Braided by Beth Ricanati MD

Author:Beth Ricanati, MD
Language: eng
Format: epub
Publisher: She Writes Press
Published: 2018-01-21T16:00:00+00:00

Mise En Place: Get Organized; It’s Key

When you are ready to begin, you need to get everything out. You need to set up. You need your mise en place. Chefs have their mise en place—French for “putting in place.” Literally, setting up everything ahead of time, putting everything in its place.

I place all six ingredients on the counter before I begin. It makes everything so much easier. I didn’t learn this from reading food memoirs, though I’ve got an entire bookshelf of them. Rather, I learned this as a physician at the bedside, in the hospital when I prepared to insert a large IV—specifically, one known as a central line—into a patient for this first time. Beyond terrified, I stood almost paralyzed. After all, it had been the thought of having to do this very procedure that had kept me up for weeks before starting my internship training. I had almost convinced myself that I would never be able to complete such an invasive and potentially painful procedure.

Fortunately, an exceptional woman stood next to me at the patient’s bedside. She was a third-year resident in her last year of training and very calm, cool, and collected. Rather Grace Kelly–like, I thought. A woman just a few years older than I, whom I would come to respect tremendously, a woman who would come to teach me so many of the skills I learned that first year of my medical residency. I watched silently as she set up the mise en place right there on the patient’s bed, on top of the patient’s sheets, just next to the patient: she set about creating a sterile field (area) for us to insert this very large IV into the patient’s femoral artery (main artery of the thigh). She began by laying down a plasticized blue sheet. On top of that, she carefully arranged all the supplies that we would need for the procedure: the needles, gauze, and various little vials and tubes. If something would need to be opened later, she opened it now. She made it easy. She made it organized. I felt myself calming down; I felt my confidence returning.

After that experience, I copied her. Every time I needed to insert a central line during my residency, I set up my mise en place and successfully inserted the IV. I did this every time I went on to teach the residents and medical students on my team, as well.

Years later, practicing women’s health in Cleveland, I learned the value of mise en place again. Here, I did Pap smears every day in clinic. I had to do this invasive and potentially uncomfortable procedure on young women (maybe their first time), on old women (perhaps changed by menopause), on morbidly obese women, and on everyone in between. A really cool gynecologist I worked with patiently assisted me one day when I couldn’t easily do the Pap smear. I fretted, anxious and frustrated with myself, and feeling badly for the patient—who, incidentally, had a great reservoir of patience.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.