A Work in Progress

Last night was my last city shift and last clinical of the semester. Yay! Our first and only interesting call was for an overdose. The patient was on an MTA bus. She was sitting up, conked out with sporadic snoring respirations. I started the IV (my fastest yet!) and drew up the Narcan. I gave it to her and about a minute later she woke up, good as new, until about a minute after that, she started puking everywhere. Now, everyone that knows me knows that I have strict rules about vomiting. I have my ‘no puke zones’ which basically include every area within, let’s say, a 50 yard radius of me. I just hate it. Well, who doesn’t really? If somebody’s throwing up, no one says: “Ooh, where! Let me see!” So, we’re in pretty close quarters with this patient as she was puking all over. Then suddenly I thought: “Hey, I’m okay. I feel fine!” I was so proud of my tummy for not letting me down in this most gross situation; no queasiness here! We finally got rid of her (just ...

What a bizarre evening I had yesterday. My last ER shift was anything but forgettable. Let’s see. The highlight of the day could be one of many things: a. I was successful on all of my IV attempts. This was uber exciting considering my ER record. I hate sticking people twice. Needless to say there was plenty of happy dancing and pleased patients. b. On my last shift there was a guy in one of the psych rooms who had already been there for a while. He needed a place in a mental hospital and had run out of is schizophrenia meds. Imagine my surprise when he was still there last night. He was not transferred until I left, making his ER stay an extreme 96 hours! A classmate of mine also saw him over the weekend. At that time he was using the butter from his lunch as lotion. Note to self: don’t run out of psych meds. c. I missed cafeteria dinner, so I went to an alternative food place in the hospital for dinner. My supper of champions consisted of a muffin. Nutritious and delicious! I decided...

Last night was probably the nicest ER shift I’ve had thus far. Fortunately it was my second to last ER shift. That thought alone makes my day better. I was 2 for 2 on my IVs and did a few direct blood draws, fun! The funniest story started long before I arrived. The patient in question had been seen and discharged twice before my shift started. First he was taken to his ‘home’ by a private ambulance company. Unfortunately for them it was a false address. When no one answered the phone at home the pt. claimed that they didn’t usually pick up. When aforementioned private ambo company discovered the fake address, they brought the patient back to the ED. Said pt. was later discharged again. I must mention here that he was missing an important extremity and had an ugly unhealed abscess in a nasty place. (so yucky that the tech said, “You can come in and help as long as you don’t breathe and don’t laugh.” a worthy challenge) Now, back to the story. At the time of this discharge, he felt it w...

I never like reading really long entries, so I figured you didn't either. Later that night we had a call for an unresponsive person. The patient was responsive when we got there. You could tell she was feeling better, especially when she threw a beer bottle at her boyfriend. She was even more awake when she started slapping the crap out of him. That’s when we left and waited for the police outside. We got three regular police cars and a car of plain clothes cops, that was pretty cool. We were hit out for a hurt foot at a nearby recreation center. We found this big guy lying on the floor crying and yelling “Don’t touch it!” referring to his ankle. As my preceptor put it, the ankle was definitely, probably, for sure, maybe, really, perhaps, undoubtedly, perchance broken. But this guy was acting like his leg got cut off. He had new tattoos all over him and looked like he could take a lot. Now, my mother had a bilateral malleolus a few years ago, and she barel...

I was in the city a few nights ago. My preceptor and I are talking, and he rags me for using too many alcohol preps again! He said, “You’re good at IVs, but you take too long, and you use too many alcohol wipes. You’re not gonna get an aseptic field here.” I know, I know, but I can’t help it! You practice how you play, so I’ll probably be using ‘too many preps’ forever. He is right about fast. When you need an IV, you need an IV. But, when I’m a medic, I’m going to use as many alcohol preps as I want. For the rest of the night, I’m thinking ‘quick and dirty’ IVs. My first call in the city that required ALS was also my first experience with the wonder drug, Narcan. We pulled up to find this guy sprawled out on the parking lot of a gas station. An engine crew was already there, bagging him. My preceptor said, okay, start a line. Wait a sec, this dude isn’t breathing! I wanna tube him! Then, as soon as I turned over his hand, I realized why he only needs an IV. He had already used his vei...

