I HAS ONE!
Specifically, I managed to at least land an interview for Children's Hospital of Pennsylvania's summer externship program. My first choice of placement? ER of course. If i can learn to put an IV in a tiny little arm, I can sure as hell put one in a BIG arm.
Fingers crossed that I get a spot!!!
Wednesday, February 18, 2009
Comprehensive Care Plan
Today was our designated day to create a "comprehensive care plan" for any patient on the tele floor. I picked a sweet LOL going in for a mitral valve replacement tomorrow. She let me do a complete workup on her, including history, complete physical exam, patient teaching, nursing diagnoses, et cetera. She said that she was "bored, so why the heck not!?" I love patients like that. You get to learn SO much from them.
I even got to do something helpful for her- I was with her in the Echo lab when her REAL nurse called in- her APTT was over 150, meaning DISCONTINUE THE HEPARIN!!! IN A HURRY! So I did so, and felt, for about a tenth of a second, like a Real Nurse. Then it passed.
We've started learning about EKG interpretation in class, which is totally and completely awesome. I used to be able to only read Very Bad Things, like Torsades des pointes, v-fib, v-tach, and of course, asystole. Now I can read PVCs, a very few kinds of bundle branch blocks (assuming NO other complicating factors), and junctional rhythms. Very Very Cool.
What I DONT understand is one of my fellow students. I asked the professor if I could go hang out in the telemetry room once all my charting was done, and before she could answer, Fellow Student says "WHY would you want to do THAT?"
Me:"Um...because they show you lots of neat things about cardiac rhythms"
FellowStudent: "Who CARES? Its not on the TEST!!!"
It boggles the mind. I want to know, because i DONT KNOW IT. That's actually reason enough for me to want to learn about it, setting aside altogether the fact that I want to work in an ER, and they dont HAVE telemetry techs to read all the monitors down there. Grrr. She has NO curiosity whatsoever. And she's lazy. I wouldn't want her taking care of ME.
I even got to do something helpful for her- I was with her in the Echo lab when her REAL nurse called in- her APTT was over 150, meaning DISCONTINUE THE HEPARIN!!! IN A HURRY! So I did so, and felt, for about a tenth of a second, like a Real Nurse. Then it passed.
We've started learning about EKG interpretation in class, which is totally and completely awesome. I used to be able to only read Very Bad Things, like Torsades des pointes, v-fib, v-tach, and of course, asystole. Now I can read PVCs, a very few kinds of bundle branch blocks (assuming NO other complicating factors), and junctional rhythms. Very Very Cool.
What I DONT understand is one of my fellow students. I asked the professor if I could go hang out in the telemetry room once all my charting was done, and before she could answer, Fellow Student says "WHY would you want to do THAT?"
Me:"Um...because they show you lots of neat things about cardiac rhythms"
FellowStudent: "Who CARES? Its not on the TEST!!!"
It boggles the mind. I want to know, because i DONT KNOW IT. That's actually reason enough for me to want to learn about it, setting aside altogether the fact that I want to work in an ER, and they dont HAVE telemetry techs to read all the monitors down there. Grrr. She has NO curiosity whatsoever. And she's lazy. I wouldn't want her taking care of ME.
Monday, February 16, 2009
How To Look Pretty For Clinical
It isn't easy, I'll tell you that. Nobody really looks their best rolling out of bed at 5 AM, pulling on our godawful uniform, and hightailing it to the hospital, but I do make an effort. I'm vain, and I'm single, and dammit I want to look my best, insofar as it is possible. It doesn't help that I have a DIFFICULT skintone. I am SERIOUSLY pale (like, porcelain pale) but without pink undertones in my skin. I'm the world's palest olive tone, the sort that LITERALLY turn green when they're sick. You can see most of my veins through my skin.
On the other hand, you do NOT want to be that girl who shows up with a ton of makeup on- you'll look silly, and you probably did your makeup under different lighting. Hospital lighting is NOT forgiving of makeup errors. There is a girl in my clinical group who seems to think that she cannot go out without bronzer. You can TELL. She looks muddy.
