It's Bronchitis

I still don't feel terribly sick, but my mother (rather overprotective), convinced me to go over to the Health Services building to get checked out. As expected, it's bronchitis. As far as I'm concerned, it's probably viral (for chrissakes, most things ARE) but because of the asthma, they wanted me to take antibiotics, "so you dont wait too long to go to the ER, which you KNOW you will, while claiming it's "not really that bad". I guess they do have a point. It sounds like something I'd do.

So no Halloween for me. Trick or treat???

Hi, I'm Unresponsive!

Last night, in spite of (ok BECAUSE of) The Cough, I acted as a spare victim for the EMT class on campus. My friend Meg was assisting with teaching, and needed a person upon which to demonstrate a Rapid Trauma Assessment. As I cannot currently run away, that person was me.

The RTA involves touching just about everywhere quite rapidly on a person, palpating and skimming to look for "DCAP-BTLS"- deformitites, contusions, abrasions, punctures, burns, tenderness, lacerations, swelling. Essentially, it's summed up as "well THATS not good". Meg is a rockstar, and was demonstrating to these VERY nervous students how you can do a complete assessment without your victim feeling sexually harassed. It helps that they dont make the students strip the mock victims, although one girl was HORRIFIED to learn that we strip ALL trauma patients. He he he he he!

I only vaguely remember being that green. The problem with those of us who are nursing students as well as EMTs is that we keep adding to our field assessments- no longer is it "lungs clear and equal bilaterally", its "lungs CTA, decreased at the bases, suspect atalectasis from stasis"

I Dont *YET* Have The Flu

But I do have some sort of violent cough- mild, almost unnoticable congestion in the nose, just mostly a VIOLENT (sounds much worse than it is) cough. For the past three days. At this point I'm pretty damn sure it's NOT the flu, but the looks people are giving me are pretty awful. I mean, ive been asked 5-6 times if i have "The Flu", though i'm not actually that sick. Two people bucked the trend, and notified me that I could have walking Pneumonia.

It's getting to the point where I'm almost tempted to go to the Student Health Center so that they can TELL me I dont have anything wrong with me, and write it on a slip of paper...last year people would have asked me if I had a cold. This year they think I'm Typhoid Mary.

Go figure.

Dear God The Exhaustion (Part 2)

Last night I worked as Standby Crew for a campus event to kick off the basketball season, and that is always followed by a brief musical performance (usually by someone we've never heard of). "Oh! This will be easy!" I thought. After all, the event started at 7pm, and would be over by 10! What could POSSIBLY go wrong???

We were there for FIVE MINUTES before we had TWO patients, both found in the bathrooms puking their guts up (thank heaven for small favors- they made it to the bathrooms) because THESE geniuses thought that aggressive drinking was the best way to attend a basketball event. The irony is, they were so sick, and so drunk within the first FIVE MINUTES (ie. before anything had HAPPENED at the event) that they missed the whole thing. Local Hospital was being EVIL and on full diversion (we're not sure why...we think it's because they dont like us) so our Duty Crew (the people who were on the actual night shift) were taking two patients at a time to a farther hospital, which turned the whole thing into a Mass Casualty Incident.

The thing about MCIs is that you have one as soon as your number of patients overwhelms your resources and personnel. We were at that point about 15 minutes into the event- public safety officers were scouring the building for sick or drunk people, and kept calling us. We had 7 EMTS, working in 3 teams (3 on the rig, two pairs with a jump-kit each)...there WAS another crew, a paid professional squad, but they were technically on call only for the athletes and the entertainment, NOT for the students. As a result, they wouldn't transport for us, leaving us at several points with patients stacked up waiting for rides to the hospital.

By 10 pm we had upward of 12 patients, and 7 VERY testy EMTs. I'm exhausted, and I just slept for 8 hours. Ugh. I hate hate HATE drunk students.

Dear God The Exhaustion (Part 1)

Last night I pulled an overnight for the campus EMT squad- it was a Thursday, so I expected SOME drinking, but to get some sleep. Apparently the gods of EMS did not favor us. Our first call came in at 1230, after we were all tucked into bed- me, one of my favorite girls on the squad, our HILARIOUS driver for the evening, and R, the best looking guy in the whole nursing school, who also happens to be hilarious. We were paged to UPSTAIRS, in the student health center, for a kid who "hurt his ankle" and was in 9/10 pain...while munching crackers and sipping gatorade. "9/10 you say?" I asked sweetly "Oh that must be SOOO awful for you- I'm SURE you have no appetite with pain like THAT!"
"Oh no- I'm STARVING!" my patient replied happily. That's -2 pain scale points for you, plus ANOTHER two dropped for making coherent conversation without wincing when we moved you. 5/10 sounds about right.

2nd call came in about 220, once we were all BACK asleep, the first of the inevitable Intox Evaluations- a bunch of frat parties at bars off campus had gotten out, and two prize human beings had decided to pee in the parking lot...in front of both campus security and the local PD. Yeah. Bad idea. Took the one who looked worse off to the hospital, left the other one to be arrested, then BACK to campus for ANOTHER drunk, discharged because he wasn't THAT drunk, then back into bed by 310...only to be awakened at 530 for ANOTHER drunk, stumbling around shoeless. By this point we were all so punch-drunk that L started giggling at the patient and couldn't ask him any questions.

I've had 4 hours of sleep...and I'm working a standby tonight.

I am going to DIE!

PSYCH!!!

Wednesday was our first day of psych clinical at Hospital Nobody's Ever Heard Of. For the first few weeks I have been assigned to the adolescent unit...which seems to be entirely populated with kids committed for 1. violence and/or 2. sexually inappropriate behavior.

