Wednesday, February 29, 2012

Aspiration.

I just fully aspirated half my cup of coffee. Granted, it wasn't a full cup of coffee, but 20 minutes later I am still coughing and sputtering.

This brought some thoughts to my mind. I just spent 3 night shifts at the hospital, 2 of those nights I was on the floors assessing one patient Q4. This particular patient has severe kyphoscoliosis which is in fact nearly occluding his airway. To solve this problem he received a trach, but it needed to be a certain trach in order to mold to his anatomy - enter the Bivona. This trach has no inner cannula - which makes me increasingly nervous. Especially since the quality of this patient's secretions have been becoming sticky and thick. We keep an emergency crycoid kit in his room. Seriously. Part of the problem is that while in the ICU we were using the Optiflow device on this patient in order to keep his secretions loose and flowing. Once he got transferred out to the floors he was switched over to a cold neb/ trach cradle. It's not that we don't use the optiflow on the floor - but we were trying to wean him to a device he would be likely to go home with. Given the permanent nature of his trach. Anyway.

The cold neb was definitely not doing the trick and although we were instilling his trach with normal saline Q4 to keep the goodness flowing - we were having more and more difficulty even passing a 14 fr catheter. At all. Luckily this was during day shift (when I wasn't around) and using some force they were able to get the catheter through. We went right back to the Optiflow and everything cleared up. Amazingly.

The point of this all was my realizing that having normal saline poured directly into your lungs (instillation) must feel like absolute crap.

Friday, February 24, 2012

CPR works. Sometimes.

We got called to a code blue in interventional radiology. So basically they injected this awesome old lady with some dye and she fully coded. There was also some fentanyl involved. Of course a billion of us (ok maybe 5 RTs) responded to the code. We were fully in control of the situation while the Dr's were arguing about what to do. We set up for intubation, were doing CPR, bagging, doing an ABG - you know everything that usually goes on at codes. On the second round of CPR suddenly the lady's eyes shot WIDE open. She started breathing. We removed the mask from her mouth. And then she started screaming at the top of her lungs. Shrieking actually. It was terrifying and the most awesome code I have ever been to.

Then the resident running the code pumped her full of normal saline and fully overloaded her heart. We took her to the ICU where she completely failed the task of breathing and we intubated her at that time.

Sunday, February 5, 2012

Resumes and Jobs

So a temporary line has come up that I think I would like to apply for. It's perfect for me, since it only lasts until June - so if I hated it at least I wouldn't be tied in for long.

The problem is my resume. Since being a student and being hired into this current job I haven't had much cause to update my resume. So now I am wondering what a true health care resume should like.

So far the only thing I can add to my resume is:
  • A year of clinical experience
  • Up to date CPR
  • Up to date N95 mask size. 
That's sure to impress.


Wednesday, February 1, 2012

The Casual RT

I had an extremely awkward 'one on one' conversation with the manager of our department the other day. The first thing that made it awkward was the fact that it was sprung on me with no notice. Maybe I am strange, but I am the kind of person that would like a bit of time to prepare for an annual review. Instead I was paged at noon and told it would be happening at 1 pm. OMG. Full panic mode sets in for me. Blergh. I am an employee. I have a manager. And he wants to talk to me. This is awful news! Or terrific! Or terrifying!

He asks what my plan is. I don't have a plan and don't have time to think up a lie about this. Unfortunately. So I am just honest. I'm truly not sure how it went. I shared. I probably over-shared.  I share that I would like to finish my bachelors degree, which is true, it is a goal I have for sometime in the future. And he suggests maybe getting the CRE (is that a Canadian thing? Certified Resp Educator) for some fictional future job I might have. And that's the other thing. He has questions about where I would like to work - not only in which department, but at which hospital. There's a new hospital opening soon and I have a feeling we're a little bit afraid of losing some staff.

The truth is I still like being casual. I don't want a line. That doesn't go over well in conversations about goals and long term employment.

To be continued. Obviously.