It's been a week since my Internship has ended. To be honest, I don't miss it nearly as much as I imagined that I would.
I stopped by the ER earlier this week to drop off a present for a staff member (not schmoozing, promise!) and as I was waiting to pass off the gift, I stood by the admissions desk and before me was a man checking in for a left sided droop in his face that had occurred quite suddenly.
The Tech admitting the man was already making a phone call to those in the back of the department alerting them to the fact of a possible stroke.
And as I stood there, watching another moment in the ER unfold, I re-called all the good and the bad and realized that though it was tough in the long haul, I'll never forget what I have learned and what I will carry with me always. It's been a good run.
Goodbye, so long, farewell, au revoir
______________
And now as an advertisement, I've recently started another blog, but this one is completely different (be forewarned!) than my Internship blog. Check it out if you would:
:)
http://a-funy-thing.blogspot.com/
Saturday, May 8, 2010
Saturday, May 1, 2010
The Ninetieth Hour
Done is better than perfect
It's funny how (well, at least for me) the last day of anything often makes you re-consider why you started the task at hand in the first place.
The day started off with a Doctor (a female, imagine that!) scolding me for a grevious error I was not aware that I had commited, and then telling me that she knows that the ER is an "exciting place to be, but..." Honestly my first thought (well, besides sheer cynicism) was to just swallow it and spend the next six hours commited to seizing every opportunity, to make the most out of this final day.
That lasted....five minutes.
I once more was largely with staff I did not know, and as a result they were not familiar with me so within thirty minutes to the start of my shift I was so ready to just leave for the day and reminisce about the good times that I had previously experienced. But, I had a made a commitment, and I was going to spend the day in the ER whether it was good or bad, but to be honest, all I could think about was how ready I was for the day to end.
You always have an idea of how something will turn out, but our expectations often do not live up to the reality of the given situation. However, when I look back at my hopes at the beginning of this Internship, I realize that I knew that this would be difficult at times and some days would be less than pleasant, but at the core, it turned out exactly as I hoped it would (minus being offered an awesome job) :) I did after all write: "I know that there will be shortcomings, I'll come across as a dork, and some days will be horrible. That's okay. I didn't go to school thinking that I'd be a life saver. I went because this is my passion. This is where God has called me." And how true this still remains.
I did finally get to see a closed femur fracture that makes no sense how the patient broke it in the first place. Even the ambulance crew that brought him in didn't suspect it; they thought it was a hip fracture. Apparently he was walking outside, lost his balnce, fell and toppled over onto his left side. The pain was so unbearable that he could not walk. Upon admittance to the hospital, he explains that he is "only allergic to marriage" and when doctors told him he has a heart condition he'd "have nothing of it" thus living in denial about any health problems he may have. He also smokes a pack of ciagarettes a day and drinks a six pack of beer daily. Thus, your ideal candidate for perfect health!
And so, my ninety plus hours of Internship time has finally come to an end. I said a few goodbyes, I actually got a hug (gasp!) and as quickly as I came, I walked through the department, down the hall, past the exam rooms, through the doors, and out into the admitting area. I said a final goodbye to one of the Tech's who have aided me on this journey and her parting words were:
"It's a rough world out there"
And so it is.
________________________________________________________
Thus concludes my Internship journey and blog. Thank you so much for taking the tme to read about my progression and adventures. Thank you for laughing, crying and encouraging me, as I lived and learned in the Emergency Department. I will be posting a closing blog within a few days, just to wrap things up nicely....just for you, my wonderful readers.
What a story it has been.
:)
It's funny how (well, at least for me) the last day of anything often makes you re-consider why you started the task at hand in the first place.
The day started off with a Doctor (a female, imagine that!) scolding me for a grevious error I was not aware that I had commited, and then telling me that she knows that the ER is an "exciting place to be, but..." Honestly my first thought (well, besides sheer cynicism) was to just swallow it and spend the next six hours commited to seizing every opportunity, to make the most out of this final day.
That lasted....five minutes.
I once more was largely with staff I did not know, and as a result they were not familiar with me so within thirty minutes to the start of my shift I was so ready to just leave for the day and reminisce about the good times that I had previously experienced. But, I had a made a commitment, and I was going to spend the day in the ER whether it was good or bad, but to be honest, all I could think about was how ready I was for the day to end.
You always have an idea of how something will turn out, but our expectations often do not live up to the reality of the given situation. However, when I look back at my hopes at the beginning of this Internship, I realize that I knew that this would be difficult at times and some days would be less than pleasant, but at the core, it turned out exactly as I hoped it would (minus being offered an awesome job) :) I did after all write: "I know that there will be shortcomings, I'll come across as a dork, and some days will be horrible. That's okay. I didn't go to school thinking that I'd be a life saver. I went because this is my passion. This is where God has called me." And how true this still remains.
I did finally get to see a closed femur fracture that makes no sense how the patient broke it in the first place. Even the ambulance crew that brought him in didn't suspect it; they thought it was a hip fracture. Apparently he was walking outside, lost his balnce, fell and toppled over onto his left side. The pain was so unbearable that he could not walk. Upon admittance to the hospital, he explains that he is "only allergic to marriage" and when doctors told him he has a heart condition he'd "have nothing of it" thus living in denial about any health problems he may have. He also smokes a pack of ciagarettes a day and drinks a six pack of beer daily. Thus, your ideal candidate for perfect health!
The Doctor enters the room, takes one look at him and says "You have a broken femur." Immediately she orders that a hare traction splint be placed. For those of you unfamiliar with this medieval looking device, it's use is quite simple and handy: It realigns bone ends to the proper position with a mechanical device to pull traction on the injured area.
Funny story is we used these all the time when I was in school, and one time during a practice session, someone pulled traction on my healthy uninjured, un-painful leg and wound up disturbing my back for a few weeks. Word to the wise: Only use this when medically needed.
As the day wound up, I found myself having a conversation with....an employee who I've known for the duration of my Internship. We've talked about what class was like for me last semester and when I took National Registry what it was like. I've told them about my IV class, and the road to my certification. And after all this time, know what they asked me?
"So when are you taking Registry?" (Note: National Registry is the exam that needs to be taken and passed in order for one to become a certified EMT such as myself)
Really? Seriously? Of course, I should have been tipped off earlier when they told me that I really have no idea how little they care about...anything. But, it was a wonderful way to realize that often times people aren't listening to what you're saying.
And so, my ninety plus hours of Internship time has finally come to an end. I said a few goodbyes, I actually got a hug (gasp!) and as quickly as I came, I walked through the department, down the hall, past the exam rooms, through the doors, and out into the admitting area. I said a final goodbye to one of the Tech's who have aided me on this journey and her parting words were:
"It's a rough world out there"
And so it is.
________________________________________________________
Thus concludes my Internship journey and blog. Thank you so much for taking the tme to read about my progression and adventures. Thank you for laughing, crying and encouraging me, as I lived and learned in the Emergency Department. I will be posting a closing blog within a few days, just to wrap things up nicely....just for you, my wonderful readers.
What a story it has been.
:)
Tuesday, April 27, 2010
Good enough
I love the Emergency Department. I know that when I look back on this time in my life I will never forget walking through the automatic doors, into the admitting area and then being buzzed back into the ER. As I walk by triage, corner past a few exam rooms and enter the expansive department, I always glance around for staff that I know. Initially, this was intimidating--I'd often introduce myself and then there'd be that awkward pause of "Okay....now what?" But these days, I just walk right in, say hello, and get to whatever task is at hand for the moment.
The phone ringing indicating that the ambulance is trying to get ahold of the department is reminiscent of that creepy ringing phone in a scary movie indicating impending doom. But it must be answered.
The initial flow of staff when a genuine emergency is ushered into the room as they quickly rush to hook them up to monitors, do blood draws and evaluate--where I get to see staff at their best.
The interaction between the staff as they laugh and talk amongst themselves about the various patients who have come their way that shift.
All things that I will always remember.
However, with the good also comes the bad. For some reason, certain staff has chosen to either not remember me or to forget who I am, regardless of how many times I have introduced myself. This has grown tiresome. As I've stated before (probably many times) I hate the way most women treat me. I had one female Tech approach me today when the department was dead quiet and essentially tell me to not stand around, that I'm free to follow "whoever". This, I obviously know. And I wasn't standing around, either. I was waiting for my assigned Tech to return after telling me to stay put. But I digress. Treat me poorly, what does it matter anymore...(I say this cynically, don't start worrying about me just yet)
I also had a Nurse today turn and ask me for help and then look at me in horror because she thought I wasn't wearing my name badge. I was simply standing behind a patient and the badge was not clearly visible. You should have seen her face though....sheesh. Scary! Then she introduced herself....but we have met every week for the last month. Why does she not remember me?!? .....thus is my story.
And finally, our favorite pal, A. My goodness, I cannot wait until I never see them again. No one person has ever tried to annoy me more subtly than them. Ugh. I wish I could go into more details, but I cannot. And please don't get the impression that I'm insane or something of the like. I'm just saying--as I'm sure anyone reading this has experienced what it's like to have to avoid someone in close quarters....it's manageable but super annoying.
I helped take care of a woman today who has been repeatedly beaten up by various boyfriends, has a broken wrist as a result of the last one, was covered with bruises and quite obviously drunk but very sad. Not much to write about her, just someone that stuck out in my mind today. She told me that I was "awesome" and that it was nice to have someone who cares. I think often times these people are blown off because they're deemed unworthy in one way or another. It's a tough thing to see, and I know I can't do much to help, but it doesn't stop me from feeling bad for these people with no one to turn to. ....ugh. The human condition.
On the other end of the spectrum, have you ever seen someone and are struck by the fact that something is not right with them? That there is something evil lurking within? We had a patient in today who had a grand plan to kill all the Police/have them kill him. He was about 6' 6" and weighed 350....maybe 400 pounds. He was scary and as the Police and ER staff talked with him, he was clear about his intentions to kill. But his eyes....oh his eyes. There was something there that I have never seen in anyone before, and don't care to see again. God only knows what will become of this man who is intent on committing terrible crimes against people.
I asked an Ear, Nose and Throat Doctor if I could watch him perform a procedure and learned that however wonderful the human body is, there is something deeply disturbing watching a tube be stuck down someones nose and looking at the vocal cords, tonsils and epiglottis (cartilage that covers the windpipe). The Doctor was great though as he showed me how to look for deviated septums, and show me that for this particular patient her nose was just great, straight and clear for the purposes of sticking his various tubes into. Neat....but really not for me.... :)
Final patient of the day was a little boy who broke his arm while playing at the park. Typical fracture, common break for children but when the orthopedist came in, I was less than impressed as he told the child to "man up". He did a great job repairing the injured arm, but man alive...his bedside manner was severely lacking. But hey. Maybe he had a horrible day or something. Who am I to judge....