On that note, here's what I've found can be done in a relative haze, and still make you look human without making it obvious that you're wearing makeup.
1. MOISTURIZE. Hospitals are dry, you will be dry, invest in some good moisturizer with an SPF (for when you DO go outside), use it liberally.
2. CONCEALER, for spottiness. Make sure you test it on yourself in NATURAL light, AND under nasty halogens. This will help prevent it suddenly becoming scarily visible at the hospital, and ruining all your work.
3. FOUNDATION- if you wear it, wear as little as possible, mix it with moisturizer, and for God's sake, make damn sure it really matches your skintone.
4. BLUSH!!!!! I cannot stress how much I love blush. I recommend a very light pink for people as pale as me. Something NATURAL looking. Brush it with a really big brush over the apples of your cheeks, then dust a TINY bit on your chin and brow bones. This part might not be necessary for people who actually have color in their skin, but I find it does WONDERS for me. Makes me look human, refreshed, happy. It is also far easier to use than bronzer. DO NOT USE BRONZER. It doesn't look right under hospital lights, I don't know why. Blush is much more forgiving, and gives you color without that "i swear i was just in cancun" fakeness.
5. MASCARA- if you can use it this early in the morning. I usually go for a brown color, and use just one coat of something that will not clump. Rimmel is good. It opens up your eyes, helping you look alert.
6. Clear Eyes solution. Seriously. If you were up late writing your care plan, use this so your patient's dont know.
And that's basically my morning routine, give or take a few products depending on how alert I am. I can't help my uniform, but dammit at least I look awake!
On the other hand, you do NOT want to be that girl who shows up with a ton of makeup on- you'll look silly, and you probably did your makeup under different lighting. Hospital lighting is NOT forgiving of makeup errors. There is a girl in my clinical group who seems to think that she cannot go out without bronzer. You can TELL. She looks muddy.
On that note, here's what I've found can be done in a relative haze, and still make you look human without making it obvious that you're wearing makeup.
1. MOISTURIZE. Hospitals are dry, you will be dry, invest in some good moisturizer with an SPF (for when you DO go outside), use it liberally.
2. CONCEALER, for spottiness. Make sure you test it on yourself in NATURAL light, AND under nasty halogens. This will help prevent it suddenly becoming scarily visible at the hospital, and ruining all your work.
3. FOUNDATION- if you wear it, wear as little as possible, mix it with moisturizer, and for God's sake, make damn sure it really matches your skintone.
4. BLUSH!!!!! I cannot stress how much I love blush. I recommend a very light pink for people as pale as me. Something NATURAL looking. Brush it with a really big brush over the apples of your cheeks, then dust a TINY bit on your chin and brow bones. This part might not be necessary for people who actually have color in their skin, but I find it does WONDERS for me. Makes me look human, refreshed, happy. It is also far easier to use than bronzer. DO NOT USE BRONZER. It doesn't look right under hospital lights, I don't know why. Blush is much more forgiving, and gives you color without that "i swear i was just in cancun" fakeness.
5. MASCARA- if you can use it this early in the morning. I usually go for a brown color, and use just one coat of something that will not clump. Rimmel is good. It opens up your eyes, helping you look alert.
6. Clear Eyes solution. Seriously. If you were up late writing your care plan, use this so your patient's dont know.
And that's basically my morning routine, give or take a few products depending on how alert I am. I can't help my uniform, but dammit at least I look awake!
Short post
I am spectacularly unmotivated today, and have the day off from clinical due to my instructor not having a babysitter for President's Day. I think I'll go to the gym so I don't sit around doing NOTHING.
Also, I should finish this care plan on pain.
Also, I should finish this care plan on pain.
Sunday, February 15, 2009
The Drunkest Guy Yet
Last night was an interesting shift. 18 hours, two calls, which isn't bad. The first one was no big deal, (moderate concussion, easy transport, cooperative patient).