I was propositioned in the first 5 minutes, but apparently I have the Icy Glare of Doom that makes most of the guys back the hell off. I dont really like being touched, so the "stay an arms length away from the patients so they cannot attack you" rule is just fine by me.

I'm already wondering what the hell we're supposed to be doing here...aside from the one REALLY COOL thing we get to do, which is Crisis Descalation class, which involves both verbal AND physical de-escalation, which sounds fun.

What I Did On Fall Break

Up in the Frozen Northlands we had a bit of an early cold snap, which allowed for some early snow-frolicking...which I LOVED, as I am, in demeanor as well as in appearance, pretty much a cross between one of santa's elves (height, and love of winter holidays) and the White Witch of Narnia (demeanor before 8 am, when awoken at night, ok...i can be a bit irritable). I LOVE snow. I love it to an almost unreasonable extent. For one thing, it makes driving WAAAAY easier. This may seem odd, but clearly you are not from the Frozen Northlands. Snow makes reflections on BOTH sides of the road. You simply drive down the dark bit in the middle! This is a serious improvement, as we have no streetlights.

I GOT TO DRIVE THE AMBULANCES!!! both of them! M, my training lieutenant, took me out and let me drive around at high speeds, yelling "STOP!" at random, to get me used to being startled. It was awesome.

We had two calls: 1. MVA of a motorcycle on a notoriously dangerous stretch of a state road that has already claimed 5 critical injuries THIS YEAR. Naturally, we went REALLY fast to get there, only to find a perfectly lucid man, lying on his back NOT MOVING. He was NOT MOVING because his brother, a rather large gentleman, had threatened him with death should he move before the arrival of the EMTs. I LOVE people like this. They make my job easy. We cleared is C-spine, and took him in for evaluation, because he had a crash at 30-40mph off a motorcycle, but he was FINE. Wear a helmet, kids, it really DOES help.

2. Chest pain and epistaxis in a 20 y/o male: AKA cold dry air leads to nosebleed, young man panics because his mother is CRAYZEE, and thinks he's having a heart attack. We explain that "family history" of heart problems (AT 80!!!) is NOT the same as a "previous history" of heart problems, and that he is fine. Really. FINE, and to please go to bed.

other than that, i did TONS of chores, and got to see my beloved Bella, my evil Devon Rex cat. Pretty good. Then an 8 hour drive back down here, because of the GW bridge being designed by Satan himself.

Medsurg is done!

No more med-surg for the Little D! Finished today by running around doing moderately useful tasks, like finding coffee for a terminal cancer patient, and getting a doc to order nicotine gum. He said she needs a quit smoking consult. I pointed out that with metastatic lung cancer, it's a little late at this point to tell her "i told you so", and just to please order the damn gum. I really think she GETS that smoking is bad for you, what with all the surgery, the radiation, the chemo, and the DYING.

On the bright side, I got an A. ~insert happydance here~

AND I NEVER have to go back to Bob's Hospital again!

After break I'll be going to Psych Hospital Nobody's Ever Heard Of, outside Philly.

Midterms

Thursday afternoon I'll be leaving for the Frozen Northlands for a week of running around in an ambulance, hopefully punctuated with a nice hike up Mt. Washington with the Little Brother and his buddies. This should be an excellent test-run of our winter gear, and we're hoping for snow.

I MAY be able to post (especially if I get any good traumas) but in the Frozen Northlands the internets are quite temperamental (especially if the weather gets interesting...power, running water, and internets are apparently some things for which my area is simply NOT a priority)

Hopefully tomorrow (last clinical day at Bob's Hospital) will pass without anything icky happening, and with a decent grade...wish me luck!

Patient Assessment WIN!!!

Today I WON at patient assessment- Moaning Dood was an intractable pain patient- essentially, we pumped him full of more pain meds than I've ever seen given, and he would mutter "it's still an 8"...and then go to sleep.
On one of these visits, the nurse was pushing the IV meds (we DO NOT do IV push, it's apparently a legal risk) and I decided to take advantage of Dood's distraction to do a reassessment of his pulses, dont ask me why. I laid the backs of my hands on his calves and...um...hummmmmm....
One leg was noticeably cooler than the other one! I'd read about it, and been lectured on it, but it was REALLY obvious. So I tried to get a pedal pulse, and couldn't find one, so I ran to the ICU and stole their Doppler...which ALSO failed to find a pulse. At this point I dragged the nurse back into the room to check my findings AGAIN, and when she couldn't get anything with the doppler, we decided it was time to call in the doctors.

It turns out he had been scheduled for a doppler scan of all limbs back on friday...but then it was the weekend and it was never done. He's hypercoagulable. I hope we saved his leg- since it still had capillary refill, some blood must have been getting through, hopefully enough to hold it for a while.

Help Is On The Way

I've always loved to watch firetrucks and ambulances go past, probably because when I was a baby, and would startle at the noise, my mother would bounce me up and down and say "Help Is On the Way!!!"

I think maybe EMS would be better off all around if everyone thought of it that way- not "oh no! something has gone terribly wrong" but "Help is on the way!"

Two more clinical days at Bob's Hospital- and if we're REALLY lucky (ha ha) the nurses will be going on strike either tomorrow or Tuesday...which will mean we CANT go to clinical, and Will Have To Be Flexible. Because if there's ONE BLOODY THING we learn in nursing school...Nurses Are Flexible!

I am disappointed that I cannot put my feet behind my ears. Apparently flexibility has limits.