So I started my goodbyes tonight to the folks who won't be around this Saturday. Strange saying goodbye because I A) hate them and B) feel like everything shouldn't be wrapping up, really I feel like I just started. Yet, here I am.
Good enough.
The phone ringing indicating that the ambulance is trying to get ahold of the department is reminiscent of that creepy ringing phone in a scary movie indicating impending doom. But it must be answered.
The initial flow of staff when a genuine emergency is ushered into the room as they quickly rush to hook them up to monitors, do blood draws and evaluate--where I get to see staff at their best.
The interaction between the staff as they laugh and talk amongst themselves about the various patients who have come their way that shift.
All things that I will always remember.
However, with the good also comes the bad. For some reason, certain staff has chosen to either not remember me or to forget who I am, regardless of how many times I have introduced myself. This has grown tiresome. As I've stated before (probably many times) I hate the way most women treat me. I had one female Tech approach me today when the department was dead quiet and essentially tell me to not stand around, that I'm free to follow "whoever". This, I obviously know. And I wasn't standing around, either. I was waiting for my assigned Tech to return after telling me to stay put. But I digress. Treat me poorly, what does it matter anymore...(I say this cynically, don't start worrying about me just yet)
I also had a Nurse today turn and ask me for help and then look at me in horror because she thought I wasn't wearing my name badge. I was simply standing behind a patient and the badge was not clearly visible. You should have seen her face though....sheesh. Scary! Then she introduced herself....but we have met every week for the last month. Why does she not remember me?!? .....thus is my story.
And finally, our favorite pal, A. My goodness, I cannot wait until I never see them again. No one person has ever tried to annoy me more subtly than them. Ugh. I wish I could go into more details, but I cannot. And please don't get the impression that I'm insane or something of the like. I'm just saying--as I'm sure anyone reading this has experienced what it's like to have to avoid someone in close quarters....it's manageable but super annoying.
I helped take care of a woman today who has been repeatedly beaten up by various boyfriends, has a broken wrist as a result of the last one, was covered with bruises and quite obviously drunk but very sad. Not much to write about her, just someone that stuck out in my mind today. She told me that I was "awesome" and that it was nice to have someone who cares. I think often times these people are blown off because they're deemed unworthy in one way or another. It's a tough thing to see, and I know I can't do much to help, but it doesn't stop me from feeling bad for these people with no one to turn to. ....ugh. The human condition.
On the other end of the spectrum, have you ever seen someone and are struck by the fact that something is not right with them? That there is something evil lurking within? We had a patient in today who had a grand plan to kill all the Police/have them kill him. He was about 6' 6" and weighed 350....maybe 400 pounds. He was scary and as the Police and ER staff talked with him, he was clear about his intentions to kill. But his eyes....oh his eyes. There was something there that I have never seen in anyone before, and don't care to see again. God only knows what will become of this man who is intent on committing terrible crimes against people.
I asked an Ear, Nose and Throat Doctor if I could watch him perform a procedure and learned that however wonderful the human body is, there is something deeply disturbing watching a tube be stuck down someones nose and looking at the vocal cords, tonsils and epiglottis (cartilage that covers the windpipe). The Doctor was great though as he showed me how to look for deviated septums, and show me that for this particular patient her nose was just great, straight and clear for the purposes of sticking his various tubes into. Neat....but really not for me.... :)
Final patient of the day was a little boy who broke his arm while playing at the park. Typical fracture, common break for children but when the orthopedist came in, I was less than impressed as he told the child to "man up". He did a great job repairing the injured arm, but man alive...his bedside manner was severely lacking. But hey. Maybe he had a horrible day or something. Who am I to judge....
So I started my goodbyes tonight to the folks who won't be around this Saturday. Strange saying goodbye because I A) hate them and B) feel like everything shouldn't be wrapping up, really I feel like I just started. Yet, here I am.
Good enough.
Tuesday, April 20, 2010
Three
After today, I only have two more times scheduled to be in the ER. Funny how when I first began this Internship I thought it'd be very hard to get enough hours in, let alone complete the program. And yet, here I am....counting down the final times that I will get to have this hands on experience.
Today started off well. I got to see a man get his shoulder put back into its socket. Apparently, it's been an issue he's had for three or four years now--his shoulder just comes out way too easily and sometimes, try as he might, he cannot get it back into place. He was accompanied by a friend, and the moment I entered the room, I had that crowd pleasing effect of all the guys automatically adjusting their behavior, words, everything. (Note: this change is as evident as the light of day--there's no hiding it, unfortunately)
It took a bit of work on the behalf of the Doctor, Physician Assistant, Nurse and I, but we all got his shoulder back into place. The patient, so pumped up on Propofol was saying all sorts of silly things, but once he came to, he turned out to be quite normal, but still needed his vitals monitored.
And so, I was left in the room with two very silly, very much trying hard to impress me guys. One kept telling me how he and his friends are a "tough crowd" and his friend (the patient) relayed to me how his shoulder just popped out of socket--he was reaching for a glass of water, coughed, and out came the shoulder (?!?!)
Come discharge time, Mr "I'm from a tough crowd" comes up to me as I'm trying very hard to look incredibly busy staring at a computer screen and asks me for my number....in front of some of the other staff members. It generated many laughs, jokes, and high fives, and...a very red face from me.
The best story of my day came when I was ushered into an exam room, not quite sure who was there but based upon the urgency of the tones, I knew it was something serious. Lo and behold, there was a young man with a hand drenched in blood. It was funny--my first thought was "Hmmm. Good special effects". Nice to know my mind is geared towards false movie injuries instead of real life...
So, he's freaking out, his hand is gushing blood and I'm quickly filled in that he was cutting foam with a table saw, was guiding the foam through with his left hand when it got caught in the saw. The end result was partial amputation of three of his fingers, the worst being his pinky finger. It was not only mangled, but his bone was sticking through. I got the task of putting him on oxygen and cleaning up his non injured hand. Try making small talk with someone whose hand is falling off right in front of you.
At one point, the Doctor comes in to examine the hand and give the patient some injections, and Mr. Patient asks "Is there anything I can put into my other hand just to squeeze it?" And suddenly....everyone is looking at me. So, I glove up, hold hands with this guy and he squeezes the hell out of my hand while I try to console him.
Last I saw of him, he was being admitted to the OR, but according to the ER staff, it wasn't looking so good for his hand...the nail beds of his three injured fingers were destroyed, and the x-ray of his pinky showed incredible more than likely un-reparable damage. According to a Paramedic, due to the severity of damage to his pinky finger, it would be un-wise to just amputate that finger--there's a high chance of infection spreading to the rest of the body, so....this poor kid just may wind up losing his hand. Just like that. Word to the wise, don't use a table saw. The damage it can do is incredible.
Today started off well. I got to see a man get his shoulder put back into its socket. Apparently, it's been an issue he's had for three or four years now--his shoulder just comes out way too easily and sometimes, try as he might, he cannot get it back into place. He was accompanied by a friend, and the moment I entered the room, I had that crowd pleasing effect of all the guys automatically adjusting their behavior, words, everything. (Note: this change is as evident as the light of day--there's no hiding it, unfortunately)
It took a bit of work on the behalf of the Doctor, Physician Assistant, Nurse and I, but we all got his shoulder back into place. The patient, so pumped up on Propofol was saying all sorts of silly things, but once he came to, he turned out to be quite normal, but still needed his vitals monitored.
And so, I was left in the room with two very silly, very much trying hard to impress me guys. One kept telling me how he and his friends are a "tough crowd" and his friend (the patient) relayed to me how his shoulder just popped out of socket--he was reaching for a glass of water, coughed, and out came the shoulder (?!?!)
Come discharge time, Mr "I'm from a tough crowd" comes up to me as I'm trying very hard to look incredibly busy staring at a computer screen and asks me for my number....in front of some of the other staff members. It generated many laughs, jokes, and high fives, and...a very red face from me.
The best story of my day came when I was ushered into an exam room, not quite sure who was there but based upon the urgency of the tones, I knew it was something serious. Lo and behold, there was a young man with a hand drenched in blood. It was funny--my first thought was "Hmmm. Good special effects". Nice to know my mind is geared towards false movie injuries instead of real life...
So, he's freaking out, his hand is gushing blood and I'm quickly filled in that he was cutting foam with a table saw, was guiding the foam through with his left hand when it got caught in the saw. The end result was partial amputation of three of his fingers, the worst being his pinky finger. It was not only mangled, but his bone was sticking through. I got the task of putting him on oxygen and cleaning up his non injured hand. Try making small talk with someone whose hand is falling off right in front of you.
At one point, the Doctor comes in to examine the hand and give the patient some injections, and Mr. Patient asks "Is there anything I can put into my other hand just to squeeze it?" And suddenly....everyone is looking at me. So, I glove up, hold hands with this guy and he squeezes the hell out of my hand while I try to console him.
Last I saw of him, he was being admitted to the OR, but according to the ER staff, it wasn't looking so good for his hand...the nail beds of his three injured fingers were destroyed, and the x-ray of his pinky showed incredible more than likely un-reparable damage. According to a Paramedic, due to the severity of damage to his pinky finger, it would be un-wise to just amputate that finger--there's a high chance of infection spreading to the rest of the body, so....this poor kid just may wind up losing his hand. Just like that. Word to the wise, don't use a table saw. The damage it can do is incredible.
Tuesday, April 13, 2010
Downward
As my internship wanes, I am discovering that I am tired of being the "Intern". I either want a job in this profession or just give up the whole idea entirely. It's not because I don't love it--I love EMS so very much, but this....this is wearing on me. Things certainly changed when the whole "situation" with A occurred. My fun times in the ER vanished rather quickly, and try as I might to not allow it to happen, everything changed. Ugh. I realize that whoever is following this blog of mine must think that I'm bi-polar....continual highs and lows. But maybe that's just the wave of the ER---up's and downs and... nothing in between. I just want a paid position now--I guess I'm no longer content in being the observer--I want to interact more with the patients.
By now you should know that most things that are presented to the ER do not phase me. Except for today when someone told me that the cute little girl in the room across the hall was being held on a psych watch for "suicidal ideations". I check her medical history and see that she's been physically and sexually abused. And for the first time since I began my ER journey, I felt something akin to my heart cracking as I thought and pondered who would do this to a child? How? The thought literally depressed me...hurt me--and I don't know why. (Minus the obvious answers)
Her and I wound up spending about an hour together today, and she had moods swings that ranged from sweet to downright mean--telling me I'm stupid because I wouldn't play the games she wanted to. It was a bit funny being reemed by an eight year old. However, once she was coaxed out of her foul mood, we had a good time as she styled my hair and asked me to sing for her--for whatever I do must "come from the heart". By the time I left, she was hugging me, asking me not to leave and just stay with her.
Other than my encounter with this child, nothing of note occurred, but I learned a valuble lesson for the day. This little girl helped me place some things into perspective, and opened my eyes to the fact that my time at the ER hasn't all been for naught. It's all in the little things.
