Thursday, December 29, 2011

Medical Cooking Hack

While making Coq a Vin the other day we realized we were out of cheese cloth for the spice bouquet. It was boxing day, nothing was open and also I did not want to go outside. 

A quick google search revealed that sterile gauze is actually a good substitute. I just so happened to have some in my first aid kit, and I soon found that actually it was better than cheese cloth because it was already cut to the right size for making a spice bouquet! Coq a Vin was saved!


Wednesday, December 28, 2011

Why do patients die at Christmas time.

I'm casual. Not surprisingly I work a lot of shifts around holidays when everyone else would like some time off. Unfortunately I am working way too much. I have 8 shifts in 10 days. I am exhausted. Also I have lost my voice.

Anyway. Several of our long term patients passed away. And that's totally depressing. It's like they had just the amount of energy to make it to Christmas time. One in particular had been on our pulmonary unit for months, waiting for a lung transplant. Unfortunately it never came.  Her CO2 just started climbing and there was nothing we could do about it.

On Christmas eve I was called to the hospice, an area which we normally do not service. One of our patients who had recently moved over to the hospice from our wards was having difficulties with oxygenation. I sorted it out as best as I could (which involved moving the patient to a new room, and about 7 more pages that day) and promised to come back the next day to say Merry Christmas! The next day I was merrily wandering in when the nurse stopped me and gave me the bad news.

Luckily on one of our other units everyone pitched in to buy a chronic vent patient who actually lives at the hospital a hockey jersey of his favorite team. It is now his singly worldly possession. So that cheered me immensely.

Thank god.






Wednesday, December 14, 2011

Vomit Comet

Grossest intubation ever. An older fellow who had been mouth breathing for lord knows how long suddenly required intubation during rounds. His airway was nearly completely occluded by thick, crusty, dried out secretions. I was wearing an N95 mask as per policy. Thank god, because I was totally dry heaving. I can put up with most disgusting things. Like the most disgusting suction (some things should not be inside lungs) followed by lunch eating. No problem.

As I was waiting patiently for multiple residents to figure out intubation, and could see the whole thing on the glydescope, tears were streaming down my face as I dry heaved.

I need to work more frequently. I'm losing my touch.

Thursday, November 10, 2011

Retro pay - Yeah baby!

I have FINALLY received my retro pay. Up here in Canada (in my province anyway) when we are hired we are paid 90% of the full rate of pay as Graduate RTs. We write the registry exam the first Monday in July. Then it takes about 6 weeks for them  to mark it.  Once the results come back we are to get full pay from the date we wrote the exam. Because we have magically become Registered RTs (overnight). This usually takes a few pay periods. Or if you are me, a few months. A few emails to payroll. Etc. Finally. Finally my retro pay has come in.

Thank god. Since I was away for the past entire month, it is totally awesome to have this on my paycheque this pay period.

I haven't been working much, which is sad for stories. I've been working about 2 shifts a week and resisting short call. I just cannot bring myself to answer the phone at 5am and get my butt ready for work. I've been keeping myself busy with some other stuff though. I have been babysitting a bit and doing a bunch of accounting work. Also Netflix and AppleTV are my nearly constant companions. Even though the Netflix selection in Canada is not near the selection in the States I still like it.

Also - I have recently stepped way outside of my comfort zone and tried hot yoga. I though that I was going to die - but here I am - so therefore I must have made it. Even though I sweated more than I thought imaginable and thought I was going to throw up. I need a lot more massages, and maybe a few visits to the chiropractor.

And finally. I have a major eye twitch. It started after my first shift back after holidays. You know the one where I was completely slammed in the emergency room? So now I am left to wonder.

  • Is my eye expressing the anxiety I experienced during that shift (maybe partially)
  • Have I been drinking too much coffee. (likely)
  • Have I been staring at a computer screen too much (possible)
  • Have I been doing too much filing (definite)
  • Do I need to go to bed earlier (doubtful)

Monday, November 7, 2011

How a Bad Day Starts

Having returned from vacation, and then a week of no shifts, I climbed into my car not even thinking about the state of the gas tank. The car is kind of a POS and the gas gauge does not work in any way - it always reads full without fail.

Anyway, I made it most of the way to work before the car started sputtering and cut out. It recovered long enough (who knows how) for me to pull into a parking lot, and died as it coasted into the parking spot. UGH. Luckily I had left myself plenty of time to get to work and luckily it wasn't too freezing cold. So I walked the rest of the way to work. I wasn't even late.

My first day back and I was in the emergency room. What an absolute nightmare. Multiple intubations, BiPap, PFTs!? (yes, we rarely do bedside spirometry but in the midst of the chaos the ER doctor insists on bedside spirometry for a patient that we have absolutely no baseline for). Epic. Then a doctor let my student put a nasal airway into an unconscious patient before we intubated. Massive nosebleed. Brilliant.

Today was my second day back and it was a coaster. I had one patient all day - a moderately high maintenance trach patient with an anoxic brain injury from an OD years ago. I passed him to the wards staff member before shift change and was able to pass on a clean slate - something I really enjoy.

Friday, November 4, 2011

Short Call

This gives new meaning to the phrase, "Short call."

By 11:30 I have pretty much given up on getting called into work for the day shift. Not today. Apparently someone called in sick and scheduling wasn't notified. At 11:30 they were calling for someone to come in and cover whatever they could.

But I was busy at Costco selecting delicious coffees. And cheeses. 

Thursday, November 3, 2011

Back At Last

I have returned to the land of Canada. It is cold and should start snowing any day now.

My first day back at work is this Sunday coming up, until that time I have a date with my couch and Netflix.

Heart.

Sunday, October 9, 2011

Europe bound

One of the fantastic things about being employed is the ability to stash some funds. For trips. To Europe.

Yes I will be in Europe for the next 3 weeks, returning October 30th. Hopefully I have no hospital related storied to share in that time. Ha!

Thursday, October 6, 2011

When not to get Sick.

Our schedule has been released for Christmas. I am working the 22, 23, 24, 25th - all days! It was exactly what I hoped for.

Further - all my friends are working on those days too! Because of course all the experienced staff took the time off - so it is all casuals.

Advice to you - never go to the hospital during a long weekend or any other kind of holiday. Because only casual staff will be working. Not that we aren't super competent and caring - but sometimes it is nice to have some experienced staff around.

Monday, October 3, 2011

The Worst Night.

I got called in the other night to augment the ICU. I got called in the late afternoon and hadn't slept all day - which I thought would be fine because if there are 4 people on usually the breaks are a bit longer. And then you can actually get a sleep.

I know by now not to actually have any expectations like that. I arrived at work to find I had been switched to the floors. Ok. No problem.

TOTAL PROBLEM.

