Friday, August 01, 2008

Day 2: more excitement

Another really great day at the hospital. In the morning I took complete care of my patient (same as yesterday). I got to talk to the family about discharge a bit. I did my first IM injection - a pneumonia vaccine. My nurse was patient and gave me good feedback and tips afterward.

I did a gastric tube feeding for a different patient's lunch. I listened to his belly while we squirted in air to make sure the tube was in place. I aspirated the contents from his previous meal, measured, and put them back in. Then we flushed with water and I gave him lunch. You just pour in the can of liquid slowly and let gravity draw it down into the stomach.
As we watched it flow the patient said "Did you hear about the tomatoes?" Hmm no, we said. "This man was known for growing these beautiful red tomatoes. His neighbor asked him how they got so big and red. Well, he told his beautiful neighbor, every night I take off all my clothes and walk around in front of my garden, and my tomatoes blush this pretty red color. What a great idea, she said, I'll have to try it. So that night she took off all her clothes and walked around her garden. The next morning the man asked her if it worked. Well, she said, my tomatoes are still small and green. But you should see how big and long my cucumbers are!"
Imagine that you're pouring lunch into a guy's stomach down a tube while he tells you raunchy jokes. What a surreal experience. Oh, and he followed up with two more to finish the meal (but they weren't as funny).

Once my patient was discharged around 1 pm I could only roam. Our unit was pretty quiet so Darcy, my clinical instructor, scouted out something exciting for me to do. In the meantime there was a COR code call (cardiac/respiratory arrest). Darcy was on the COR team so she grabbed me and we ran down together. We were the first to arrive since it was the unit right below us, but immediately there were 20 or 25 people there - COR team, medical teams with students, nurses, respiratory team, lab people, the works. I couldn't see much but I could seem them start compressions and bagging (breathing), and they tossed yellow gowns in the room because he was another MRSA dude (isolation is an afterthought in an emergency). I was shooed away soon, but I couldn't see over the heads anyway. I later learned the worked for 15 minutes but weren't able to save him. It was so exciting and adrenaline fueled, I'm really pleased to have been able to see how the response team comes together and what exactly makes a COR response.

But the excitement didn't stop there! Ok, it was more mellow, but very interesting. Darcy let me follow around the IV nurse in the surgical and medical ICU's. The character of each floor is pretty unique. I must say I preferred these types of units. We checked various IV's (peripheral, central, PICC) for infections and dressing changes. She found a guy I could try an IV on, but then the Cath lab got a patient and they thought that would be a more unique experience so I switched over to cardiology. The patient had come into the ER late that afternoon. They put a catheter up his femoral artery to his heart to get angiograms of his coronary arteries. He had a few 18 year old bypasses that were full of plaques. So then they placed a filter, used a balloon catheter to place a stent, removed the filter, and checked perfusion. I sat outside the lab behind a glass wall with the record keeper. She explained what was going on while we watched both live and on the monitor images of his heart. I'm almost ashamed to say the sweetest part is that I was sitting in a chair for the whole two hour procedure. My poor legs!

So interesting, so much to learn. At some point during the day I had a couple epiphanies.
1) I'm so much happier being here learning all these new things, compared to where I was last year and the year before, stuck in administration and management. It's definitely a sacrifice and struggle, but it's definitely worth it.
2) I'm so grateful to have a healthy body myself and for my family. I'm so glad I'm not the one visiting their parents in the hospital. I'm so glad I don't have to help my husband eat breakfast, take a bath, or use a urinal. I hope and pray we continue to be blessed with healthy, functional lives.

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