By now you should know that most things that are presented to the ER do not phase me. Except for today when someone told me that the cute little girl in the room across the hall was being held on a psych watch for "suicidal ideations". I check her medical history and see that she's been physically and sexually abused. And for the first time since I began my ER journey, I felt something akin to my heart cracking as I thought and pondered who would do this to a child? How? The thought literally depressed me...hurt me--and I don't know why. (Minus the obvious answers)
Her and I wound up spending about an hour together today, and she had moods swings that ranged from sweet to downright mean--telling me I'm stupid because I wouldn't play the games she wanted to. It was a bit funny being reemed by an eight year old. However, once she was coaxed out of her foul mood, we had a good time as she styled my hair and asked me to sing for her--for whatever I do must "come from the heart". By the time I left, she was hugging me, asking me not to leave and just stay with her.
Other than my encounter with this child, nothing of note occurred, but I learned a valuble lesson for the day. This little girl helped me place some things into perspective, and opened my eyes to the fact that my time at the ER hasn't all been for naught. It's all in the little things.
Tuesday, April 6, 2010
Having a wonderful time. Sort of.
I've come to the logical conclusions that like all of us, we have our good and bad days. I suppose that the environment of a job is much like a person--ups and downs on a frequent (or infrequent) basis. Today, it was as if the ER had a personality change from how it was last week. I often get a bit tachycardic entering the department because I have no idea what lies before me--happy staff? Angry staff? Shouldn't be so unpredictable, but life is, so really why would I expect the ER to be any different....we all have our bipolar days.
Unfortunately, not much happened today in the way of patients. Kind of a non dramatic, non trauma day. The theme for the first portion of the day was: Car Accidents. Everyone kept coming in after crashing or being hit in to. Little kids, pregnant women, men....take your pick.
One man had been having a lot of stress lately but went to work, only to discover that he was feeling even more anxious and having strange sensations in his chest. His boss granted him permission to go to the ER but shortly on his way, he discovered that he was feeling confused and even worse than before. He then calls his boss who instructs him to come back to his job and someone there will take him to the ER. It was at that time that he passed out and crashed into a light pole in front of the Police and many bystanders.
His chest pain had only increased upon his arrival to the ER and after receiving the preliminary care one receives when experiencing chest pain, a nurse handed me a pair of Trauma sheers and instructed me to cut off his clothing. I learned that it's a lot harder than it looks---as I'm busily trying to cut off his two shirts, the thought struck me that there should be a class on how to properly remove clothing from a patient in pain. I know for one that'd I benefit greatly because I spent half my time struggling with the dang scissors and the other half methodically tearing his shirt apart. Then came the part of removing his pants while keeping his boxers on. Again, not an easy task. Comical, really--if you want to put a word onto it. Little innocent Sarah stripping a man (almost) naked. Oh, awkward.
My next favorite patient whom I only got to see for a short quantity of time was this 90 year old cute as a button lady. I believe she weighed somewhere in the 66 pound range (I'm not exaggerating) and had the strangest voice I've ever heard: Try talking in your most high pitch voice that you can attain. Then take that voice and bump it up to or three levels, and even still--you'll be far off from what her voice sounded like. It was so high pitched that for the life of me I had no idea what she was saying, so I looked like an idiot nodding my head and smiling at her as I helped transport her to another ward of the hospital.
So when the ER is having a good day, and I once more have the feeling that I'm not an outsider trying desperately to fit in, I'm quite at ease and happier than one can fathom. Below is how I've often felt when all is right in the Emergency Department:
Unfortunately, not much happened today in the way of patients. Kind of a non dramatic, non trauma day. The theme for the first portion of the day was: Car Accidents. Everyone kept coming in after crashing or being hit in to. Little kids, pregnant women, men....take your pick.
One man had been having a lot of stress lately but went to work, only to discover that he was feeling even more anxious and having strange sensations in his chest. His boss granted him permission to go to the ER but shortly on his way, he discovered that he was feeling confused and even worse than before. He then calls his boss who instructs him to come back to his job and someone there will take him to the ER. It was at that time that he passed out and crashed into a light pole in front of the Police and many bystanders.
His chest pain had only increased upon his arrival to the ER and after receiving the preliminary care one receives when experiencing chest pain, a nurse handed me a pair of Trauma sheers and instructed me to cut off his clothing. I learned that it's a lot harder than it looks---as I'm busily trying to cut off his two shirts, the thought struck me that there should be a class on how to properly remove clothing from a patient in pain. I know for one that'd I benefit greatly because I spent half my time struggling with the dang scissors and the other half methodically tearing his shirt apart. Then came the part of removing his pants while keeping his boxers on. Again, not an easy task. Comical, really--if you want to put a word onto it. Little innocent Sarah stripping a man (almost) naked. Oh, awkward.
My next favorite patient whom I only got to see for a short quantity of time was this 90 year old cute as a button lady. I believe she weighed somewhere in the 66 pound range (I'm not exaggerating) and had the strangest voice I've ever heard: Try talking in your most high pitch voice that you can attain. Then take that voice and bump it up to or three levels, and even still--you'll be far off from what her voice sounded like. It was so high pitched that for the life of me I had no idea what she was saying, so I looked like an idiot nodding my head and smiling at her as I helped transport her to another ward of the hospital.
So when the ER is having a good day, and I once more have the feeling that I'm not an outsider trying desperately to fit in, I'm quite at ease and happier than one can fathom. Below is how I've often felt when all is right in the Emergency Department:
Sunday, April 4, 2010
Domino Effect
I really thought that I'd gotten beyond the point of having to introduce myself to staff and tell them why I'm at their ER. To be honest, I feel like an automated recorder now: "Hi I'm Sarah." "Are you doing a clinical here today?" "Well, no, actually I'm doing an Internship through Front Range" "An Internship? For what?" "I'm a certified EMT, and I thought it a good idea to do a voluntary Internship just to gain more experience" I'm really, really tired of saying this.
Saturday I was with Techs that I haven't yet met, and since it was two women, I don't think they quite cared to meet me. Friendly, but stiff as if I'm intruding on their work day. I understand that to them I am just a student, but come on, give me the benefit of the doubt here.
The first Tech I was with explained to me what a blood draw is, and why we would do one. Seriously? I already told her I'm IV certified, but it was if she didn't care. Methodically, she explains: "This is a butterfly needle. It's used for drawing blood" Wow! I just stopped paying attention and instead focused on the patient who was there for a voluntary psych hold because he was hearing voices. During his blood draw, he began crying. His tears were....yellow. Seriously, this man was crying bright yellow tears.
After that, my Tech left--maybe on lunch break, I don't know. I was just left standing there in the department feeling quite uneasy. I wandered around, entered exam rooms with some of the nurses and watched them evaluate patients. It was quite ordinary, overall. But one of the nurses who actually does know me was showing me this woman's feet and ankles which were extraordinarily swollen, and at the very least, at least I got to observe swollen feet. A sign of congestive heart failure, perhaps.
Another Tech--a rather tall man--nicknamed Sasquatch by some of the staff began speaking to me. Funny thing is, I've officially met him three times now, but he still has no idea who I am. Can I blame him? No. I think overall I'm not a big stand out student/Intern, so why should he remember me? It doesn't matter because for three hours he and I had a jolly time together. He told me stories from his days in the field and about his wife who is a nurse and all the exciting things she's seen. It was nice to have company, for this day was no ordinary day.
We worked together on a young man who had sudden acute lower right abdominal pain. A nurse asked us to get 'Vittles" (vitals) on him, and even though this man was supposedly in heart wrenching agonizing horrific pain, he still was aware of the fact that a young woman (me) had entered the room and was trying to coax and work on him. Funny seeing men's entire demeanors change, even if they're "dying" when I appear. I've gotten more than my fair share of admiring looks, winks, and efforts to be charming. If only they knew how they appeared to me. This poor guy accidentally kicked me in the arm as I was taking his blood pressure--I guess the severity of his pain was so bad that he could not lie or sit still.
I also helped irrigate the wound of a two year old who had just been bitten on the neck by a Black Labrador Retriever. The wound while relatively small made me wince because a) I have a black lab and b) what would now happen to the dog?
Another woman came into the ER with chest pain, and when I entered the room, she had her hospital gown on backwards. It was explained that she'd have to switch it around, and so she did--with apparantly no unease with the fact that she was topless and braless and had the biggest chest I've personally ever seen. Well, when it came down to it, I was assigned to perform her EKG, and it was quite difficult placing stickers around her enormous chest. So, I'm working on getting everything ready and she turns to me and says "Can you imagine what these were like before I had my breast reduction surgery?!" Egads. The very thought....
Alas, my big friendly giant Tech had to go work in admissions, so he had to swap places with another staff member. Unfortunately, this staff member is no longer allowed to talk to me (no lie--this is a continuance from Wednesday's blog about "doing the right thing") so I was once more alone. The other female Techs didn't want me to assist and so I once more wandered aimlessly, probably looking like an idiot. Said staff member (we'll call them A for simplicities sake) went out of their way to avoid all eye contact, and even when I was told to go into the same room that A was in, it would create an awkward and uncomfortable atmosphere.
The last patient of the day before I left was brought in via ambulance. He was ushered into the room and since A was working on the patient, I chose to not join in on the fun. But then this Tech comes up to me, completely oblivious to the fact that I'm in the ER all the time and says "You need to go into the room. It'll provide great experience. Anytime an ambulance comes in, you should go in, you don't have to stay out here". And really, what could I say? So in I went. And in the small room were the ambulance crew, a nurse, A and me. I'm on one side of the patient, A is on the other and there is no eye contact made, no words spoken. It's a bit hard to work in unity with someone who now refuses to acknowledge your existence. Not that I blame them--their job is at risk, but still--it was agreed upon that they could talk to me if it was job related. Not so much, apparently.
Well, this patient stunk. He was missing teeth, looked like a bum, and talked so slurred that I would swear he was drunk out of his mind. He was covered in urine, the bottoms of his feet were black, and you couldn't understand a word he was saying. We chose just to cut off his clothing due to the nature of the situation. When another Tech appeared and asked if we needed any help (mind you, there were six billion people in the small room already) A yells out "Yes!! We need your help!!" and so one more was added to the mix, which was fine with me because I actually wanted to get out of there. Surprisingly, smelly people gross me out.
A common mistake of EMS providers is the assumption that a patient is drunk when they are in fact, severely diabetic. This man had a blood glucose reading of over 700. Normal blood glucose is between 70 and 150 mg. This reading would thus indicate a serious medical problem. However, he was also complaining of pain in his scrotum, and the EMS provider explained it to the doctor as feeling "like a hockey puck". The doctor, a comical man turns to me and says: "I'm sorry sir. You have.....a hockey puck" Hahaha....