I had so many people to see, I had one 30 minute break all night. The other person on the floors had approximately 2 people to see all night. She offered to help a few times throughout the night, but I had it under control, lots of stuff but only one at a time. Except for at 10 pm when I had two patients requiring trach care and two patients requiring cough assist all at the same time. I got through it.

Ok. So 6 am. I am exhausted, I have 2 sputum inductions to do, and 1 sleep study to download. She asks if there is anything she could do to help. So I say, yes - go ahead and do one of the sputum inductions. Her reply, "Uhhh, is there anything else I could do?" Seriously. What a bitch.

So my goal is to not be an RT like that ever. If someone is busy and you are not - help them. It's simple. And keeps other people from calling you a bitch.

Monday, September 26, 2011

My Nose is Itchy.

I worked only one day out of the last set up in the ICU, As such I fell victim to the phenomenon that I like to call - "You will have the patients no one else would like to care for." This included a quadriplegic who is actually quite nice but is a lot of work. In fact, if you take this patient (let's call him Simon) as one of your patients for the day, you will actually only have to take on one or two other patients - just because he is so damn time consuming. Also, since you end up spending a lot of time in his room you end up doing several non-RT functions. So. At 9 AM Simon's day begins with cough assist which is coordinated with physiotherapy. In case you have never heard of cough assist, it is basically a vacuum which blows air into lungs, then sucks it out - which sort of simulates coughing in a patient with no ability to cough. Usually 3 breaths are done (in, two, three, out, two, three), patient is suctioned, and then this is repeated 3 or 4 times. Physio co-ordinates care with us in order to do exhalation vibes.

After cough assist is done physio gets to leave the room. I swear to god they think this is the easiest patient in the entire hospital. Then we do some TLC breaths with the bagger. Phew. Almost done. Ok, so now administer some Ventolin and Atrovent in preparation for the next step. What Simon? Your eyes are itchy? Ok, so now get a cloth and scratch Simon's eyes. Ok. So the cloth isn't wet enough. Get the cloth wetter. Soak the eye. OMG. Wrong eye. Ok. The cloth isn't the right temperature. Fix that. Neck is itchy. Nose is itchy. Ok. Solved the itchy problem. Almost done right? No.

Simon has an antibiotic nebulized through the vent circuit. Easy peasy, pop it in and go? You wish. Ok. The antibiotic is a powder. It needs to be re-constituted right before you give it. So you mix it up with the normal saline. Now you need to exchange the exhalation valve and flow sensor on the vent so that doesn't get gummed up with this sticky mixture. Ok, done and done. Neb mode started on the vent. Now you get to sit around and wait 30 minutes while it runs. Fantastic. Itchy neck. Itchy eyes. Can you put some lotion on my face? Can you put some eye drops in my eyes? Yes, yes, and yes. Increase the volume on the TV. No, too loud. No, not loud enough. WHAT? You want some ginger ale?! Right. So we let him suck up some ginger ale, swish it around in his mouth and then we suck it out with a yankeur. Fantastic. 20 times. Then Simon starts telling me about how he misses coffee, and pringles (which I misinterpret as "pickles" and he turns purple with frustration trying to make me understand), and beer. I feel terrible for him and also feel terrible for not wanting to scratch his eyes or the inside of his nostril. Sigh.

So, the antibiotic finishes and then I have to switch back to the original exhalation valve and flow sensor.

Repeat at 1600 hours.

Oh. Also, I forgot to mention that this patient is on the vent - so you have to bag him between sets of cough assist. With your free hand. And he is fully on isolation - don't forget your gown and mask. And finally? Simon can't really vocalize - better get really awesome at reading lips.

Wednesday, September 21, 2011

Off to India!

No - not me. I wish I were going to India.

We have had a patient in our hospital for months and months. He came from India to visit his daughter - with very poor lungs. Yet, his Indian doctor said it would be ok for him to travel. He was here one day when he went into respiratory failure. He has been in the hospital multiple times. He has been intubated multiple times. He has had multiple trachs. His health insurance ran out a long time ago. As a result his daughter has had to re-mortgage her house in order to pay for his medical bills. Yes - this can happen in Canada too. Numerous medical professionals have been donating their time to his cause since his insurance ran out.

The past few weeks have been focused on getting him well enough to travel home.  That day was yesterday. I was preparing him for travel - which mostly just involved some last minute suction and sending emergency trach supplies with the transport team - when the Dr came in to say that she wasn't sure that he could travel. I couldn't believe it, but eventually he was cleared and when I came back from lunch he was gone.

The transport team came from Taiwan. I can't even imagine how they found a transport team in Taiwan to come to Canada, collect this incontinent man with a trach and travel first to Frankfurt and then on to India. Seriously. I can't imagine the cost of four first class seats the entire way.

This is the second time I have seen this already in my time in the hospital. Elderly family member travels overseas, and either insurance runs out or doesn't at all cover a previously existing medical condition. Both times this involved a patient with COPD and greatly decreased lung function. Both times resulted in financial destruction for the families involved.

Seriously - think twice before having your elderly family member travel overseas to see you. Maybe you should go visit them instead.

Monday, September 19, 2011

What's Wrong?! What isn't Wrong!

We have a laryngectomy patient who is having some complications. Last time I saw him, he was still in the ICU, and he has moved out to the wards now. I saw him twice yesterday. The first time I had a student with me and, lets be honest here, she did the bulk of the work. So the issue is that due to bleeding there are many blood clots that need to be cleared out of his airway. We do this using sterile swabs, tweezers, gauze, and finally instilling saline and suctioning the crap out of his lungs. So. That went well the first time. When we arrived he was on the phone with his wife. Except he can't talk - so he would listen to the phone and then hand it back to the nurse who would listen to what the wife had to say and then convey what the patient was trying to say. Very frustrating. For everyone. At one point the nurse said, "Your wife would like to know what is wrong." I laughed to myself. This poor guy has had so much trouble in  hospital - What's wrong??? What isn't wrong. Anyway. She wasn't interested in coming down to the hospital so he was going to have to wait until morning to see her. And lucky us would get to continue to care for his laryngectomy site.

Later that evening, after my student had got home for the day, I had to see him again. Now the poor guy was vomiting up copious amounts of bile. Luckily for me, because I wasn't that interested in irritating a vomiting patient, the ENT resident was there with her little scope and she said it looked pretty clear in there. I just cleaned up some superficial clots and got the hell out of dodge.

Wednesday, September 7, 2011

Short Change Over

Due to some sort of scheduling mix up... I imagine it went something like this....

Scheduling lady - "Do you want to work such and such a shift?"

PeonRT (without looking at schedule at all) - "Yes! I am short on shifts! I will work anytime possible!"

So... I ended up working until 7 am and returning to the hospital at 3 pm. Never again.

Saturday, September 3, 2011

The grossest thing I have ever seen...