The SECOND patient was a whole different story. 3 am is never a good time to be hauled out of bed, and we knew it wasn't going to be an easy call when we could smell the alcohol from OUTSIDE the room. The patient was (sorta) conscious, but he thought it was Halloween, he kept giggling, and he repeatedly climbed out of the stairchair because "seatbelts dont belong on chairs!!!" He hadn't vomited at all, which was a blessing from a messiness standpoint, but I have no idea how he managed to drink so much and not get sick. His friends estimated that he'd had 10-15 shots in the preceeding hour, and must have JUST stopped drinking before the campus cops found him.
Once on the ambulance, he repeatedly attempted to grab my breasts while I took his blood pressure. Who knew that "no, these aren't for you" actually WORKS as a deterrant? Then he passed out, which made things easier.
Hope he's ok...KNOW he won't know better.
The SECOND patient was a whole different story. 3 am is never a good time to be hauled out of bed, and we knew it wasn't going to be an easy call when we could smell the alcohol from OUTSIDE the room. The patient was (sorta) conscious, but he thought it was Halloween, he kept giggling, and he repeatedly climbed out of the stairchair because "seatbelts dont belong on chairs!!!" He hadn't vomited at all, which was a blessing from a messiness standpoint, but I have no idea how he managed to drink so much and not get sick. His friends estimated that he'd had 10-15 shots in the preceeding hour, and must have JUST stopped drinking before the campus cops found him.
Once on the ambulance, he repeatedly attempted to grab my breasts while I took his blood pressure. Who knew that "no, these aren't for you" actually WORKS as a deterrant? Then he passed out, which made things easier.
Hope he's ok...KNOW he won't know better.
Friday, February 13, 2009
Hyacinth
I would just like to state, for the record, that hyacinths smell AMAZING...and that I got some at Trader Joes for 2 bucks. WHEEEEE!!!
Wednesday, February 11, 2009
Unexpectedly Emergent
Today I had a lovely pt. on contact precautions for MRSA colonization (no active infection), and got to follow her to the lab where they were testing her brand new internal defibrillator. What this involves is quite nerve-wracking. They sedate the patient, pace her on the T-wave, which sends her into V-fib, and then WAIT and see if the defibrillator can kick her back out of it into sinus. This was the SECOND test. The day before the test had failed, and they had to use the external paddles. This time, after ten heart-stopping seconds, she cardioverted, and all was well.
The second drama in the day unfolded about 4 minutes after I left the lab: one of my classmates came running up to say that a girl in my carpool had collapsed in the hallway, unconsious, and was being taken to the ER. Needless to say, the two of us in the carpool with her ran down to the ER, and stayed there until her discharge 4 hours later. Diagnosis? Vaso-vagal syncopy, with mild bump on the head. Basically, she stood still in a freezing room for four hours, and hadn't eaten in 6. When she walked OUT of the cath lab into the hallway, which was VERY warm, and her blood started moving again, she passed out and bumped her head. All is well, but it made for QUITE an exciting day. The best part was taking the EKG electrodes off her every 20 minutes so that she could go to the bathroom, because they had her IV running in so fast.
The second drama in the day unfolded about 4 minutes after I left the lab: one of my classmates came running up to say that a girl in my carpool had collapsed in the hallway, unconsious, and was being taken to the ER. Needless to say, the two of us in the carpool with her ran down to the ER, and stayed there until her discharge 4 hours later. Diagnosis? Vaso-vagal syncopy, with mild bump on the head. Basically, she stood still in a freezing room for four hours, and hadn't eaten in 6. When she walked OUT of the cath lab into the hallway, which was VERY warm, and her blood started moving again, she passed out and bumped her head. All is well, but it made for QUITE an exciting day. The best part was taking the EKG electrodes off her every 20 minutes so that she could go to the bathroom, because they had her IV running in so fast.
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