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Sunday, January 18, 2015

LP = Lumbar Puncture / Spinal Tap

Finally... the moment you've all been waiting for...
or not!

I thought it would be fun to explain a little bit about
 my new job as a 
Lumbar Puncture (or as some say) "spinal tap" nurse.
Recently I posted a little synopsis about my career as a nurse 
before I started this new position in November. 
 I said I would be back for more on what I do now.
It may not be for the faint of heart so proceed with caution...

When I went to interview for this job, I totally thought it was a job in which the nurse assisted the doctor by setting up the Lumbar tray, handing him test tubes to collect the fluid and sending the fluid to the appropriate lab for testing. I wrong, within a few minutes of the interview I found out 
WE... THE NURSES actually DO the procedure! 
I immediately wanted this job.

Not only do the nurses preform the spinal tap but we (the nurses) teach and train the residents and Medical student how to do it. How cool is that. It'll be awhile before I do any teaching, since I'm still learning the skill myself. I have done 57 successful "Spinal taps" and have to do 100 before they let me fly totally on my own. Right now I do it all on my own, but one of my co-workers comes in the room and watches to make sure I'm doing everything right, she's also there for moral support  in case I cant get into the tiny space between the vertebrates (and that happens even to the seasoned LP nurse)
* all photos are from Google images, but this first on looks exactly like it could be my hands and my patient.... I love this job!

 The 3.5 inch needle is inserted into the L 3-4 lumbar space in the lower back, this person is collecting the spinal fluid in the clear test tubes

 We go about this blindly only guided by anatomical landmarks  experience and a lot of skill.
I'm getting pretty good at getting the patient scrunched up in the fetal position (like the photo below). 

Positioning is really the key to getting in between those vertebrate.
I sit behind the patient first feeling for the hipbone, then drawing an imaginary line down to the spine, there is a lot of pushing and prodding before I made my mark... 
I want to make sure the needle goes in the "sweet spot" for collecting the spinal fluid.

 My new job is humbling, each day brings challenges, we call these challenges "bad backs" meaning arthritis, narrowing vertebrate, curvature of the spine etc.
All these things make it more difficult to get into the space to collect the fluid. 
In addition to the physical challenges we have the normal fears, apprehension and tears
 that come along with a procedure like this one.  I love meeting with my patients before the procedure to explain the procedure, to get to know them a little , and to reassure them that everything will be ok! After the procedure they are usually surprised at how easy it was and 
 how all horrible things they imagined just didnt happen. 
 I love that.

Just in case you're curious why we even do Spinal taps,
here's a little LINK for you to check out.


  1. Very informative :) I like the pictures. Such a cool thing to get to do! You'll be a pro in no time. I'm glad you're liking it. I'm totally gonna link on the LINK.

    1. Thanks for the vote-of-confidence Brianna, It's been a refreshing change :)

  2. Your explanation of this procedure, from a professional and personal perspective, shows us precisely why you are a nurse. You were made for this job and your patients are blessed by you and your work.

    1. Oh Thanks Audrey, i love the technical/skill-part of nursing, this new job is refreshing, challenging and rewarding... I'm loving all of that. :)

  3. I'm sure you're wonderful at working with the patients and easing their fears. Glad you're so happy in your new job!