First a moral lesson. There are 2 very sick people in our ICU right now. One developed a Legionalla Pneumonia after going in a hot tub. As someone about to face a long cold winter, the thought of never going in a hot tub ever again is horrifying and sad. But I am definitely considering adding that to my list of DO NOT DO EVER's. This person is currently proned and oscillated. The second person (who this post is about) was wrestling with a buddy, broke some ribs, developed a pneumonia and now has multiple chest tubes, and well.. I don't want to ruin the surprise. So to summarize kids - do not go in the hot tub and do not wrestle.

Back to the grossest thing I have ever laid eyes on. Our friend in the ICU had a necrotizing pneumonia, which left some empty spaces in his lung, which then abscessed and collected large amounts of fluid. In the meantime he developed an infection of the pleural fluid which loculated into several separate specific areas. So the doctor thought it would be beneficial to have multiple chest tubes inserted under the guide of CT and Interventional Radiology. Chest tubes 1 and 2 went in without much trouble at all, and drained what appeared to be normal looking pleural fluid drainage - what we normally see in a chest tube. This is where things get truly fantastic. The Doctor was not wearing a mask, or goggles, or a gown. He inserts the last chest tube and a GUSH/EXPLOSION of grey, foul pus erupts out and all over him. I have truly never seen/smelled anything like it. Also. The Doctor was wearing fancy shoes. Fantastic.


Tuesday, August 23, 2011

Another first.

First sick day :(

As casuals we aren't paid when we are sick - so that is unfortunate. On the other hand, I can't imagine it is that fantastic for my karma if I go to work sick and give the chronic vent patients a pneumonia or something. So I am at home watching BBC documentaries about WWII.

Nerding out with a box of kleenex.

Monday, August 22, 2011

What's one step up from a Peon?

I need to change this blog slightly. I am no longer a student of Respiratory Therapy. I am also no longer a provisional Therapist. I passed the Registry Exam! Which means I can now sign my full name, and then RRT. What a treat!

Also, things that have been keeping my from writing all of my adventures down is a giant wedding. Well it wasn't so giant - but I am married now!  Hurray! So everything that has been occupying my mind for the past few months (moving, graduating, writing the registry, getting married) is now over. I have so much more free time! This is also good, because since I have been working a TON i have lots of stories to tell.

If there are any readers left that is...

Friday, July 1, 2011

Happy Canada Day Y'all


So. How will I be spending this lovely holiday? Studying of course. Everyone else in Canada is attending parties and enjoying a day in the park, I am memorizing Egan's. Whatever, I totally love it.

On Monday (American Happy Day - I believe is called Independence Day) I will be full-on celebrating by writing an all day exam. So happy Independence Day in Advance. Enjoy your long weekend! May it be filled with sunshine, family and FIREWORKS!

Tuesday, June 28, 2011

The Life of a Casual

I was supposed to have one shift over two weeks - mostly due to my need to study for a very important registry exam that is one week away.

Two days before my shift they called to cancel it. Apparently someone cancelled their vacation - which is totally ok because that happens. So instead of sleeping all day in preparation for a night shift - we went to buy a new couch. This one.
Axis sofa - from Crate and Barrel
So after a long day of picking out couches. Who calls me but SCHEDULING. Wondering if I want to come in for a night shift - my original shift. So someone cancelled their vacation - then called in sick. I was so irritated and of course not prepared to go to work. So I spent the night sleeping awesomely in my own bed. Then I got called in for a 3-11 shift the following day - so everything evened out in the end.

Anyway. I have 6 days left of studying. So I'd better get at it. 

Monday, June 20, 2011

The Return of Red

So. I am not yet done my orientation to the hospital - and I had a student all weekend! How ridiculous. We had a good time though - me and my little student. I taught him how to do trach care. I remember how awkward and awful I was at that when I first started my practicum, and how I learned eventually that it is actually no big deal.

Today I orientated to a long term care facility and was pleasantly surprised. It's more like a family environment there, with long term vented patients hanging out and watching tv - or playing on their computer - or whatever the eff they want to do.

I've completed my wards orientation. All that remains is my ICU orientation! Almost done. Working is actually unbelievably exhausting, which is what is keeping me from writing. I don't know why, but at the end of every shift I can barely function. Also, I have the infamous registry exam hanging over my head. I really need to start studying for that! Oh to be a REAL RT.

Wednesday, June 8, 2011

An Actual Working RT

So. I have finally finished my orientation in Wards and also Emergency. So this means I can work on my own in these areas. This has happened only once so far - I was just happily helping my friend move when scheduling called to ask if I would be able to come in that night! I knew I wouldn't get much sleep that day, but I also know sometimes nights can be a bit slow and maybe I could grab a nap. Nope. I was kept busy running all night to various problems. The hospital I work at has a pediatrics wards (which isn't that common in my city because we have a children's hospital) and I had two asthmatic peds. I am totally unfamiliar with any policy and procedures here and that made the process a little uncomfortable. Add in a resident who knew absolutely nothing, and I was up there every 20 minutes. Also - I had to do an overnight oximetry on a Sr who wouldn't stop talking to me about her husband, and I couldn't get the sat probe to work - so I was there for a LONG time.

Other than that I have been busy orienting to other areas of the hospital. I am officially done all areas in the first week of July!

Thursday, May 19, 2011

And she's back.

OMG. I have been so stupid busy. And I know everyone says that - but I actually mean it.

I moved. I started my new job. Nothing in our new house works. Well not nothing, but enough to make me mad. Every day.

So my new job. First I had a 6 day orientation that encompassed skills and computer programs. Most of my passwords work now. Kind of. I still can't run ABGs. No problem - not like that is an important part of the job or anything.

Since the classroom orientation I have had 2 shifts in wards. It has been awesome. I have done cap gases, and car seat tests, and some guy pulled out his trach, and we went to a code Blue but the patient was already dead. Also I bought new scrubs! And also got some free ones from the hospital.

I love it. I love my new job, I am so excited. I am also looking forward to things slowing down so that I can tell more stories here!

Thursday, April 28, 2011

I have not disappeared.

You deserve to know how my last day in the hospital went.

First I was dealing with an intoxicated woman who I extubated in the morning. Second I was dealing with an intubated preemie. Not what I envisioned for the last day.

I was kept busy running between the NICU and ICU - and kept afloat with the promise I would be able to leave at 1.

Success - we extubated the baby. Now only to clean the vent and I wouldn't have to deal with that part of the hospital ever again. Ever tried pushing a Babylog down the hall? It's a little top heavy. I hit a bump and the vent did a faceplant. I was kind of in shock, said a few choice words, and then looked around to see who was watching. No one around. I struggled to get the vent back into a vertical position and survey the damage. It wasn't good. The entire front was smashed, and hanging a little off center. Eventually I worked up the nerve to push it downstairs and own up to the damage. Biomed says there is a 50% chance the vent will make a full recovery. I told them to take it off my pay.

