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.