The only nice part of the day that didn't make me feel like no staff member cared about my existence came as I was headed out the door. A Tech said "You're leaving? Feels like you just got here--time flies..." I know that's not very heartfelt or anything, but for a day like yesterday, it just dampened my soul. I guess I'm just not used to people not liking me, and not being able to converse with me. With the loss of A's communication, I seemingly have lost where I truly do belong. It's like the domino effect: One small change causes a similar change nearby, which then will cause another similar change, and so on...
Saturday I was with Techs that I haven't yet met, and since it was two women, I don't think they quite cared to meet me. Friendly, but stiff as if I'm intruding on their work day. I understand that to them I am just a student, but come on, give me the benefit of the doubt here.
The first Tech I was with explained to me what a blood draw is, and why we would do one. Seriously? I already told her I'm IV certified, but it was if she didn't care. Methodically, she explains: "This is a butterfly needle. It's used for drawing blood" Wow! I just stopped paying attention and instead focused on the patient who was there for a voluntary psych hold because he was hearing voices. During his blood draw, he began crying. His tears were....yellow. Seriously, this man was crying bright yellow tears.
After that, my Tech left--maybe on lunch break, I don't know. I was just left standing there in the department feeling quite uneasy. I wandered around, entered exam rooms with some of the nurses and watched them evaluate patients. It was quite ordinary, overall. But one of the nurses who actually does know me was showing me this woman's feet and ankles which were extraordinarily swollen, and at the very least, at least I got to observe swollen feet. A sign of congestive heart failure, perhaps.
Another Tech--a rather tall man--nicknamed Sasquatch by some of the staff began speaking to me. Funny thing is, I've officially met him three times now, but he still has no idea who I am. Can I blame him? No. I think overall I'm not a big stand out student/Intern, so why should he remember me? It doesn't matter because for three hours he and I had a jolly time together. He told me stories from his days in the field and about his wife who is a nurse and all the exciting things she's seen. It was nice to have company, for this day was no ordinary day.
We worked together on a young man who had sudden acute lower right abdominal pain. A nurse asked us to get 'Vittles" (vitals) on him, and even though this man was supposedly in heart wrenching agonizing horrific pain, he still was aware of the fact that a young woman (me) had entered the room and was trying to coax and work on him. Funny seeing men's entire demeanors change, even if they're "dying" when I appear. I've gotten more than my fair share of admiring looks, winks, and efforts to be charming. If only they knew how they appeared to me. This poor guy accidentally kicked me in the arm as I was taking his blood pressure--I guess the severity of his pain was so bad that he could not lie or sit still.
I also helped irrigate the wound of a two year old who had just been bitten on the neck by a Black Labrador Retriever. The wound while relatively small made me wince because a) I have a black lab and b) what would now happen to the dog?
Another woman came into the ER with chest pain, and when I entered the room, she had her hospital gown on backwards. It was explained that she'd have to switch it around, and so she did--with apparantly no unease with the fact that she was topless and braless and had the biggest chest I've personally ever seen. Well, when it came down to it, I was assigned to perform her EKG, and it was quite difficult placing stickers around her enormous chest. So, I'm working on getting everything ready and she turns to me and says "Can you imagine what these were like before I had my breast reduction surgery?!" Egads. The very thought....
Alas, my big friendly giant Tech had to go work in admissions, so he had to swap places with another staff member. Unfortunately, this staff member is no longer allowed to talk to me (no lie--this is a continuance from Wednesday's blog about "doing the right thing") so I was once more alone. The other female Techs didn't want me to assist and so I once more wandered aimlessly, probably looking like an idiot. Said staff member (we'll call them A for simplicities sake) went out of their way to avoid all eye contact, and even when I was told to go into the same room that A was in, it would create an awkward and uncomfortable atmosphere.
The last patient of the day before I left was brought in via ambulance. He was ushered into the room and since A was working on the patient, I chose to not join in on the fun. But then this Tech comes up to me, completely oblivious to the fact that I'm in the ER all the time and says "You need to go into the room. It'll provide great experience. Anytime an ambulance comes in, you should go in, you don't have to stay out here". And really, what could I say? So in I went. And in the small room were the ambulance crew, a nurse, A and me. I'm on one side of the patient, A is on the other and there is no eye contact made, no words spoken. It's a bit hard to work in unity with someone who now refuses to acknowledge your existence. Not that I blame them--their job is at risk, but still--it was agreed upon that they could talk to me if it was job related. Not so much, apparently.
Well, this patient stunk. He was missing teeth, looked like a bum, and talked so slurred that I would swear he was drunk out of his mind. He was covered in urine, the bottoms of his feet were black, and you couldn't understand a word he was saying. We chose just to cut off his clothing due to the nature of the situation. When another Tech appeared and asked if we needed any help (mind you, there were six billion people in the small room already) A yells out "Yes!! We need your help!!" and so one more was added to the mix, which was fine with me because I actually wanted to get out of there. Surprisingly, smelly people gross me out.
A common mistake of EMS providers is the assumption that a patient is drunk when they are in fact, severely diabetic. This man had a blood glucose reading of over 700. Normal blood glucose is between 70 and 150 mg. This reading would thus indicate a serious medical problem. However, he was also complaining of pain in his scrotum, and the EMS provider explained it to the doctor as feeling "like a hockey puck". The doctor, a comical man turns to me and says: "I'm sorry sir. You have.....a hockey puck" Hahaha....
The only nice part of the day that didn't make me feel like no staff member cared about my existence came as I was headed out the door. A Tech said "You're leaving? Feels like you just got here--time flies..." I know that's not very heartfelt or anything, but for a day like yesterday, it just dampened my soul. I guess I'm just not used to people not liking me, and not being able to converse with me. With the loss of A's communication, I seemingly have lost where I truly do belong. It's like the domino effect: One small change causes a similar change nearby, which then will cause another similar change, and so on...
Wednesday, March 31, 2010
And so on
I've had a very strange week at the hospital. Last Wednesday some things took place that while inappropriate to detail set the stage for me to make a good impression on the staff quite inadvertently, and have been told to apply the next time there is hiring, and for the first time, I believe that I have a fair chance at a job all because I did something that I didn't want to do. Again, sorry for the lack of details--let it suffice to say that it's best to do the right things, always, even if it embarrasses the hell out of you.
So today I saw head trauma at its best. The patient fell down a flight of stairs and from the looks of it, destroyed her head. Massive amounts of blood gushing out of seemingly everywhere. It's common knowledge that the head bleeds profusely when injured, but my goodness, to see it is something else. Making matters more complicated was the fact that she was hearing disabled, and so to try and evaluate a patients level of consciousness is difficult when that person cannot communicate through words. For fear of brain bleed and spinal cord issues, a CT scan was ordered, and I got to see the inner most parts of this woman's head.
We also had a patient today who accidentally lit his leg on fire after dropping a cigarette after pumping gasoline (nice combo!). He suffered from second degree burns, and last time I checked he was on massive pain medication.
I assisted in the suturing of a little girl who was playing with a knife (imagine letting your two year old mess with a kitchen knife, grr!) and surprisingly she lacerated her index finger. I'm fairly certain my ear drums are destroyed from all the bloody murder screaming she did into my ears as I tried to help her.
And finally, a patient was presented to the ER for abdominal cramping--she was five weeks pregnant and had noticed some vaginal bleeding. Upon a pelvic exam it was determined that she was actively having a miscarriage. I wasn't in the room for the exam, but suddenly a Tech appears with a small container labeled "dentures". However, when she opened it up, and showed me, there before me lay the miscarried fetus. While it was not very developed, there still was a sense of sadness because while some may argue that it was never alive, I do hold to the belief that it was a forming human being, who for whatever reason had died.
Not to end on a sad note, though....
I'll be back on Saturday, and hopefully will have more tales to share....
So today I saw head trauma at its best. The patient fell down a flight of stairs and from the looks of it, destroyed her head. Massive amounts of blood gushing out of seemingly everywhere. It's common knowledge that the head bleeds profusely when injured, but my goodness, to see it is something else. Making matters more complicated was the fact that she was hearing disabled, and so to try and evaluate a patients level of consciousness is difficult when that person cannot communicate through words. For fear of brain bleed and spinal cord issues, a CT scan was ordered, and I got to see the inner most parts of this woman's head.
We also had a patient today who accidentally lit his leg on fire after dropping a cigarette after pumping gasoline (nice combo!). He suffered from second degree burns, and last time I checked he was on massive pain medication.
I assisted in the suturing of a little girl who was playing with a knife (imagine letting your two year old mess with a kitchen knife, grr!) and surprisingly she lacerated her index finger. I'm fairly certain my ear drums are destroyed from all the bloody murder screaming she did into my ears as I tried to help her.
And finally, a patient was presented to the ER for abdominal cramping--she was five weeks pregnant and had noticed some vaginal bleeding. Upon a pelvic exam it was determined that she was actively having a miscarriage. I wasn't in the room for the exam, but suddenly a Tech appears with a small container labeled "dentures". However, when she opened it up, and showed me, there before me lay the miscarried fetus. While it was not very developed, there still was a sense of sadness because while some may argue that it was never alive, I do hold to the belief that it was a forming human being, who for whatever reason had died.
Not to end on a sad note, though....
I'll be back on Saturday, and hopefully will have more tales to share....
Tuesday, March 23, 2010
How many firemen...?
My very first patient of the day was someone who had severely lacerated his thumb with a knife and needed sutures. He was extraordinarily nice chatting with me about how he had once been an EMT. He tells me that I should work at Children's Hospital because I have the "demeanor" for it, and that I would be well received with patients and staff. I took this as a compliment until he followed through with that I would probably not be able to deal well with adult patients who yell at me or are rude to me. Ha. If only he knew how wonderfully some people treat me!
She passed out again at the hospital while using the restroom and apparently her heart stopped momentarily, but spontaneously restarted. Last I saw of her she was meeting with a cardiologist and being wheeled to the Cath Lab.
My favorite patient of the day was a woman who had fractured a vertebrae in her back and was in severe pain. Since mostly men were working today, guess who was in charge of following her around when she got up to use the restroom...? She just kept repeatedly saying "Shoot. Ow. Give me a minute. Shoot. Ow" Over and over again. And she'd make this weird grunting sound--difficult to reproduce but we generated odd looks as we transported her around.
Of course every day here is something awkward. I've been seeing a lot of old person body parts of late, something I could certainly do without. But I hear it's all part of the job, so maybe one day I really will get used to spreading a woman's legs as we place a urinary catheter, or not blush when people (men) seem to lose all their pride when walking through those ER doors and let everything hang out--whether we want it to or not. ;)
The days of this Internship are speeding by and as time progresses I am finding myself more and more at home in the ER and quite at ease with the staff--and they me. I'm quickly discovering that my time there is not enough, but I relish every moment--even with those special patients who come my way.