Part two of my auditory clinicals. On the IV front, last night was better. Some successes and a few direct blood draws, (I’m happy to report I’m no longer afraid of butterfly needles). Something new was when my nurse and I took bloods from one guy by him sticking a butterfly into his radial artery…that was interesting. That same patient had a tracheostomy and needed a vent to help him breathe. Unfortunately, something was wrong with the vent and it kept making this God awful noise. Imagine the most annoying noise you ever heard…then double it in annoyingness and intensity. Now play it in you head every five minutes or so for about two minutes...for about an hour. Pleasant, no? That’s what the vent was doing and it was making me crazy, I heard it all the way home. I was sitting at the nurses station while this was going on and a random voice from one of the nearby rooms yells “Turn that effing thing OFF!!” (you can imagine he did not say ‘effing’) but, my sentiment ...

The last two nights I had shifts in the ED. As a result I’m posting two entries today, yay! The underlying themes of these shifts had to do with hearing, and the borderline loss of my IV mojo. It’s only slightly reassuring when the local “IV masters” (as I like to call them) tell you “Oh don’t worry, everyone has a bad day.” Funny, they say that even though they just got that ridiculous IV on your last patient after you missed twice in their best veins. It was just so sad, a Sunday night: no happy dances, wasted 20 gauges, and alcohol preps freakin’ everywhere! (one of the days few redeeming features). Other than that on Sunday we had this guy who was older than dirt and stone deaf. For some reason he came sans hearing aid which allowed for some hilarity. Everytime I went by the room, rather, anytime I was in the vicinity of his room, I could hear someone yelling something at him. There’s not much friendly banter when a patient can’t hear. Questions like “Do yo...

In a valiant effort to avoid work today I opened a photobucket account and put up some pictures for your viewing pleasure. There are a few of me, and others from my travels. I do feel it's presumptuous of me to think you have nothing better to do than look at my pictures, but I don't have anything more entertaining to offer you. There are plenty of fun ways to waste time on the internet, and I consider myself somewhat of an expert in the field. I've written a handbook called: “The Internet and you: Wasting time Efficiently" I was toying with other titles such as- “The Internet is more effective at wasting your time than TV: a case study.” “The Internet: differentiating between useless trivia and false facts” “1 Million and 1 uses for the IMDB” “A college students guide to the Internet” “Proficiency at procrastination” Well, if you're still up for a little time wasting, here's the link to my pics, enjoy! I'm going to try to make my evening more productive ...

Everyone in the health service industry must experience hypochondria every once in a while, you just know too much. It’s my time. Last week I had a little cold, although I insisted I was not sick. My generic “Dayquil” and copious amounts of vitamin C told that cold where to go. Then, on Thursday I started to feel weird. I felt extremely tired for no reason and just plain beat. I chose to ignore it, but abstained from usual ER night activities, (except for watching ER). On Friday I went out for happy hour, but immediately after the happiness set in, I felt the extreme tiredness again (okay, I’ll throw in a medical term here: malaise. This word perfectly describes how I was feeling.) Oh yeah, I also adopted this lovely healthy sounding and ladylike cough. At this point I definitely had TB. (That one patient I saw last week was coughing…I think, yeah, well, at least when I die I’ll be in good company with Chopin, Thoreau, and Eleanor Roosevelt.) So right there at happy hour I could have c...

I think this is what my preceptor may start calling me. I administered my first IV med yesterday and apparently I use excessive alcohol preps. Now, come on. I’m practicing for national registry! I’ve got to do this crap right! I need at least 2 preps for the IV site. Plus, I feel that if there is still ‘dirt’ on the second one, that calls for a third. Then, I need one for the medication bottle, and one for the Y port site. Also, I need a couple for the bench seat, the floor, to develop my OCD, in case someone faints, one to de-funk my pen, and others for miscellaneous scrubbing and cleansing; the uses are endless. Then, what if I drop one? (as I did, and thank God I had an extra!) I’m not sure how it happened but when I was finished administering 2 doses of Narcan there were alcohol preps strewn all over the ambulance. What can I say? I like them. Maybe it’s the clean feeling I get from using them. Or, maybe it’s a subconscious attempt to override the stank that some patients produce w...