Finally I stopped in to check on my extubated lady. She was not too impressed with me. I was just trying to encourage her to breathe deeply and cough, you know, to prevent being intubated again. Crazy me! Her response - "F*** you. You F**king B**ch. I am going to F**king kill you." Yikes. I looked at her restraints, they seemed to be in good shape. I looked at my watch - 1:05. I wished the nurse good luck and didn't look back.

So that was that. The end of my practicum year. Just like that.

We went to Hawaii for the weekend - which was fully amazing, and I want to live there. And now I am packing because I am moving.

Start date of work is May 9th. New adventures to be had! I plan on keeping the blog and updating it frequently. If I had adventures while fully supervised, just imagine how crazy it will be when they let me out on my own!

I will continue to be a Peon of Respiratory Therapy.

Wednesday, April 20, 2011

Just another day.

I had a lovely weekend in the ICU. It wasn't too busy, which was nice because I am winding down (which is ridiculous and dumb - because I should be winding up).

At some point a lady in full renal failure needed to be intubated. I fully volunteered which was crazy and amazing. Unfortunately I accidentally stabbed myself in the eye with the ET tube. The end with the cuff. No one knows how it happened. And the tube went in the patient anyway - first try, great view. It was a total rush and I felt invincible. This is likely going to be the first and last time I ever intubate in an ICU, since the hospital I will be working at doesn't let RTs intubate. And then I tried an artline (which I couldn't get, and neither could anyone else) and I was glad to try because... the hospital I will be working at doesn't allow RTs to do artlines. Damn residents having all of the fun. BOO.

Then. we were called to a code. A patient that I had been watching deteriorate all day. Not to worry - the Dr had also been watching the patient deteriorate all day - it's not like I was being negligent. We did CPR for about 20 minutes. I got into a semi-argument with my preceptor about when to give breaths. Per ACLS, once an advanced airway is in place you are just to give breaths every 5-6 seconds. Per my preceptor every thirty seconds give 2 breaths. Even the Dr called him on it but it was still awkward and weird. And irritating.

One shift left tomorrow. One free shift ever. Ever.

Saturday, April 16, 2011

Finish Line

First of all I would like to give a huge shout out to my classmate who is running the Boston Marathon on Monday. You are awesome and I am so glad that we met at RT school.  Isn't it surprising where life leads you and the people you meet and who becomes your close friends.

I am reaching my own finish line. I have 5 (possibly 3!? depending on how the hours are added up) shifts left and that seems completely unbelievable. I remember my first days at the hospital - they can basically be summed up like this:

  • set up the ventilator? right now? like a patient needs it? OMG.
  • you want me to an ABG on this totally stable patient? (freaking out)
  • assist the intubation? Like someone has the laryngoscope already in some dudes mouth and is my job to get the tube ready or bag them up? OMG OMG OMG
  • Trach care - don't even get me started on trach care. Does this hurt? Can you talk? Are you not talking because you have a trach in or are you brain damaged?
  • Lactate of 17? WTF.
Ok so basically anything freaked me out. Assess the patient? No way. BiPap = Scary. Basically the only thing that I have ever really truly felt comfortable doing from the beginning was suctioning.

I always felt a little less mentally prepared than many of my classmates for the hospital setting. I know many of them barged into the hospital armed with all of their knowledge and skills from the many competencies we were subjected with at school. They seemed to have no fear, which was ok because I had more than enough fear for everyone.

I think I have finally outgrown this. After a 3 month hiatus from the ICU (due to Children's Hospital, PFT lab, Sleep Lab, and home care) I have returned with my skills intact. I spet the past two days in the ICU effectively alone. And it was fine. I managed the vents, and took care of the problems. It was totally fine. Granted nothing crazy happened, but I felt totally prepared, like if something crazy happened I would know what to do. I know all the steps. I know how to prepare for an intubation. I know how to set up and insert an artline. I can do the things that are required of me in a calm and calculated manner. 

Well I guess one less than optimal thing happened. But it wasn't my fault. I assisted a bronch on an elderly gentleman with a trach. It was absolutely the most swollen, irritated lungs I have ever seen. Mostly the bronch went ok, even though I forgot to hook up the suction and also it was being performed by a resident. After the bronch, however, my patient proceeded to cough up frank blood all effing day. He had blood all over himself, and then he would desat to the 50's and then I would suction thick and clotted plugs out of his lungs, and his sats would improved. At one point he gestured me into his room. He wrote this on his note pad - "please call the Dr. - I am ready to die." He was still alive when I left the hospital. Apparently the last thing he wrote on his notepad was - "I am packing it in." And he was dead by 10 pm. Unbelievable.

Also another one of my patients passed away. Actually 2 of them. That's always a little depressing, but expected. 

Today was really quiet, but had a disproportionately high amount of ABGs. I think I did 10 today. I got every single one of them - even the lady who had a BP of 60/30. She had two pokes - and both of them were completely by landmark because I could not feel a pulse at all. Skilled - right here.

Addendum: You know what won't help heart failure? Ventolin. For the love of god stop paging me and just give your patient some Lasix.

Thursday, April 14, 2011

World's Oldest Man Dies

Oh wow - I can't even imagine living this long. Good for him!!



http://www.theglobeandmail.com/news/world/americas/worlds-oldest-man-dies-in-montana-at-114/article1986262/

Big test = Good bye school.

So I have written the last test I will write at school. I am done. For better or worse :)

There were so many questions on this test that I never would have known the answer to because I never would have studied it. For example:

What is the shape of Klebsiella. (RODS for the love of god the answer is rods)

Also - if there is a question about protease/anti protease - the answer is lung disease. Honestly that is all I can remember now - a 6 hour test, in two parts - and that is all of my memories! There were some really tricky case studies, in which I actually had no idea what was wrong with the patient. Like that ever happens in real life :P

And then after we all went out for a beer! I have 7 shifts left and then I will be back at home full time and I can't wait. I am so excited and so nervous to start my new job as a casual RT at the hospital! Mostly I am excited to get some new scrubs - that are not red.

Taken at my favorite beer drinking location - Post Exam

Monday, April 11, 2011

Rewards

Once again I have been rewarded for my terrible school habits. My paper/poster - this one here - is finally marked. I got a really fantastic mark on it, thus reinforcing my terrible behavior and ensuring that I will continue to procrastinate long into the future.

New challenge? Studying for a 3 year cumulative exam which take place tomorrow. Blerg.