As this Internship progresses, I am finding myself not stunned, shocked, or phased by much anymore, except for a few things. Can you guess what they may be?! I do however, keep waiting for my first dead patient....it has not yet occurred but I really thought that it would today. We had an elderly woman who had passed out for seemingly no apparent reason and upon presentation to the ER her heart rate was about 34 beats per minute. As I adjusted her monitoring system thinking that there was no possible way her pulse could be that low, her heart was going into all sorts of wacked out rhythms yet she continued to speak to the staff as if this were an ordinary doctor visit, even while staff is wheeling in the crash kit and an AED (Automated External Defibrillator--bad news for you and your heart if you need to be shocked).
She passed out again at the hospital while using the restroom and apparently her heart stopped momentarily, but spontaneously restarted. Last I saw of her she was meeting with a cardiologist and being wheeled to the Cath Lab.
Second best was an almost 700 pound man who was whiny and nasal and generally.....difficult. Unfortunately he needed to be transported to another hospital, but it is extremely difficult, (if not impossible) to move this heavy of a patient from one bed to another without collapsing or further damaging the patient. So, we called in the Firemen. Not one, or two, or even three. We called in ELEVEN of them, and also had staff members assisting his transition. Now you can start the joke:
How many firemen does it take to move an almost seven hundred pound man?As he's being moved from one bed to another, he's complaining about how his oxygen is getting cut off, he can't breathe, they're hurting him....the works. Staff told me that he's become so accustomed to not doing anything anymore he relies on everyone else for....everything. I'll never forget the sight of seeing him transported away. He had no shirt on, and was literally pouring over the sides of the bed, every which way. In fact, this man weighed so much they couldn't even lift up the cot to put him in a more comfortable position.
Of course every day here is something awkward. I've been seeing a lot of old person body parts of late, something I could certainly do without. But I hear it's all part of the job, so maybe one day I really will get used to spreading a woman's legs as we place a urinary catheter, or not blush when people (men) seem to lose all their pride when walking through those ER doors and let everything hang out--whether we want it to or not. ;)
The days of this Internship are speeding by and as time progresses I am finding myself more and more at home in the ER and quite at ease with the staff--and they me. I'm quickly discovering that my time there is not enough, but I relish every moment--even with those special patients who come my way.
Monday, March 15, 2010
Looking Up
I don't want to speak too hastily, but I believe that I have finally fit in with the staff of the hospital. I realize that this may sound a bit silly, but you know when people like you and when they're pretending to like you. How, in a weeks time we can joke around with each other is beyond me, but I am plum pleased.
So today I got to see live and in person my very first drug addict. It was weird walking into the room with my Tech because you immediately knew that something was wrong. When asked why the young lady and her friend were at the hospital, there was a lot of silence, then some hemming and hawing, and then a "she missed her vein". This young woman is lying on her bed looking freaked out and kind of scary. She's balding (common for meth addicts) and though at first glace you'd know something was wrong, I doubt you could guess she's a drug addict. Unless of course you examined her arms-- she has enormous bruises and welts covering the entirety of both arms.
The Tech explains she and I need to do a blood draw, and this patients friend states that she may become "agitated" and that the blood draw will be "difficult". As if on cue, the patient begins moaning, crying, whining and screaming that we're hurting her. Unfortunately, she began this crying before the needle was even in the skin. It's amazing that a vein was even able to be located, to be honest. Drug addicts veins are a tad different than those who do not use drugs. Imagine that. Apparently her friends frequently shoot her up, so why this IV/blood draw was so painful was beyond me. However, she was badly infected in many areas and running a low grade fever, so even she needed medical attention.
In my down time today, the ever so courteous staff allowed me to start IV's on them. Surprisingly, their techniques are a bit more complicated then what I learned in class, so it was an excellent refresher and a lesson in what I can do better for when I am doing this on real life patients who need help.
I went with a 96 year old patient to have an MRI done today. It was sad seeing this poor elderly woman in terrible pain from a fall with no family by her side. As the Nurse prepped her for the MRI, removing her false teeth, I realized how much it sucks to get older. I know it sounds sentimental, and perhaps corny, but have you ever looked at an elderly person an wonder who they were when they were younger? All that lay before me was a frail woman, barely cognizant, no teeth and in immense pain. Surely she is much more than that, but at that moment, she was merely another patient in the Emergency Department who needed an MRI.
As it turns out, the person doing the MRI had gone to high school with my brother, so I introduced myself and got an invitation to return another time to go over some case studies and other things of interest. Ahh, it pays to know people ;)
The MRI machine cost three million dollars, and per patients costs over $4000 to have one done. Should you be wearing anything metal, it literally will be ripped off your body and can/will impale the poor patient. The magnetic force is so strong that it has the ability to lift a car. And, the newer the machine, the louder it will be. It's amazing to watch an MRI in progress--the human body is simply amazing, and this machine details the intricate workings.
So, another great day down at the hospital. The staff are now asking me when I'll be back.
Things are looking up.
So today I got to see live and in person my very first drug addict. It was weird walking into the room with my Tech because you immediately knew that something was wrong. When asked why the young lady and her friend were at the hospital, there was a lot of silence, then some hemming and hawing, and then a "she missed her vein". This young woman is lying on her bed looking freaked out and kind of scary. She's balding (common for meth addicts) and though at first glace you'd know something was wrong, I doubt you could guess she's a drug addict. Unless of course you examined her arms-- she has enormous bruises and welts covering the entirety of both arms.
The Tech explains she and I need to do a blood draw, and this patients friend states that she may become "agitated" and that the blood draw will be "difficult". As if on cue, the patient begins moaning, crying, whining and screaming that we're hurting her. Unfortunately, she began this crying before the needle was even in the skin. It's amazing that a vein was even able to be located, to be honest. Drug addicts veins are a tad different than those who do not use drugs. Imagine that. Apparently her friends frequently shoot her up, so why this IV/blood draw was so painful was beyond me. However, she was badly infected in many areas and running a low grade fever, so even she needed medical attention.
In my down time today, the ever so courteous staff allowed me to start IV's on them. Surprisingly, their techniques are a bit more complicated then what I learned in class, so it was an excellent refresher and a lesson in what I can do better for when I am doing this on real life patients who need help.
I went with a 96 year old patient to have an MRI done today. It was sad seeing this poor elderly woman in terrible pain from a fall with no family by her side. As the Nurse prepped her for the MRI, removing her false teeth, I realized how much it sucks to get older. I know it sounds sentimental, and perhaps corny, but have you ever looked at an elderly person an wonder who they were when they were younger? All that lay before me was a frail woman, barely cognizant, no teeth and in immense pain. Surely she is much more than that, but at that moment, she was merely another patient in the Emergency Department who needed an MRI.
As it turns out, the person doing the MRI had gone to high school with my brother, so I introduced myself and got an invitation to return another time to go over some case studies and other things of interest. Ahh, it pays to know people ;)
The MRI machine cost three million dollars, and per patients costs over $4000 to have one done. Should you be wearing anything metal, it literally will be ripped off your body and can/will impale the poor patient. The magnetic force is so strong that it has the ability to lift a car. And, the newer the machine, the louder it will be. It's amazing to watch an MRI in progress--the human body is simply amazing, and this machine details the intricate workings.
So, another great day down at the hospital. The staff are now asking me when I'll be back.
Things are looking up.
Wednesday, March 10, 2010
Reverse
If anything, today was entirely different than Monday. The highlights of today were the lowlights of Monday and vice versa. I'm grateful that there are people looking out for me, and give my utmost thanks first and foremost to those who are trying to get this Internship to work better so that the experience is even enjoyable than it already is.
Considering I was only at this hospital two days ago, I was recognized by most of the staff, and have noticed that I've already begun making friends here. (!!!)
First patient of the day was a rather large man with severe right lower quadrant pain. He had a cardiac history past, but it was my understanding that this was not a cardiac issue. When left alone in the examining room with him, I found that I had little to say besides questioning him about his pain and where it radiated to, and I realized that I'm in a totally different place than I've ever been. I've somehow gained this right to ask people pertinent questions about their visit to the ER and they actually treat me with respect. I've noticed that almost all the patients I've come in contact with are openly willing to share their life story. To cut to the point, it's amazing.
The ER was not busy today until about an hour before I left. However, I divided my time between following Techs, Nurses, a Physicians Assistant and a Doctor. Everyone here seems very open and willing for me to shadow them and are open to questions about any procedure.
An elderly man came in with scalp avulsion (a forcible tearing or surgical separation of one body part from another) and I got to watch as his scalp was literally stapled back together. Bloody, but fascinating.
Another moment I was assisting with an EKG when the announcement "Code Blue" was announced. Code Blue is the secret term for active CPR in progress, and all of a sudden, I admit, I got terribly excited. It was only then that I realized how morbid I am: I get excited because there's the possibility I could see people dying. Fortunately for the patient, his heart had only temporarily stopped--then started again--so the code was called off.
I also assisted/watched two urinary catheters placed, but this time in placed in women. Let me tell you, this is no better an experience than watching/assisting it placed in men. It's gross, uncomfortable, and makes you feel strange internally...difficult to explain unless you've seen the procedure.
I paid a visit to the psych ward where there are always the best of the best just waiting for you to meet with them. In this case, it was an unruly woman who was playing the lively game of "Guess how many times I can say a four letter word that starts with F in less than five minutes" Let's just say the count was extraordinarily high--and I had to help draw blood on her. Psych patients sure are special...
A call from the ambulance came in for an unresponsive woman with bradycardia (slow heart rate) so the room was set up and I eagerly awaited her arrival. She came in with a dangerously low blood pressure and respiratory rate yet managed to stay somewhat aware all throughout. The Doctor placed a Central Venous Catheter into this woman's chest where her subclavian vein is located (right below where the clavicle bone is located). This is quite a procedure to watch and I was right next to the Doctor. He placed the catheter, slit open a small portion of her chest with a scalpel, drew some blood, kept the catheter in and stitched it up. To me, simply amazing. To the staff, more than likely, a normal day at work.
My final patients of the day were two people involved in a car accident. I got to attend to this little girl who was dearly sweet and very concerned that her pulse, blood pressure, and pulse oximetry levels were not good enough. She was also asking what happens if she "stops doing good". Fortunately, her exam checked out just fine but on the way home I happened to see where the accident had taken place, and the damage was extreme--the little girl was fortunate to walk away from the accident with no damage.
I look forward to next week....let's see if anyone remembers me, and if maybe this time I'll be able to participate in more patient care. I'm itching to do an IV/blood draw again...
:)
Considering I was only at this hospital two days ago, I was recognized by most of the staff, and have noticed that I've already begun making friends here. (!!!)
First patient of the day was a rather large man with severe right lower quadrant pain. He had a cardiac history past, but it was my understanding that this was not a cardiac issue. When left alone in the examining room with him, I found that I had little to say besides questioning him about his pain and where it radiated to, and I realized that I'm in a totally different place than I've ever been. I've somehow gained this right to ask people pertinent questions about their visit to the ER and they actually treat me with respect. I've noticed that almost all the patients I've come in contact with are openly willing to share their life story. To cut to the point, it's amazing.
