How to prevent fainting (for the squeamish medical student)

by     11 Comments    Posted under: Career, Medical Schools

how to prevent faintingDuring my A-levels, when a close friend of mine confided in me that he was thinking about applying for medical school but felt faint at the very sight of blood it got me thinking.

I was desperate to study medicine but hadn’t considered whether I too might be unsuitable because of similar fears.

During my work experience, aged 16, I had seen a huge facial tumour excision with a pedicled flap reconstruction. I remember having to sit down after feeling a little dizzy. Needles and other equipment associated with pain also made me a little uncomfortable. The desire to become a doctor was stronger then these concerns and I put them to one side hoping I’d get over them in time.

My friend ended up applying for a different course altogether and I’ve since lost touch with her but it seems obvious that there must be individuals in a similar position to my friend and I, and who worry about being too squeamish for a medical career.

In my experience this is, in most cases at least, an irrelevant concern.

Speaking for myself I found that I was indeed a little disturbed by certain horrible things in the early years at medical school. When I looked around me, many others were too.

On our very first day at medical school, the trauma team decided to lecture us on the most spectacular injuries they’d treated that year. It was supposed to be entertaining and informative. Once the close up photographs of facially injured patients with teeth sticking out of strange places began to appear, two students fainted and a few others had to leave the room.
All continued with the course and graduated five years later and one of them is today a successful general surgeon.

As time went on I became immune to all manner of seemingly squeamish sights and built up my resistance to almost anything over the years. I say almost anything, as there are still certain horrifying situations for me, listed later.


For anyone actually worried about this issue, the following is important:

Every single student that ever embarked on a medical career has felt horrified or faint on occasion. This is entirely normal even if many won’t admit it. If you are someone who can stand through a lengthy, painful or bloody procedure on day one at medical school (not that you’d ever be expected to), you’re probably not normal and you are probably unsuited to being a good doctor.
So now, to the main point of this argument. I think that the main difference between students is that whilst most manage to avoid making a fool of themselves, a few cannot help but faint publicly whenever the opportunity to do so presents itself.

I therefore gathered the following anti-fainting tips from various doctors across different specialities. They should help the novice avoid the major embarassment of fainting in front of a hundred fellow students in a lecture room, or collapsing mid-seizure into an open abdomen in theatre.

1. Maintain adequate fluid balance
As a medical student and as a junior doctor, you will be busy and you will neglect your own needs sometimes. If you are dry, you are more likely to drop your blood pressure and feel faint. Keep well hydrated. Your urine should be light in colour and high in volume. In summary, keep peeing and stay vertical.

2. Look after your blood glucose levels.
Thinking of missing breakfast before the weekly consultant ward round? You’ll have only yourself to blame if you later feel dizzy and sweaty when the ward round gets particularly smelly.

3. Increase venous return
This is a common technique, taught to me by one of my senior students during junior surgery attachment. The idea is to push blood out of reserve areas whilst standing, which means tensing your calves, thighs and buttocks (in that order). An alternative way of achieving the same thing is to rock a few degrees forwards and backwards on the balls of your feet. This is effective and very discrete.

4. Escape, avoid, run away.
There are times when the best way to remain standing is to look away from the offending scene, avoid a certain situation or failing that, to politely leave and sit down somewhere out of sight of your colleagues.

In summary, don’t worry if you are affected by this initially or are concerned that you might be. You will eventually grow out of it with increased exposure.

My own initial discomfort at the sight of blood or pain had disappeared by the time I was a fourth year medical student. There are however a few ugly things that can still upset me on a bad day:

1. Bad feet
You will at some point see very badly looked after feet. If concerned, try to avoid becoming too involved with diabetes or vascular surgery as I have.

2.Infected ulcers
As above.

3.Toenail removal
Long bloody operations where the patient exits theatre in a body bag are not the most fulfilling events but cannot, in my book at least, be compared to the removal of an infected, ingrowing toenail. Somehow watching one is worse than doing one.

4. Patients screaming in pain
Severe pain should not really be witnessed in hospital, as modern analgesic methods are sophisticated enough for most eventualities. Of course obstetrics is the obvious exception here, but I’m sure they too will exit the dark ages if and when a medical degree becomes a prerequisite for midwifery.

Sorry.

 

  • Euan

    Hey that was awesome! I’ve subscribed…

    • Leo

      Thanks Euan! I hope we manage to make it worth your while.

  • Stanley Goldman

    Sound advice -I wish I had it when I were starting. I wonder whether there is any data about how many med students are affected by this…

  • Jen

    Thanks for the post, just got forwarded you subscriber email by a friend as I’m thinking of applying next this September. It’s either medicine or dentistry for me. Hope you have some up to date info on personal statements pretty soon.

  • Sophie

    Great advice!
    I had a similar problem on one of my work experience placements. I was watching a stoma bag being changed early in the morning and suddenly felt quite sick and had to leave! Since I have not had any problems, and have observed in theatre, so it seems it was a one off, but I was extremely worried for a while that I would not be suitable for a medical career. Think a few people on forums have similar concerns, so will direct them here!

    • Leo

      Thanks Sophie.
      I remember watching a pedicled forehead flap being raised aged 16 and almost hitting the floor. I too worried it would happen again at some point.

      I followed the advice above though during my early years at med school and have thankfully managed to pursue a surgical career without any major problems so far!

  • Mo

    A bit harsh on the old midwives there Leo.

    Must admit that they have a hard reputation though!

  • Lucy

    I am a 12th grader, and I am currently interning at a local hospital. During my internship, I’ve observed c-sections, breast implants, orthopedic surgery, and a wide variety of other procedures while standing right next to the surgeon the whole time. I’ve never felt even the slightest queasiness, but today I fainted while watching my second epidural.

    I’m really nervous that this incident might be an indicator that I don’t have what it takes to become a doctor. It’s my dream to become a surgeon someday. Does this fainting episode mean that I won’t make it as a surgeon?

    • Leo

      Not at all.
      In fact it’s funny how some things make you faint whilst other, perhaps more bloody things, do not.
      If you ask most surgeons they’ll probably relate a similar story to yours (if they’ll admit it at all) and I know plenty of surgeons who find certain things like epidurals more disturbing than big open surgery.

      You’ll see so many of these things over the coming years that everything will become normalised.

      Leo

  • Jill

    I am second year pre-med student, on the physician assistant track. I have been in the OR to watch a total knee replacement, and felt uncomfortable and faint and left the room only to return and have the same feelings. I have come along way with my inability to handle certain medical aspects- I used to hate getting shots and had extreme anxiety about needles in general. I worry that I am not going to physically be able to complete the 5 week surgical rotation I will need to complete in graduate school. Any other tips or tricks anybody can suggest will be awesome! I already do the tips suggested here, and I feel like mentally I am over it, but physically I cannot stop my body from feeling this way and am very frustrated and concerned. Thanks!

    • Leo

      Hi

      Second year pre-med is too early to instantly overcome this. And to be fair to you a knee replacement is pretty heavy going at times!
      You just need more time and more gradual exposure.
      Some people take a little longer than others to get used to it but everyone gets there in the end.
      Try the tricks suggested above. Above all make sure you are well hydrated and stay relaxed!

      And please let the rest of us know if you discover any other helpful tips!

      Leo