Stolen from an article somewhere:

Live in rooms full of light
Avoid heavy food
Be moderate in the drinking of wine
Take massage, baths, exercise, and gymnastics
Fight insomnia with gentle rocking or the sound of running water
Change surroundings and take long journeys
Strictly avoid frightening ideas
Indulge in cheerful conversation and amusements
Listen to music



Aulus Cornelius Celsus (c. 25 B.C.-c. 50)





Saturday, April 9, 2011

The Walk in Clinic.

I have been sick for weeks now. I thought it was strep throat, and then it turned into a head cold. And then it turned into what I was sure was a sinus infection. I have spent way too much money on remedies that google suggested I have. The best one being:


with a close second being my sickness fallback:


Nyquil and I have a very close and dangerous relationship spanning many years. I used to use it just to fall asleep - but now I reserve it specifically for nasty, nasal clogging illnesses. This sickness alone I drained an entire bottle. 

Anyway - after weeks of illness, and sleeping in for work twice (thank god for the most patient home care boss I have ever met. Well I have only met one - but this one is really nice) I finally found time to drag myself to a walk in clinic. 

I gave the lady my information. And I waited. and waited. All told I only was there for 2 hours - which is a roaring success as far as I am concerned.

While I was waiting, the girl next to me suddenly divulged that she just needed 2 stitches removed. She had tried to do it herself, but just couldn't figure it out. I was like - SERIOUSLY? Come here, I can take out your stupid stitches. But lucky for both of us, she got in next.

Then. An asthmatic came and sat down next to me. She took her newly obtained symbicort (i could tell because it was red) out of the bag and tried to use it. It was a disaster. She didn't know anything about it! So what could I do but teach her everything I know about symbicort. I told  her how you have to twist the bottom of the turbuhaler until you hear a click, inhale deeply and hold. She was surprised that I knew this. 
I told her I was a respiratory therapist. This is only a half-lie, I am nearly really a respiratory therapist!! Then I told her about how she should rinse her mouth or she would get thrush - and then she was really impressed with this medicine that some doctor in the ER had prescribed. 

I felt pretty good about having performed my good deed for the day. Little did I know I was about to be punished.

For the next 30 minutes the asthmatic lady went on and on about living in New York City, and driving in the Holland tunnel, and throwing money at the toll booth, and getting out of your car in the tunnel to talk to people you knew during rush hour traffic. I didn't buy this at all - "You knew people in the tunnel? I bet that didn't happen very often." She assured me it did, but then she qualified by saying it might just be people you recognized from prior times in the tunnel. 

And on.
And on.

And thank god I got called to see the Dr. next. 

Tuesday, April 5, 2011

You haven't seen anything until....

A diabetic came into the ER. He was suicidal and had try to kill himself by taking too much insulin. It didn't work. As a rule, I don't think that is the quickest, most effective way to put an end to your suffering. Unless you would like some more suffering, in the form of hospital treatments. He was given tons of dextrose. He was mostly fine, albeit a little cranky and uncomfortable.

And oh yes. He cut off his own toes. Not all of them, just the second toe on each foot. Clean off. I'm guessing there must have been some infection or gangrene to those toes and got sick of looking at it. It was very bizarre and disturbing. For me. But at least he was protecting his airway. And I was still sick, so I went back to the break room and waited for something else to happen. It never did.

So now I'm into my home care rotation. I LOVE home care. I love visiting people in their homes, and seeing them in the office to fit them with a CPAP mask or help them with any other concerns they may have. I have three more days of that.

Then I have to get down to some serious studying for our final. There's a lot I've learned over the past 3 years that seems to escape me at precisely the moment that I could use it the most!

The thing that seems to have the most trouble sticking in my mind is Gas Laws. I am terrible at them, and get them wrong on every test. Every one.

I found this good resource for brushing up on them - Chemtutor Gas Laws. Enjoy :)

Saturday, April 2, 2011

Still Sick.

I am still sick. In fact I had to call in sick today - which is not good news. With only one month left of practicum I am increasingly worried about getting all of my hours in. As it stands right now (based on calculations in my own spreadsheet *nerd*) I can afford to miss exactly 0 more hours of work. This is assuming I get 8 hours of credit for our final exam. I'm not sure if we do, and I may actually be in the negative. In which case I'll have to pull some double shifts or something. Dear god. I'm suddenly regretting missing 2 of my PFT shifts.

Oh well, nothing I can do about that today - from the couch. So instead I'm working on my last homework assignment and watching Mystery Diagnosis on TV. I like to try and diagnosis the patient before the TV show does. I'm successful about 25% of the time - usually when there is some sort of Respiratory connection. I was right on top of Methemogoblinemia and also Alpha 1-antitrypsin. Recently on Untold Stories of the E.R. I heard them shout, "Where's the RT?" So that made my day. Kind of like when Canada is mentioned on an American TV show.

And sometimes when I have some down time I like to read things on the internets. One thing I found that caught my eye was this article - How to Have Hobbies in College. As years have gone by I find that I have no hobbies. All I do is study, and do work (bookkeeping) and when I am not doing either of those I am spending my time in a way that can't really be defined (sleeping, talking, eating, watching tv). Recently someone asked me what I liked to do for fun.... and I couldn't answer. How embarrassing. Honestly I think I enjoy just doing nothing. But for those of you who would like to have better time management in order to fit in some fun, the article lays out a good plan.

Cough cough sniffle.

Wednesday, March 30, 2011

Just my bad luck

I'm ill. With just one month to go I have contracted what feels like strep throat. Last night it was so hard to swallow I thought I had epiglottitis and was about to take myself to the hospital to be intubated.

I'm finished my days at the Sleep Lab - which turned out to be an awesome time. Yesterday, I watched all the probes get put on, and then I followed a Dr around while he told people that they needed CPAP (worst job ever). The people who work there are fantastic and the time just flew by. However now I need to do my two nights - which I don't really understand. Why on earth would they have us do nights? The exact same thing happens during the day and during the night, except the daytime is busier. Hopefully my sickness makes me sleep all day :P

I have my home care rotation next week. That's right it starts on Monday, and the guy just emailed me yesterday (after I emailed him.. again) to inform me that the dress code is business casual. That is perfect! Because all I brought here this time were scrubs and fleece pants! Awesome! I know! I will go shopping with my extra money - with all the money I have made this year. UGH.

Countdown:

  • 2 Night Shifts at the Sleep lab
  • 4 Home Care Shifts
  • 1 Classroom Day
  • 1 Exam
  • 9 Hospital Shifts
That's really not that much. I think I'm going to make it!

Monday, March 28, 2011

The Drudgery Continues

So today I started at the Sleep Lab. The person I worked with today was not even an RRT, but she had her PSG (polysomnography technician) designation. FYI, Canada does not have a PSG designation or program. If sleep is really what gets you excited then you can be accredited through the States. Sleep does actually get me excited, but not in the same way. I actually just like to sleep.