The ER was not busy today until about an hour before I left. However, I divided my time between following Techs, Nurses, a Physicians Assistant and a Doctor. Everyone here seems very open and willing for me to shadow them and are open to questions about any procedure.
An elderly man came in with scalp avulsion (a forcible tearing or surgical separation of one body part from another) and I got to watch as his scalp was literally stapled back together. Bloody, but fascinating.
Another moment I was assisting with an EKG when the announcement "Code Blue" was announced. Code Blue is the secret term for active CPR in progress, and all of a sudden, I admit, I got terribly excited. It was only then that I realized how morbid I am: I get excited because there's the possibility I could see people dying. Fortunately for the patient, his heart had only temporarily stopped--then started again--so the code was called off.
I also assisted/watched two urinary catheters placed, but this time in placed in women. Let me tell you, this is no better an experience than watching/assisting it placed in men. It's gross, uncomfortable, and makes you feel strange internally...difficult to explain unless you've seen the procedure.
I paid a visit to the psych ward where there are always the best of the best just waiting for you to meet with them. In this case, it was an unruly woman who was playing the lively game of "Guess how many times I can say a four letter word that starts with F in less than five minutes" Let's just say the count was extraordinarily high--and I had to help draw blood on her. Psych patients sure are special...
A call from the ambulance came in for an unresponsive woman with bradycardia (slow heart rate) so the room was set up and I eagerly awaited her arrival. She came in with a dangerously low blood pressure and respiratory rate yet managed to stay somewhat aware all throughout. The Doctor placed a Central Venous Catheter into this woman's chest where her subclavian vein is located (right below where the clavicle bone is located). This is quite a procedure to watch and I was right next to the Doctor. He placed the catheter, slit open a small portion of her chest with a scalpel, drew some blood, kept the catheter in and stitched it up. To me, simply amazing. To the staff, more than likely, a normal day at work.
My final patients of the day were two people involved in a car accident. I got to attend to this little girl who was dearly sweet and very concerned that her pulse, blood pressure, and pulse oximetry levels were not good enough. She was also asking what happens if she "stops doing good". Fortunately, her exam checked out just fine but on the way home I happened to see where the accident had taken place, and the damage was extreme--the little girl was fortunate to walk away from the accident with no damage.
I look forward to next week....let's see if anyone remembers me, and if maybe this time I'll be able to participate in more patient care. I'm itching to do an IV/blood draw again...
:)
Monday, March 8, 2010
Almost Lost
Where to begin...
The day started out excellently. I arrived at my designated time after rushing over from my medical terminology class, nervous as can be. I enter the ER and standing there is the Tech I first had months ago when I was a student and completing my clinicals. She instantly recognized me and ushered me into the department, quickly introducing me to staff including very friendly Doctor's and Nurses. One of the other Techs actually said he remembered me from my first clinical there. Imagine that!
So everything is going great, the Tech that I am assigned to is wonderful and I'm feeling huge relief and major thankfulness that the day is going swimmingly. The department is busy, and I'm following the Tech going room to room assisting with everything, and feeling generally great about it.
And then...
In walks a Paramedic in training. He approaches me and asks what I've seen so far. For some reason, I'm stumbling over medical terms, and generally sound like I have no idea what I'm talking about. I tried to relay the info to him about a man who is hypotensive (low blood pressure) and tachycardic (fast heart rate). We chat, and he tells me to go listen to an elderly woman's lung sounds. I reply I don't have my stethoscope. FAIL!! He wasn't pleased, but after some begging, he loans me his. I leave feeling rather sheepish.
I enter the room and ask the elderly lady for permission to listen to her lungs. I tell her to take a deep breathe, she does, then holds it for a long time. (Psst, don't do that) I tell her to exhale. She does. The key to breath sounds is to inhale and exhale in an even manner so that whoever is on the receiving end can listen and see if there are issues. This lady also has a horrific cough (result of COPD and emphysema) so all I can really hear is diminished breath sounds bilaterally (both lungs).
Did I also mention that her friend told me that this lady is feisty, and my dear patient also proudly announced that she is...er...the term for a female dog? Imagine all this coming from a very cute looking woman in her mid eighties! All things considered, this made it a bit tough to get the job done.
I head back over to the Paramedic in training, and explain to him what I've heard. He begins this series of questions about the respiratory system. I was pretty much lost at the beginning, and as he questioned me, I realized how little I know, and by the time our conversation was finished, I was convinced he thought I knew nothing, and I felt quite poorly about my lack of knowledge.
Thanks to my excellent Tech she re-assures me that I'm fine and then allows me to do EKG's (electrocardiograms) on a few patients. It goes marvelously, and I'm starting to feel confident in my skills.
Until discouraging moment number two occurs. (I'm telling you, this was not my day)
The director of the Emergency Department approaches us and tells my Tech that I am not allowed to do anything in the way of patient care. No EKG's, no splinting, no vitals, no nothing. Her explanation? How does she know what I have learned in school is compatible to what the hospital has its employees do? As I tried to explain she kept putting me down in the name of "not trying to put me down", and telling me that I'm untrustworthy and overall, may not be competent, because really, she has no idea who I am.
Sad moment indeed.
Honestly at this point, I don't know what I would have done without my Tech. She is a marvelous woman who is real, honest, and professional. We talked about the issue at hand and decided that what I needed to do next is get in touch with the EMS director at my school and see if we can get this issue straightened out because really, what's the point of me spending all this time and money if all I can do is stand around and watch? I'm not allowed to do anything hands on, so I honestly was very discouraged.
Bad as the day looked; I still wound up having fun and enjoying myself:
What an adventure, indeed.
"Develop success from failures. Discouragement and failure are two of the sureest stepping stones to success."
The day started out excellently. I arrived at my designated time after rushing over from my medical terminology class, nervous as can be. I enter the ER and standing there is the Tech I first had months ago when I was a student and completing my clinicals. She instantly recognized me and ushered me into the department, quickly introducing me to staff including very friendly Doctor's and Nurses. One of the other Techs actually said he remembered me from my first clinical there. Imagine that!
So everything is going great, the Tech that I am assigned to is wonderful and I'm feeling huge relief and major thankfulness that the day is going swimmingly. The department is busy, and I'm following the Tech going room to room assisting with everything, and feeling generally great about it.
And then...
In walks a Paramedic in training. He approaches me and asks what I've seen so far. For some reason, I'm stumbling over medical terms, and generally sound like I have no idea what I'm talking about. I tried to relay the info to him about a man who is hypotensive (low blood pressure) and tachycardic (fast heart rate). We chat, and he tells me to go listen to an elderly woman's lung sounds. I reply I don't have my stethoscope. FAIL!! He wasn't pleased, but after some begging, he loans me his. I leave feeling rather sheepish.
I enter the room and ask the elderly lady for permission to listen to her lungs. I tell her to take a deep breathe, she does, then holds it for a long time. (Psst, don't do that) I tell her to exhale. She does. The key to breath sounds is to inhale and exhale in an even manner so that whoever is on the receiving end can listen and see if there are issues. This lady also has a horrific cough (result of COPD and emphysema) so all I can really hear is diminished breath sounds bilaterally (both lungs).
Did I also mention that her friend told me that this lady is feisty, and my dear patient also proudly announced that she is...er...the term for a female dog? Imagine all this coming from a very cute looking woman in her mid eighties! All things considered, this made it a bit tough to get the job done.
I head back over to the Paramedic in training, and explain to him what I've heard. He begins this series of questions about the respiratory system. I was pretty much lost at the beginning, and as he questioned me, I realized how little I know, and by the time our conversation was finished, I was convinced he thought I knew nothing, and I felt quite poorly about my lack of knowledge.
Thanks to my excellent Tech she re-assures me that I'm fine and then allows me to do EKG's (electrocardiograms) on a few patients. It goes marvelously, and I'm starting to feel confident in my skills.
Until discouraging moment number two occurs. (I'm telling you, this was not my day)
The director of the Emergency Department approaches us and tells my Tech that I am not allowed to do anything in the way of patient care. No EKG's, no splinting, no vitals, no nothing. Her explanation? How does she know what I have learned in school is compatible to what the hospital has its employees do? As I tried to explain she kept putting me down in the name of "not trying to put me down", and telling me that I'm untrustworthy and overall, may not be competent, because really, she has no idea who I am.
Sad moment indeed.
Honestly at this point, I don't know what I would have done without my Tech. She is a marvelous woman who is real, honest, and professional. We talked about the issue at hand and decided that what I needed to do next is get in touch with the EMS director at my school and see if we can get this issue straightened out because really, what's the point of me spending all this time and money if all I can do is stand around and watch? I'm not allowed to do anything hands on, so I honestly was very discouraged.
Bad as the day looked; I still wound up having fun and enjoying myself:
- A man walked up to me with a cup full of urine and asked me what he should do with it (...)
- I went to take a temperature on a 95 year old woman and she thought it was a rectal thermometer, so she began lifting up her gown. I told her it was for her ear, so she opened her mouth instead
- A man told me that "walking" was just too much of a nuisance (nothing was medically wrong with him)
- The man mentioned earlier who was hypotensive and tachycardic told me jokingly that he's "dying" and hates "when that happens"
What an adventure, indeed.
"Develop success from failures. Discouragement and failure are two of the sureest stepping stones to success."
Wednesday, February 24, 2010
Whatever's Clever!
For some reason, every week I have to battle within myself to go the Emergency Department that I've been interning at for the last month. I'm not sure if it's because this is a hospital I do not personally enjoy, or if it's that same fear of getting yelled at, ignored, or forgotten about week after week.
I walk into the ER today and for a second I believe that the nurse in admitting recognizes me. She does not, but she does ask "what's your name again?" I then get handed off like a nuisance to a Technician who surprisingly recognizes me. Of course, this is a male Tech and believe it or not, guys are always friendlier to me than woman are. Imagine that....!
So he and I gallivant around the department--it is unusually busy, and the charge nurse--a woman who is about ten feet tall, (no lie) is calling out orders to everyone else. She is stressed though at this point, and as a side note, I'm not sure what a charge nurse does besides yell at people and sit at a desk.
Naturally, she hates me. Though she does not seem to remember me, I well remember her. I saw and spoke to her at my very first clinical back in September, and I spoke to her a few weeks ago, while she looked at me, well to be honest, like I was retarded. So, on my part, I've tried to befriend this giantess...but she wants no part in it.
She wound up telling me to stay on the opposite side of the desk of her so that I "don't get in the way". However, where she placed me only proved to be more a hassle for any of the bustling staff, so I silently glowered yet managed to keep a cheery face on all the while. Ahh, my secret talent.
