away from the table). Take some slow, deep breaths. Then, make sure that your shoulders aren’t up to your ears, let them relax. Also, make sure your knees are not locked. Military recruits are notorious for passing out after locking their knees.
Hope this helps,
P.S. Good catch Jeff!