Let me tell you how a typical day in a sleep lab goes - in case you have never been.

  • Set up sleep patient (this take about an hour to glue probes all over their body)
  • Watch them sleep (this takes the rest of the day)
Ok, so maybe a few more things go on. Today only one tech was on, and everyone else was on holidays. A patient showed up on the wrong day so she had to get two patients ready before we could watch them sleep. A polysomnograph monitors EEG, ECG, snoring, leg movement, eye movement, chin movement and flow from your nose, so it is actually quite a process to set up and gives you tons of information. What I don't understand is why I had to spend 2 weeks yelling at people in the PFT lab but only get 2 days and 2 nights in the Sleep Lab - there is SO much more to know. 


In the afternoon a Dr. was in the office seeing and assessing patients, so I tagged along with him. We went to see one patient, who was reading a book called... "The 7 secrets to a good night sleep." Really? You had to bring that to the sleep clinic? Sigh.

Overall I would have to place the Sleep lab somewhere above PFTs but below Homecare.

Friday, March 25, 2011

Best PFT ever.

Today was my last day. I was supremely glad, although I have come to enjoy doing PFTs and they are really not that bad once you get the hang of them.

I did a PFT on the cutest 8 year old boy ever. He was hilarious. First thing, he looked at the PFT flow sensor and asked me, "Exactly how many people's mouths have already been on that today." First time I have ever been asked that. So I explained about the new filter for every person.

Then I put the sat monitor on him. He sat still while I got the 2 minute strip. When I took the finger clip off he said, "I just would like to know that that light is, how it works, and what it does." So I tried to explain the wavelengths and red blood cells.

I don't know anyone who has ever thought of how or why the pulse ox works, never mind an eight year old asthmatic.

Wednesday, March 23, 2011

CPET

CPET or Cardiopulmonary exercise testing is not that exciting. The idea is that a patient gets on a bike and pedals as hard as they can (or at a set level with increasing tension) until they cannot pedal any longer. At this point there are some figures worked out (RQ and anaerobic threshold to name a few) and the Dr has an enlightening moment about the cardiovascular status of the patient. This is the theory.

In reality this is what happens:

  • At 2:30 we start setting up the room. This involves switching gas cannisters and doing calibrations and generally setting up the equipment required.
  • At 3ish the patient shows up.
  • They get all wired up for sound, including sandpapering their skin and attaching ECG leads.
  • Preliminary flow volume loop and manual blood pressure is performed.
  • Patient sits on bike for 30ish minutes.
  • At 3:45 the Dr shows up. 
  • The patient pedals for approximately 4.32 minutes. Patient is exhausted from pedaling. It doesn't matter if the patient is 17, 40 or 80. They only ever last 4.32 minutes. Dr is always disappointed. 
  • We clean up the whole room and leave at 4:15. 
  • With the exception of one test last week where something exciting happened, and the Dr loved the test, and then decided the patient should go for an angiocath. Please note - nothing exciting actually happened during the exercise test. I think he pedaled for 5 or 6 minutes though.
I am honestly trying to not be negative about this all. But I can't. I don't like it. I find it all so rote. The same thing happens every day. Well there is a little variation. Today, for example, we had a lady forget her teeth in the plethysmography booth and then the next lady was a puker. A lot of people smell bad. Oh and the DLCO gas wouldn't work in one room so there was a lot of going back and forth between rooms. That's where the excitement ends.

Except for in my personal life, where the excitement keeps on going into the evening. I got home... and did laundry! After that I took a laptop to my grandparents and tried to teach them to use it. Futile! I don't know whose idea it was to give my grandpa a laptop (it wasn't from me, I was just delivering it) but imagine someone who has never turned on a computer in their life and also doesn't know what a mouse is and how it works. And then double it, because grandma needed in on the action too. 

Tuesday, March 22, 2011

Hired!

Wow - what a relief. I finally got a call that someone would like to employ me!
The hospital that I did the extra rotation in (in January) called yesterday to offer me a casual position. I have never been so excited! Start date is May 9th!

In other news, I have been sick for the past 2 days, so have been blissfully exempt from the PFT lab. I'll definitely be back at it tomorrow, with just 3 shifts left to go there.

Here's what I have left:

  • One week in the sleep clinic/lab
  • One week with a homecare company
  • Final Exam (for some reason I have week off around this exam. Lucky me)
  • Two weeks of wards/ICU shifts at the hospital.
And done! We are going to Hawaii for Easter and I am so excited because I have never been and I am not sure if winter will be over here by then, so I will be about due for some sunshine! :)


Wednesday, March 16, 2011

The True Definition of Dread

I drove to work today. Before I could force myself to get out of the car I drove half way back home again.

And then I talked myself into going, so I drove back.

Dread.

Tuesday, March 15, 2011

Where I do not want to work.

Hi there. I realize as time as gone along I have gotten a lot more sporadic at having great posts, and updates about life. The thing is that I have had the life sucked out of my for the past 10 months. I've already worked 1,348 hours - for free. I've done about 10 online assignments and countless online tests. I have done 2 finals, and wrote a 15 page paper.. I also made a poster. So I guess I have just lost the drive to the extra's - which is too bad because I actually really enjoy writing - and I have tried to use this site as a way to keep track of my memories.  I hope that once I have graduated, and *hopefully* gotten a job I will have more time to do things that I like again.

Ok. So this week I am at the pulmonary function lab. YAWN. I hate to be like this, I know that this is an important part of the diagnostic, and thus the treatment, process. But. Yesterday was my first day. I learned how to calibrate the equipment. Then I watched about 6 tests. I also got to see a methacholine challenge, and a cardiopulmonary exercise test. So I guess that was interesting. Honestly that would have been enough for me - just the one day. I would go back to accounting before I took a full time job in pulmonary functions. Instead I have the rest of this week and ALL next week. It is excruciating. And even though I get off at 4pm, I can't even enjoy the rest of the day because I am just dreading going back in the morning.

I feel like I am in the middle of a sadistic curling game. Hurry! Hurry! Hard! When I'm not busy yelling at people, I'm locking them in a box.

This could be me. But it's not. But doesn't this stolen photo make PFT's look exciting?

Also - I never heard from the home care company - so I guess that is a big NO. Still waiting to hear from any hospitals. Nail biting.

Thursday, March 10, 2011

Love Hate

So I was able to go from loving the children's hospital with all of my heart to hating it with every fibre of my being within 30 seconds.

Here's how it went down. I was truly loving my experience at the hospital, and as such had submitted my resume. As I had not heard anything, and am scheduled to go back to my small town hospital in a week, I approached the manager to let him know I would be leaving town next week, just in case he wanted to interview me. He then told me that I wasn't contacted because I did my training at Hospital A (my hospital), and he just flat out won't interview anyone from that hospital. WTF. I know that he has only been working in that position for a year, and last year they didn't hire anyone from my hospital - so I'm not sure what happened to taint him again my hospital so much. But. I hate the children's hospital now.