So, nothing much in the ER took place today that makes for an exciting read. I took some blood pressures, watched a drunken young man sleep who looked like an angel, yet upon waking was most assuredly not one. I watched two urinalysis procedures completed, many blood draws/IV starts, EKG's and helped transport another patient to another part of the hospital. Overall, not exciting.
However, this was my last time (or so I hope) at this hospital. Next Wednesday, I will be at another one--the one that I absolutely loved last semester (so you know I'm setting myself up for failure with these big hopes!! Ha! )
Here is what I learned from hospital one:
I walk into the ER today and for a second I believe that the nurse in admitting recognizes me. She does not, but she does ask "what's your name again?" I then get handed off like a nuisance to a Technician who surprisingly recognizes me. Of course, this is a male Tech and believe it or not, guys are always friendlier to me than woman are. Imagine that....!
So he and I gallivant around the department--it is unusually busy, and the charge nurse--a woman who is about ten feet tall, (no lie) is calling out orders to everyone else. She is stressed though at this point, and as a side note, I'm not sure what a charge nurse does besides yell at people and sit at a desk.
Naturally, she hates me. Though she does not seem to remember me, I well remember her. I saw and spoke to her at my very first clinical back in September, and I spoke to her a few weeks ago, while she looked at me, well to be honest, like I was retarded. So, on my part, I've tried to befriend this giantess...but she wants no part in it.
She wound up telling me to stay on the opposite side of the desk of her so that I "don't get in the way". However, where she placed me only proved to be more a hassle for any of the bustling staff, so I silently glowered yet managed to keep a cheery face on all the while. Ahh, my secret talent.
So, nothing much in the ER took place today that makes for an exciting read. I took some blood pressures, watched a drunken young man sleep who looked like an angel, yet upon waking was most assuredly not one. I watched two urinalysis procedures completed, many blood draws/IV starts, EKG's and helped transport another patient to another part of the hospital. Overall, not exciting.
However, this was my last time (or so I hope) at this hospital. Next Wednesday, I will be at another one--the one that I absolutely loved last semester (so you know I'm setting myself up for failure with these big hopes!! Ha! )
Here is what I learned from hospital one:
- The staff is not fans of students. Even though they once were students themselves, they'd rather that you just go away
- All the patients I have thus far encountered are really nice to me. I've gotten hugs and winks from complete strangers.
- I still love the ER but am not a fan of the way I am treated
- I still want to do this as a career
Tuesday, February 16, 2010
Four am
Though today does not constitute an "internship" day, I did do a bit of work at a hospital today, and thus, I will record my adventures...
As part of my IV class, I have to have two documented IV starts in a clinical setting. Wanting to get it over with, I scheduled my clinical time a week after class let out.
Instinctively I knew that I'd be good at starting IV's (not to toot my own horn, but I am pretty good at it :) ) so the concept of taking a 20 gage catheter and sticking it into someone’s vein is about as natural to me as it may be for you to make a cup of coffee, or ride a bicycle. Little bit of practice makes perfect...
I had to be in the day surgery ward of the hospital today, and unfortunately, surgeries are always scheduled early, so that meant that I had to arise at four am. Anyone who knows me knows that I love my sleep. But, I psyched myself up for an exciting adventure of poking people with sharp needles, and in the end, four am wasn't too impossibly hard for me to get up and going, especially when I realized that I'd rather be doing this than sitting around wondering what I was going to do with my life. It's nice to feel like you have a purpose.
After a nice hour long drive in the pitch black, a car running a red light and almost T-boning me, and observing two Police officers surround a suspicious looking man outside of a Payday cash advance store, I was well on my way to an interesting morning.
I had to walk a bit to the day surgery ward, and it was freezing. I found the place with relative ease, did the whole "I'm Sarah, I'm a student" business and was ushered back into the hospital setting that honestly looked like a nursing home. I was met by a Technician who through false kindness and gritted teeth told the receptionist (and in a round about way, me) to go away and wait in the waiting room until she was good and ready for her to retrieve me.
And so I sat. And sat. In the waiting room with the other OR patients checking in. It was about half and hour later when the same Tech (who secretly hated me earlier) announced loudly (and a bit too cheerily) "Okay Miss EMT student!!! Come on back!!!"
Well, we exchanged names, and then she told me to sit at a table and gave me a catheter to "play with". Why she thought I needed a catheter to play with is beyond me, but I sat at the table like a child and kept myself busy pretending to be perfectly contented to look at the lovely pink 20 gage needle.
I saw a nurse point to me and in whispered tones ask "Who is that? What's her name?" (Sigh. Why can't people approach me? Do I look like an ax murderer?) To which my Tech replied "Cindy". Again, if you know me, you know that I do not often mumble my words, especially when introducing myself since I seem to do it on a daily basis, and I know my own name fairly well. And how in the world she got my name so wrong is beyond me.... but, I corrected her, and she apologized, patted me on the back and called me "Hon". I don't much like being called "Hon" but there is nothing you can do about such situations.
Finally, the moment came for me to start my first real IV on a patient actually needing one.
She and her husband were perhaps the nicest people one could ever hope for when picking a patient. She had absolutely no problem with me sticking her, even when she asked how many patients I've done before and I had to tell her that she was my very first real life patient. And so, she offered me her right hand and before me lay beautiful veins. (I'm fully aware that at this moment I sound like a vampire, but good veins are a must for successful needle pokes). I usually prefer the antecubital space (the depression in front of the elbow) but this is where I was expected (and told) to start the IV.
Grabbing my needle and setting everything up, I professionally explained everything that I was doing to put her, and perhaps myself at ease. I stuck the needle in, and immediately got "the flash" (the bit of blood that lets you know that you are successfully in the vein). I advanced the catheter in just a bit more, and placed it, successfully. I then did a blood draw and finally, hooked her up to the IV to give her the fluids she would need. She told me she never even felt the needle go in. Thank God....
One down, one more to go.
My next patient was a pleasant woman who informed me that before she became a stay at home Mom, she was a bio-chemist. I'm always astounded to be in the presence of these simply brilliant people, and more so am humbled that they trust me to poke and prod them.
So, I proceeded to prep this nice lady and once more started a successful IV. She asked if I used a local anesthetic because she "honestly did not feel a thing". Yay! So perhaps I've found my knack... :)
I wound up leaving the OR about 7:30am, and sadly, no one bid me goodbye. But that's par for being an EMS student....no one really cares about your coming or going, just as long as you don't mess anything up.
As part of my IV class, I have to have two documented IV starts in a clinical setting. Wanting to get it over with, I scheduled my clinical time a week after class let out.
Instinctively I knew that I'd be good at starting IV's (not to toot my own horn, but I am pretty good at it :) ) so the concept of taking a 20 gage catheter and sticking it into someone’s vein is about as natural to me as it may be for you to make a cup of coffee, or ride a bicycle. Little bit of practice makes perfect...
I had to be in the day surgery ward of the hospital today, and unfortunately, surgeries are always scheduled early, so that meant that I had to arise at four am. Anyone who knows me knows that I love my sleep. But, I psyched myself up for an exciting adventure of poking people with sharp needles, and in the end, four am wasn't too impossibly hard for me to get up and going, especially when I realized that I'd rather be doing this than sitting around wondering what I was going to do with my life. It's nice to feel like you have a purpose.
After a nice hour long drive in the pitch black, a car running a red light and almost T-boning me, and observing two Police officers surround a suspicious looking man outside of a Payday cash advance store, I was well on my way to an interesting morning.
I had to walk a bit to the day surgery ward, and it was freezing. I found the place with relative ease, did the whole "I'm Sarah, I'm a student" business and was ushered back into the hospital setting that honestly looked like a nursing home. I was met by a Technician who through false kindness and gritted teeth told the receptionist (and in a round about way, me) to go away and wait in the waiting room until she was good and ready for her to retrieve me.
And so I sat. And sat. In the waiting room with the other OR patients checking in. It was about half and hour later when the same Tech (who secretly hated me earlier) announced loudly (and a bit too cheerily) "Okay Miss EMT student!!! Come on back!!!"
Well, we exchanged names, and then she told me to sit at a table and gave me a catheter to "play with". Why she thought I needed a catheter to play with is beyond me, but I sat at the table like a child and kept myself busy pretending to be perfectly contented to look at the lovely pink 20 gage needle.
I saw a nurse point to me and in whispered tones ask "Who is that? What's her name?" (Sigh. Why can't people approach me? Do I look like an ax murderer?) To which my Tech replied "Cindy". Again, if you know me, you know that I do not often mumble my words, especially when introducing myself since I seem to do it on a daily basis, and I know my own name fairly well. And how in the world she got my name so wrong is beyond me.... but, I corrected her, and she apologized, patted me on the back and called me "Hon". I don't much like being called "Hon" but there is nothing you can do about such situations.
Finally, the moment came for me to start my first real IV on a patient actually needing one.
She and her husband were perhaps the nicest people one could ever hope for when picking a patient. She had absolutely no problem with me sticking her, even when she asked how many patients I've done before and I had to tell her that she was my very first real life patient. And so, she offered me her right hand and before me lay beautiful veins. (I'm fully aware that at this moment I sound like a vampire, but good veins are a must for successful needle pokes). I usually prefer the antecubital space (the depression in front of the elbow) but this is where I was expected (and told) to start the IV.
Grabbing my needle and setting everything up, I professionally explained everything that I was doing to put her, and perhaps myself at ease. I stuck the needle in, and immediately got "the flash" (the bit of blood that lets you know that you are successfully in the vein). I advanced the catheter in just a bit more, and placed it, successfully. I then did a blood draw and finally, hooked her up to the IV to give her the fluids she would need. She told me she never even felt the needle go in. Thank God....
One down, one more to go.
My next patient was a pleasant woman who informed me that before she became a stay at home Mom, she was a bio-chemist. I'm always astounded to be in the presence of these simply brilliant people, and more so am humbled that they trust me to poke and prod them.
So, I proceeded to prep this nice lady and once more started a successful IV. She asked if I used a local anesthetic because she "honestly did not feel a thing". Yay! So perhaps I've found my knack... :)
I wound up leaving the OR about 7:30am, and sadly, no one bid me goodbye. But that's par for being an EMS student....no one really cares about your coming or going, just as long as you don't mess anything up.
Tuesday, February 9, 2010
God is great, beer is good, and people are crazy
Today started off a lot better than last week. Only one staff member recognized me so I had to feel awkward again and re-do introductions. One Tech even said "I didn't know anyone was coming in for a clinical today". Nice to know that no one is aware of my Internship.
So, the Paramedics brought in a man having a heart attack (aka Myocardial Infarction). At the urging of the ER staff, I went to the Cath Lab. Now, for those of you who don't know what I'm talking about, a Cath Lab simply is a "department in the hospital that specializes in cardiac cathertization which is a procedure to examine blood flow to the heart and test how well the heart is pumping" (americanheart.org)
There we have this immensely sterile room, and I'm given a cap and face mask and told to "stand by that chair over there" and watch. Mercifully, a nurse was kind enough to explain the procedure. Essentially, the Doctor and Nurse stuck a catheter into the patient's femoral artery which would lead into the heart. I watched on the screen as they explained the man was having a heart attack, and they showed me his blocked arteries. Quite simply (and amazingly) they unclogged the arteries and placed a stent to prevent this event from happening again. Words cannot express how cool this was to watch a man's beating heart on a screen and seeing a clogged artery repaired and the pain of a heart attack alleviated.
