Sunday, October 24, 2010

Exhausted!

I am done. Finally done my 4 day stretch. I have tomorrow off and then right back at it on Tuesday. This leaves tomorrow free for Grandparental Visitation. My favorite.

Anyway. I now completely excel at blood gases (knock on wood). I'm not sure when this happened, but somehow I have become good at this. I have all the steps down finally and have shaken my nervousness. So everyone at work thinks I am AWESOME. This may be a slight exaggeration, but I think that I am awesome. I walk to work now, it takes 8 minutes and the entire way there I tell myself that I am awesome and will do a great job today. It actually seems to be working even though it sounds ridiculous.

I've been giving the old lady on BiPap pep talks. Those, on the other hand, do not seem to be helping at all. I just pretend I am practicing for when my lifelong smoker of a mother is hospitalized and drowning in her own secretions all the while bitching about a life saving, albeit uncomfortable face mask. She was slightly less complainy today, or I just didn't check on her as often - I'm not too sure.

So someone disconnected themself from the ventilator today. This guy is so thrashy and he is on continuous propofol plus boluses and they can not knock that guy out. A nurse made his wife cry today by asking her to please not speak to or touch the patient. Truly. I agree.

I attended an awake intubation. Amazing and terrifying. Poor 21 year old girl with giant inflamed tonsil and a 5 mm airway. The anesthesiologist intubated over the bronchoscope. It went completely smoothly, which was shocking. My job consisted of running between the ICU and the OR for supplies (ET tube holder, bagger for transport). I try to be the most useful student that I can be in order to be loved - which is very important to me.  The pt was transported to the ICU, put on the vent on CPAP, since she was - you know - AWAKE. Later on, the doc on call - just your general run of the mill internist - put her out completely out and drained her abscessed tonsil by repeatedly poking it with an 19 gauge needle, and then pressing a suction catheter (yankauer) up against it. It was disgusting and awesome. Lord knows what will happen to her overnight.

I usually volunteer to run whatever venous gases that lab draws for us. Today all 3 of them were actually arterial. This is interesting because it is actually ILLEGAL for them to draw from an artery. And you know how much RTs love the fact that they are the arterial gas specialists. It was actually pretty entertaining watching the more senior RTs get all worked up and sending emails and calling people. Oh the rage. The rage.

The ICU really makes me love what I am doing now. It is better than the wards by about 300 million times. But I still like responding to ER calls. I'll really miss this hospital when I am done.

This is what my heart failure patient's x-ray looks like.  He should be palliative - not in the ICU.
(image from www.cardiophile.org)

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