I worked an evening shift there last night and my heart was so not into it. I was being quizzed on NO administration, and I just couldn't remember anything. I couldn't remember any of the names of the baby conditions that you would use it for (granted my preceptor was a giant BITCH) and I just plain old sucked. This was made worse by the fact that I did not care. At the end of this quiz session I was told this - "You failed that." Thanks for that. No kidding. I mean - the questions were easy, and I should have easily answered them - but I was just in a terrible mind frame.

I interviewed at the hospital I did my additional training at in January. I am still waiting to hear back from them, as well as the home care company. I'm getting pretty nervous.

Monday, February 21, 2011

Two Days Straight from Hell

The past two days in the PICU have been so busy. So busy that I have gotten to do a lot more without supervision, because quite honestly they just needed an extra pair of hands to administer a neb, or re-adjust some non invasive ventilation. The RT I was working with said she felt really bad to use me as part of the work-load, but I genuinely enjoyed it, except for the time when I was so busy I didn't get to sit down for 12 hours. Other than that, it was awesome.

I was quizzed at length by a preceptor on the gas laws. I suck at the gas laws, so that didn't go well. This was while we were taping a mask to a ventilator circuit to jimmy up some non-invasive therapy, because we were out of all the machines. We had to do that multiple times, improvise - which is part of being an RT.

On my second day, I was supposed to work from 3- 11 pm in the ER. However, they had already gone on 2 transports that day, and the ICU was full. FULL. Every room. So I spent the evening in the ICU again. There was a kid I had put on BiPap the day before - now being oscillated. And de-satting to the 50s. Absolute nightmare.

We re-taped an ETT in, which isn't all that exciting, but it was my first time, so that makes everything exciting.  It was on the little girl who was diagnosed with cancer this month. She is still hanging in there, huge abdomen from all the internal bleeding.

I went with the staff when they took a little guy to MRI (post-seizures). I bagged on the way there, and on the way back. They have a vent that can stay in the MRI suite, which is nice. You may remember my story about the last patient I took to MRI. Wow, with kids it is completely different. How we got the patient into the MRI room was this... the nurse picked him up and carried him in. DONE. We were there forever, and no one else had had a break all day either - so they sent me on a covert mission to the emergency department to retrieve some orange juice.

Then after we came back from that, this little fellow also got a lumbar puncture. All in all a pretty shitty day for him. At 18 months, he is newly adopted, and I felt so bad for his adoptive parents - they looked completely terrified!

Something else new I got to see was TPA being injected into a chest tube. I stuck around right to the bitter end of my shift to see it be sucked back out, and honestly was quite disappointed. No gush of blood or anything, just a slow trickle. Boring.

The charge nurse bought everyone pizza - out of her own pocket - as a treat to the nurses since there was going to be no breaks that night. And I ate some even though I went home at 11 :)

So updates on life... I am on reading week this week - no shifts. I have a job interview at the home care company tomorrow AM - nervous. I am still working on this stupid paper - OMG hate.

Thursday, February 17, 2011

The Dreaded Poster Presentation

In 10 days I will have to hand in a research paper. The paper should be 10 pages in length (single spaced, double spaced... I don't know!) I just started it today. When was it assigned? About 6 months ago. Good work.
So here I sit in a coffee shop, eating mac and cheese and contemplating how to start this paper. I am also listening in to the conversation at the table next to me. Spiritual enlightenment, oil annointment. Sounds awesome.

Anyhow. A key component of my research assignment is a poster board presentation. When they first told us about this, I thought they were kidding. A poster?! WTF is this? Kindergarten? I've since learned that the poster presentation is a valid way of presenting information... in the medical field anyway. I'm still not looking forward to it.

So I've been googling this. How to make a good poster.. Since I have basically failed out of art ever since I was old enough to hold a crayon.

So for anyone else out there who is being forced to make a poster here are some resources I have found helpful.

Ok, back to the paper.

Wednesday, February 16, 2011

Children's Hospital

The children's hospital is AMAZING. I love it so much. Kids are hilarious.

I especially enjoy how they hate having ventolin (albuterol for all the Americans out there) by mask. Seriously, I have never heard a kid scream such bloody murder before. Other fun times include several broken legs, MRSA open wounds, and croup croup and more croup.

Then there is the PICU. So sad. One 5 year old girl came in a week ago with stomach pain. She now has stage 4 cancer and is missing a kidney! So it is really quite depressing sometimes.

Also - there is a bitchy preceptor here too! Why must there be one of those everywhere? I hope to hell I am just a nice preceptor once I finally graduate (if I finally graduate.. and get a job).

In the midst of all this fun (essay writing, working for free) we have decided to sell our condo. So for the past 3 weeks I have been working my ass off re-painting, and fixing up all the little things wrong with it. I am tired.

And I wish I had something more entertaining to write. I will work on that.

Tuesday, February 8, 2011

Interviews and Jobs

So it is that time of year. Everyone in my class is madly submitting resumes and searching for jobs. There are multiple hospitals in the city, so everyone (well mostly everyone) is submitting a resume to every hospital. I am a little slow on the draw - I have only applied to one hospital. I hope they hire me. As you know, I have also applied to the home care company. and. good news - I have an interview with them! So we will see how that goes. 

Let me catch you up on my life.
  • Finished extra rotation at city hospital. This was a pretty good time and I am hopeful for a job. I saw a montgomery stent. Which was being held in with ties and almost fell out everytime the patient coughed. Also there was copious secretions and I threw up in my mouth. 
  • Had orientation at the Children's Hospital. I'm spending the next MONTH there. I am completely terrified. The staff there is tough. We have a competency book we need completed by the end of the year, and apparently it is so hard to get stuff signed off there. I am not looking forward to it. My first shift is tomorrow - an evening shift from 3pm to 11pm. Yay. At least I get to sleep in.
  • Debrief day. Today we had a debrief day at school. Once a month we get together with our classmates and review the assignment we have had to do the past little while. It can be a little repetitive. We had two guest speakers today. The first had some really good info on ventilating using pleural pressures as a guide. The second basically went through our ARDS notes that we had from last year. AGAIN. Same notes. AGAIN. Perfect. The day ended with cookies and pop. So at least it ended on a high note. 
Antics are sure to ensue at the Children's Hospital. Tomorrow's task - memorize all vital sign normals for all age groups. 

Thursday, February 3, 2011

Wards Wards Hurray.

Sometimes when a sedative is wearing off a patient.. a patient might go bananas and throw poop at everyone. So that was my last day in the ICU. I enjoyed a few more trips to the MRI. I watched a PEG tube (for feeding) be inserted. I had to stand for a long time with a lead cape on.

