Echo

Echocardiograms are COOL. I just had to say it. I dropped my detoxing patient off for his Echo, and the tech invited me to stay, and showed me what all of the views were for, what to look for in the heart, and even gave me memorization techniques for visualizing cardiac anatomy. This came in REALLY handy when I was able to inform the doc that there had been abnormal findings in the Echo consistant with amyloidosis. As this was an incidental finding, not something they were looking for, I was worried that it would fall through the cracks.
Not that it would matter to my patient, on his latest of many strokes brought on by completely uncontrolled HTN, seizures, and cocaine use. He HAS insurance, but he chooses not to purchase his meds, as the 4 dollar scrip cost would cut into his cocaine budget.
And he smelled like a sewer, and refused my repeated attempts to clean him up. Honestly, I was going to be nice, and clean him, but Noooooo. That was just NOT cool with him. Instead, he wanted a second lunch, so that his wife could eat too, without buying food for herself. "nope!" i said, gave him a sub-Q injection, and left the room. With the side rail up, call bell within reach, like a good nursing student.

Nightshift

Sometimes being an observer sucks. Three calls last night, ALL of them intoxicated underaged idiots. Honestly, I'd like to do a presentation to the freshmen at Orientation entitled "Please stop before you vomit: how to not be a tool when you drink". Or, if that's just TOO MUCH TO ASK, I wish they'd start drinking at 3 or 4 pm, so that the calls to evaluate drunken kids would come in at 10 pm instead of 3 am when we're all tucked into bed at the squadroom.
One interesting fact is that the reaction to being caught usually falls out along gender lines: the girls are the ones who inevitably start sobbing, say their parents will be SO MAD, and slur incoherent questions about whether they're "going to get in trouble". Sweetie, you were in trouble BEFORE we got here. Yes, you ARE going to get written up if you're so drunk they called us. Its not like the campus cops are TRYING to get these kids in trouble. If they "catch" somebody, it's usually because theyre falling all over the pavement.
As a result of this terribly unsatisfying drunkenness, no trauma, and i barely slept.

CEMS

Yesterday I spent most of the day at Collegiate EMS (CEMS), the school EMT service. I'm on duty all tonight as well. It's a little funny when I'm onshift, as my EMT cert. expired last year in March, so I'm just an Observer until my EVOC class comes around soon...on the other hand, I've seen probably a greater VARIETY of calls than most of the other CEMS techs, as a great number of CEMS calls are (you guessed it) drunk college kids. 20 or more percent are called with the drunkenness being the proximate cause of the call (help help, my roommate wont wake up, help help, my roommate is puking, etc) and another 10-20 because they were drunk and did something like fall down a flight of stairs, slip on ice, punch somebody else, etc.

If I had ONE piece of advice to offer all the college kids on this campus, it would be this: STOP drinking LONG BEFORE YOU FEEL SICK. You can still get tipsy if you want, but for the love of all that is holy, being sick is NOT attractive, a good idea, or something you will be proud of in a few years.

Valerian

New night-before-clinical ritual: Chamomile/Valerian tea to knock me out faster so I get enough sleep.
1/2 cup in, and i'm already feeling the eyes get heavy. DO NOT USE when operating heavy machinery. Also, it can prolong bleeding times, so maybe not a good idea before surgery, or if you're on coumadin or heparin.

Wow....this stuff is GOOD!

Med-Surg

Long time, no post. I fail. So I've begun my second clinical rotation at Spiffy Urban Teaching Hospital, on the CCU/Telemetry floor. WHAT a difference from the sketchy nursing home! All the toys I missed are here, from blood pressure cuffs and pulse oximeters to blood glucose monitors. LOVE it. I don't think CCU is going to be my permanent home. I didn't get that "zing!" I feel when I walk into an ER, but I think this rotation is going to be a good one. We even get to go into the OR and observe, AND the cath. lab. Which is freaking sweet.
Only one patient so far, one that I will call "Pleasently Confused Lady". 88 or so years old, pretty frail, with every stereotypical old-person-malady in the book, from osteoarthritis to gout, to diabetes to osteoporosis. And she'd just had a new hip put in, even though she is SENILE. In the nicest way, of course, she'd pat your hand, call you sweetie, and grin at EVERYONE, but she couldn't follow even simple instructions, and has NO idea why her hip hurts so much. She even denied being in pain, while twisting in bed, moaning, and clutching her hip. We gave her morphine anyway, on the OFF chance that the pain scale wasn't precisely accurate for her. You know, since her heart rate would spike every time she moaned.
Tomorrow may be a snow day, which would be a mixed blessing- I wouldn't have to get up early, but I really do like the hospital.

I LOVE Spiffy Urban Medical Center! (SUMC)

Ok, long time no post, but also long time no classes. We oriented at Spiffy Urban Medical Center on Wednesday, and it was AWESOME. I never realised just how cool it is to be in a REAL hospital with code carts, and NURSES, and DOCTORS (in case you need them). My group will be on the telemetry/ CCU floor, and it looks like it's going to be freaking sweet.
I'm so psyched to go in for our first day next Wednesday, but also loving the fact that I've got a 4 day weekend to do necessary stuffs.
Also, i can do a rockin' job catheterizing dummies so far, but never tried on a human...hope my first victim...i mean patient...is UNconsious.

One More Final Till Christmas!

I've got one more final (Pharmacology...shockingly, my favorite class) tomorrow at 1 pm! So today is Clean The Apartment (which looks like it was hit by a tiny VERY well aimed tactical nuke), pack all my stuffs, study for pharm, all that good stuff. That way I can shove all my sheets and towels and such into bags in the morning, put everything ELSE in the car (if I don't do it tonight), and go straight from the final to the ROAD!
I looked the car over, gassed it up, checked/equalized the tire pressures, I am all KINDS of set. I also located ALL THREE of my window-scrapers (you never know which one you will need, or if somebody will take one and not give it back).
Mildly inconvenient that I'll be going home at about 3 pm and not getting home till 10 or 11, but hey, it's better than driving through rain / ice / snow as I go farther north. There's BOUND to be that awful band of nasty ice around Massachusetts. And Mass drivers are batshit-crazy WITHOUT ice. (No offense Massachusetts drivers, you're nicer than CT drivers, just crazier).