The ER was busy today, and I did something I never, ever (repeat ever) imagined doing.
*Hint, the following portion is not for sensitive readers*
The technician that I was shadowing today asked me to help her place a urinary catheter. It sounds harmless. Until you understand the procedure. You take this long catheter and place it into (in this case) a man's urinary tract through the penis.
Now, I was fine watching this procedure--and secretly I was praying that I would not have to assist because a) I really don't want to be placing my hands on a man down there and b) I know there's a first time for everything, but I was content to never even assist. So imagine the sinking of my heart when I was asked to hold this man's...erm...body part open so that the catheter could be inserted.
It not only took longer than expected, it was awkward for me, and the patient. I wanted to blush, puke, and run away simultaneously. Instead, I tried not to breath in too deeply, and did my job while thinking to myself that this was something not in my plans for....my life.
But, it's over and done with. Thank God. Other than those two events for the day, I assisted in vitals, removing an IV and assisting with patients who had gotten themselves into some pretty scary accidents.
Never-the-less, this is what I love to do. I'm grateful that this week I was able to have more hands on work (perhaps a bit too much hands on if you get my gist, haha) and I think this day is one that can go in the books as some "EMT experience" that will look good on a resume.
So, the Paramedics brought in a man having a heart attack (aka Myocardial Infarction). At the urging of the ER staff, I went to the Cath Lab. Now, for those of you who don't know what I'm talking about, a Cath Lab simply is a "department in the hospital that specializes in cardiac cathertization which is a procedure to examine blood flow to the heart and test how well the heart is pumping" (americanheart.org)
There we have this immensely sterile room, and I'm given a cap and face mask and told to "stand by that chair over there" and watch. Mercifully, a nurse was kind enough to explain the procedure. Essentially, the Doctor and Nurse stuck a catheter into the patient's femoral artery which would lead into the heart. I watched on the screen as they explained the man was having a heart attack, and they showed me his blocked arteries. Quite simply (and amazingly) they unclogged the arteries and placed a stent to prevent this event from happening again. Words cannot express how cool this was to watch a man's beating heart on a screen and seeing a clogged artery repaired and the pain of a heart attack alleviated.
The ER was busy today, and I did something I never, ever (repeat ever) imagined doing.
*Hint, the following portion is not for sensitive readers*
The technician that I was shadowing today asked me to help her place a urinary catheter. It sounds harmless. Until you understand the procedure. You take this long catheter and place it into (in this case) a man's urinary tract through the penis.
Now, I was fine watching this procedure--and secretly I was praying that I would not have to assist because a) I really don't want to be placing my hands on a man down there and b) I know there's a first time for everything, but I was content to never even assist. So imagine the sinking of my heart when I was asked to hold this man's...erm...body part open so that the catheter could be inserted.
It not only took longer than expected, it was awkward for me, and the patient. I wanted to blush, puke, and run away simultaneously. Instead, I tried not to breath in too deeply, and did my job while thinking to myself that this was something not in my plans for....my life.
But, it's over and done with. Thank God. Other than those two events for the day, I assisted in vitals, removing an IV and assisting with patients who had gotten themselves into some pretty scary accidents.
Never-the-less, this is what I love to do. I'm grateful that this week I was able to have more hands on work (perhaps a bit too much hands on if you get my gist, haha) and I think this day is one that can go in the books as some "EMT experience" that will look good on a resume.
Tuesday, February 2, 2010
Day One
Day one was about as uneventful as one can hope for. A few broken bones, a couple suicide attempts--the normal stuff that brings one into an Emergency Department. I can't say that I got extraordinarily excited over any of the events, but it certainly was enjoyable watching the employees at work, drawing blood, doing vitals, patient interaction etc.
The first day of anything is always super awkward because a) no one knows who you are and b) you get forgotten about/ignored because no one knows what to say to you.
My day primarily consisted of people staring (literally, staring) at my name badge which identifies me as a student. Unfortunately, the clip for my name badge is right at my pelvic region, so it creates shall we say....an awkward feeling as people are staring at it, trying to figure out who the girl is in the white button up top and blue cargo pants.
After the moments of people staring at me, I was often mentioned as "the EMT Student" of which I am no longer...but how do you tell people without sounding uppity that you are an "Intern"? I did the class, I did registry. I should get some credit, right? (Even still, I don't know exactly what I should be doing as an Intern...
I got ignored by the staff for the most part of the day, something which I have discovered is normal. Again, people don't know who I am, or what I am doing in their department, and so human nature tends to just pretend that the person they do not know does not exist.
I also was told that because of the economy it is rather hopeless for me to find a job in this field without some hardcore experience (Hello!! What is the point of me doing this internship?!?) But I digress...maybe next week, when I'm back, interacting with the same staff members there will be some recognition of who I am. But maybe not.
:)
The first day of anything is always super awkward because a) no one knows who you are and b) you get forgotten about/ignored because no one knows what to say to you.
My day primarily consisted of people staring (literally, staring) at my name badge which identifies me as a student. Unfortunately, the clip for my name badge is right at my pelvic region, so it creates shall we say....an awkward feeling as people are staring at it, trying to figure out who the girl is in the white button up top and blue cargo pants.
After the moments of people staring at me, I was often mentioned as "the EMT Student" of which I am no longer...but how do you tell people without sounding uppity that you are an "Intern"? I did the class, I did registry. I should get some credit, right? (Even still, I don't know exactly what I should be doing as an Intern...
I got ignored by the staff for the most part of the day, something which I have discovered is normal. Again, people don't know who I am, or what I am doing in their department, and so human nature tends to just pretend that the person they do not know does not exist.
I also was told that because of the economy it is rather hopeless for me to find a job in this field without some hardcore experience (Hello!! What is the point of me doing this internship?!?) But I digress...maybe next week, when I'm back, interacting with the same staff members there will be some recognition of who I am. But maybe not.
:)
Monday, February 1, 2010
Prelude
"No one knows what he can do until he tries"
Tomorrow begins the start of an adventure I thought would never occur. I have often said that whatever I am adamant about not doing one day, it turns into something I actually do (and love) the next.
I've loved anything emergency and medical related since I was a child. From my early years I pretended I was a doctor, saving lives left and right. Only I had the knowledge and expertise to do so. But the dreams of a child are often left in the past and forgotten.
As I grew up, I found that I had no idea what I wanted to do career wise. Sure, being a doctor sounded grand, but I lacked in math and science and so, I gave up that dream. I graduated high school, went to a two year Bible college, and left still not knowing what to study. I went to a Community College and studied business, and it was okay, nothing spectacular, and I couldn't help but feel that I was wasting my time studying things that I really couldn't care less about.
Spring semester of 2009, I was stuck in a college Biology class that I didn't get, and reached a new point of frustration. I hated studying business, I hated being 22 and stuck at Community College, and I hated having no direction.
That is, until friends, family, and my boss all told me on separate occasions that I was studying the wrong thing, and that I need to study something that I love.
And so one day, scanning the school catalog, my eyes fell upon Emergency Medical Services. With thorough research and much fear, I enrolled into the program, and quite simply, I fell in love. Everything about the program I adored, even the frustrating parts when I couldn't put the regulator on the tank of oxygen correctly, or couldn't figure out the difference between a pneumothorax and hemopneumothorax....I was indeed in love.
My first time in an Emergency Department, I knew I had found my niche. I walked in, got acclimated, and felt that I was home. The frustration, the confusion, the fear all vanished. Everything clicked, and I was happy. Some of the patients I assisted will stay in my mind forever--the little boy with the broken arm, the man having the heart attack, the woman with the pulmonary embolism...they all taught me the valuble skills that cannot be learned about in a classroom.
I got my EMT certification officially in January of 2010.
I'm now enrolled in an Internship where I spend time in Emergeny Departments, ambulances and who knows what else as an introduction to the medical field without being a "EMT student". Though I'm a rookie, I now have the letters EMT after my name, I have the education, and I have the desire to learn---so whatever this Internship throws at me, I believe (with some hesitancy) that I am ready for this new journey. I know that there will be shortcomings, I'll come across as a dork, and some days will be horrible. That's okay. I didn't go to school thinking that I'd be a life saver. I went because this is my passion. This is where God has called me.
Tomorrow begins the start of an adventure I thought would never occur. I have often said that whatever I am adamant about not doing one day, it turns into something I actually do (and love) the next.
I've loved anything emergency and medical related since I was a child. From my early years I pretended I was a doctor, saving lives left and right. Only I had the knowledge and expertise to do so. But the dreams of a child are often left in the past and forgotten.
As I grew up, I found that I had no idea what I wanted to do career wise. Sure, being a doctor sounded grand, but I lacked in math and science and so, I gave up that dream. I graduated high school, went to a two year Bible college, and left still not knowing what to study. I went to a Community College and studied business, and it was okay, nothing spectacular, and I couldn't help but feel that I was wasting my time studying things that I really couldn't care less about.
Spring semester of 2009, I was stuck in a college Biology class that I didn't get, and reached a new point of frustration. I hated studying business, I hated being 22 and stuck at Community College, and I hated having no direction.
That is, until friends, family, and my boss all told me on separate occasions that I was studying the wrong thing, and that I need to study something that I love.
And so one day, scanning the school catalog, my eyes fell upon Emergency Medical Services. With thorough research and much fear, I enrolled into the program, and quite simply, I fell in love. Everything about the program I adored, even the frustrating parts when I couldn't put the regulator on the tank of oxygen correctly, or couldn't figure out the difference between a pneumothorax and hemopneumothorax....I was indeed in love.
My first time in an Emergency Department, I knew I had found my niche. I walked in, got acclimated, and felt that I was home. The frustration, the confusion, the fear all vanished. Everything clicked, and I was happy. Some of the patients I assisted will stay in my mind forever--the little boy with the broken arm, the man having the heart attack, the woman with the pulmonary embolism...they all taught me the valuble skills that cannot be learned about in a classroom.
I got my EMT certification officially in January of 2010.
I'm now enrolled in an Internship where I spend time in Emergeny Departments, ambulances and who knows what else as an introduction to the medical field without being a "EMT student". Though I'm a rookie, I now have the letters EMT after my name, I have the education, and I have the desire to learn---so whatever this Internship throws at me, I believe (with some hesitancy) that I am ready for this new journey. I know that there will be shortcomings, I'll come across as a dork, and some days will be horrible. That's okay. I didn't go to school thinking that I'd be a life saver. I went because this is my passion. This is where God has called me.
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