Then I moved onto wards. The role is a bit different at this hospital than at my training hospital.  At the bigger hospital we follow people with high oxygen requirements and assess them daily. If there are any trach patients we do trach care on them. This doesn't sound very high energy but it definitely can be. For example one day I assisted in a two hour bronchoscopy. We did 10 + Wang Needle aspirations. In case you don't know what that is - you jab a needle into someone's lung and aspirate a sample. Later that day we decannulated a guy with literally no cough. So that didn't pan out all that great. It was a whole day project of chest physio, flutter valve, and finally ended with him being re-trached. He was pretty damn grumpy.

So tomorrow I start two days in the Emergency Department.

There is a possibility that I will be able to work at this hospital. And that is exciting.

Monday, January 24, 2011

Day 1: Bigger Hospital ICU

I had the same problem again at this hospital as last time - no security card - so I am constantly locked out of places. Also, it is big and I get lost. A new thing to get used to is computer charting (but since I don't have a computer login for this hospital I can't really do it anyway) since all we do at my home hospital is paper charting. At first it seemed like it would be a huge pain, but by lunch time I loved the idea of having all the electronic charting. It saves time! It is wonderful! I don't have a password so I don't have to do it! Yay!

One major thing that I have realized is that I finally have transferable skills. It's not that I just know my way around my hospital, I actually have Respiratory Therapy skills that I can use at different hospitals and different institutions. I may actually be hire-able.. Maybe. 

In the afternoon we took a patient to MRI. It was an actual nightmare. We made it to the hallway before the patient woke up. And then we had to go back to the ICU to get sedation. So then we were on our way to MRI again. We get downstairs and it takes an hour to get everything organized. The monitors aren't working. Nothing is working. Also the patient has bacterial meningitis. So the gowns and the gloves etc. We finally get the patient on the table. He de-sats, so I am bagging, and wearing ear protection, and sweating. They try to get the patient into the MRI. Hello obesity on the rise in Canada. He doesn't damn well fit. OMG. Repeat the above - in reverse. We finally get back to the unit. Guess what! He is no longer isolation! We wore all that shit for nothing! Yay! Total time - 2ish hours. Actual things accomplished - nothing. 

The day ended with a patient with a post op abdominal bleed. Very unstable. Code on. Code off. DIC. Bag, suction, bag, suction. I left before I saw the ultimate outcome, but I doubt very much that the patient will be there tomorrow. All hospitals are the same!!


Friday, January 21, 2011

Resumes

I am not done sending out resumes. But I don't really know how to write a resume for a hospital. So far I have submitted a few resumes to home care companies. These places function more as offices - and I know how to write a resume for an office, so that wasn't too much of a stress. It was a bit of a stress though, since I really want a job. Because I am broke. RT school is long and expensive. Not as long or expensive as some other things I guess (MD for one).

I have yet to complete my hospital resumes. There are two hospitals I intend to apply for. One is the children's hospital. I would mediumly like to work at this hospital. Unfortunately I haven't even had my rotation at this hospital and since hiring is pretty much a popularity contest I don't stand much of a chance. I don't know if the school could work out more a system where they ask ahead of time if you would ever like to work at the children's hospital - and then try and schedule your rotation earlier in the year.  Anyway. I am starting my rotation in early February so will apply and hope for the best. Hopefully I will have lots of interesting things to write about that time.

The other hospital I am planning to apply for is a medium size hospital in my home city. I would only get a casual position (that is basically all the is available for any new RT these days). Next week I start a sort of mini rotation there, just to get some bigger city experience and also to get my shining face out there. I am not really looking forward to this - other than the fact I will get to be at home. I don't to be the new girl for two weeks, and then again for a month at sick kids. Ugh. And then after that I have 2 weeks at a home care company (in small city where my main hospital is) and 2 weeks at a PFT (pulmonary functions) Clinic.

My head is spinning. I kind of feel like it would be helpful if we got more advice from our school on how to properly apply for jobs at a hospital. You know.

Wednesday, January 19, 2011

Weekend from Hell

The idea now is that the student therapists are supposed to take on a full workload in the hospital. That would be fine if the ICU hadn't exploded over the weekend.

On Friday we had a patient who was perfectly fine out on Wards in the morning. By the afternoon the doctor was telling the family the patient would not live through the day - necrotizing fasciitis. TERRIFYING. I went home at the end of that day (3 hours late because it was so damn busy) and showered. Twice. And again in the morning. I have never felt so completely disgusting and crawling with bugs.

We had two back to back intubations. Like so back to back we didn't have time to re-fill the bucket of supplies. The manager called a stat meeting about nothing in the middle of all of this which was also exciting.

Over the course of the weekend I inserted 4 art lines! That was amazing! I am glad because it is probably the last time I will ever insert artlines - at the hospitals in the city I will be working in RTs rarely insert Artlines.

I have also started sending out resumes which is tortuous. I also have a migraine. Have to do a weekly discussion. Have to write a research paper. OMG.

Tuesday, January 11, 2011

Welcome Back.

I am back at my regular practicum site. Today was my first day back after Christmas, although it was supposed to be yesterday but there was a problem with Greyhound Buses, Reliability and Snow.  It sounds like it was a good day to miss though, since they had a dead baby at a c-section. Today for the first time ever I saw a peritoneal lavage. A patient came in through EMS coding. They called it a code, but  really  no one had heard from this guy in 2 days, and then they found him down in his house. With his dog sleeping beside him. Saddest thing ever. Anyway, he was like 25 degrees, so they tried to warm him with first the Bair Hugger (a giant blanket with hot air circulating t/out, and when that didn't work they cut him open at the belly button and pumped warm water into him. That didn't work either.

In my absence from blogging land I did a job shadow with a local home care company in their CPAP clinic. I liked it alright. On Thursday I am doing another day with the same company, but instead in the home oxygen area. I really think I will like that a lot more, but honestly if the company offered me a job I would take it. No matter what area it was in.

You might be wondering what a day in the CPAP clinic was like. I arrived at 7:45 AM. Since I was 30 minutes EARLY, I played Sudoku on my phone in the car for 30 minutes. I went into the office. Everyone was expecting me and was super nice. I got a coffee. I asked some questions. I looked around a giant room filled with CPAP machines and masks and some minimal oxygen supplies in case of oxygen client walking in off the street. We saw a few clients. Mostly they come in with their CPAP machine, and we download the data off of the machine. We then encourage them to use it more. Then we try to sell them a new mask for $250 to $300. I really respect this company though - they have a closet full of donated CPAP machines that they are happy to give to someone without insurance or the money for a machine. I know I am not making it sound that exciting, but I actually had a really great day. The therapists have relationships with the patients, because they see some of them week after week. Also CPAP changes people's lives. I am not even joking.