welcome

My adventures as a pre-med college student volunteering in the ER and trying to hold my own as an EMT student.

Sunday, November 28, 2010

E.D. stands for Emergency Daycare

I think every parent in the county brought their kid into the ER tonight. Seriously, at least fifteen kids came in over the four hours I was there. This is pretty unusual, seeing as I've probably noticed two kids in there prior to tonight. I was kind of excited by this, as my main interest is in pediatrics. That, and my two favorite doctors were working tonight.

One little girl came in after falling off a yoga ball, and fracturing her humorous. She was a sweetie, nine years old. Her entire family was there: mom, dad, grandpa, grandma, brother, sister. I got to watch as a paramedic splinted her arm, and I got to hold her arm steady as he did it. I could tell she was in pain, but tried to be brave. Turns out, she needed surgery and since our hospital doesn't have a pediatric orthopedist, she was transferred to a large children's hospital in a nearby city.

A little boy came in, he had just turned one at the beginning of the month. He had a small laceration to the forehead that required three small stitches. According to mom, he had just started walking and took a tumble into the corner of a table. No biggie, she was really calm and we talked for awhile about her little boy. He was super cute and only cried for a minute after the doctor stuck him with numbing medication.

One mom, however, was not so calm. Her little baby had a slight fever and a cough. The nurse listened to the lungs, everything sounded clear, and his stats came back normal except for the fever. While something minor was probably going on, the baby was in no immediate danger. When the nurse tried to explain this to the mom, you would've thought she had just told her the baby needed immediate open heart surgery or something else of that scale. This mom was FREAKING out, nurses were trying to calm her down and reassure her that kids get coughs and that he was going to be okay, but this lady wasn't having it. She was completely convinced her baby was having a seizure. Um...okay? He wasn't showing any signs of that, he was actually sleeping pretty soundly in spite of the commotion around him. I can understand a new mom overreacting, but where the heck did she get the random seizure idea from?

Last interesting case of the night, Dr. C came up to me with a piece of paper. The words "Pseudotumor Cerebri" were written on it. He told me to look it up and report back to him with questions. Neato! I found that it's a condition effecting the pressure in the brain. It causes terrible headaches and blurred vision. The pressure presses on the eyes and can eventually cause blindness without surgery. Doctor's are still trying to figure out the exact cause of it. Sometimes it can be caused from medications, obesity, or pregnancy. Sometimes it can appear to be caused from nothing in particular. I reported back with my findings. I guess a twelve year old boy came in who had been diagnosed with this condition. I was curious as to how they decipher this from just the run of the mill migraine. The doctor explained that there are many tests done. This little boy was diagnosed after a lumbar puncture and a series of eye tests. 

On a personal note, I have registered for EMT classes next semester. I'm still going to school full time to eventually become a PA (physician assistant), but I'll be doing a three month EMT program at night and on Saturdays in order to gain some more experience in the health field. I'll continue volunteering for the time-being, but this blog may go from adventures in the ER to adventures in the ambulance by summertime. Wish me luck and keep reading!

Monday, November 22, 2010

Wheelchair turned racecar

Finally, nice patients! My faith in humanity has been somewhat restored after all the appreciative people we had tonight. After a busy, depressing weekend last Friday, this week was steady but not chaotic. I was constantly transporting people to radiology, making beds, or chatting with the nurses. Everybody seemed to be a good mood, nice patients equals nice nurses! I also brought in homemade muffins for everyone, the over-night staff always appreciates something to munch on at three in the morning.

The one downer of the night was an older man, he was ninety years old, born July 4th, 1920. Nobody knew if there was actually anything wrong with him but they sent him to CT just to check.  He was very cold (it's freezing in there) and kept asking for more blankets. I tried to make him as comfy as possible and he looked content on the way to the CT test. The radiologist there that night was by herself and since the man couldn't slide from his bed to the testing bed, Katie and I helped her move him. As soon as we lifted him he started moaning in pain. It was a smooth transition, he was just older and couldn't manage much sudden movement. I tried to awkwardly smile and reassure him that the test would be fast and painless. Poor guy, for the next few minutes I watched this little frail man going through the CT machine and all I could do is ponder on the type of life he had led. He had once been a young boy full of life. I wondered what he was like back then. Was he was a wild man that lived on the edge? Did he ever have a family of his own? Did he ever think he would be an old man unable to sit up in a hospital bed without any family in sight? He made me sad, not because he was in any pain or had some sort of disease, just because he was old and frail and that wasn't fair. It's not fair to grow old. I made sure to visit him on the way out. I don't know if he even knew I was there but I gave him a little pat on the arm just in case.

After having said all of that, I don't feel like my calling in life is to work at a nursing home for a living. God bless those who do, but I just couldn't handle it. I feel like it's much easier for me to communicate with children, and so right now my focus is in pediatrics for my future career. When I started college my dream was to be an early education teacher. After working at a daycare for nearly two years, I realized that I did not want to be disciplining three-year-old children for the rest of my life. I did realize, however, that I had a way of calming down sick kids. When someone fell off the monkey bars, I was the first to soothe them and stop the tears. When more serious things happened (one child fell off the swings and broke their arm), I remained calm and kept smiling as to not panic the kid. While somebody dialed 911, I held the boy and made sure his arm didn't move. This is when I found my gift of communicating with children, and found my interest in making sick children feel better. I shifted my focus from teaching to medicine, so far, I am very happy with that decision.

Tonight in the ER, a little boy was brought in by a family friend that was watching him for the night. He was worried when the boy's cough turned from a small "ahem" to a deep hacking. The doc ordered an x-ray to see if there was fluid in his lungs. I went to transport him to radiation, and he was scared to death of me. He refused to get out of bed, and covered his head with a spider man blanket. I smiled, and somehow convinced him that the wheelchair was pretty much the same thing as a race car, and that we were going to take awesome pictures of his tummy. He thought that sounded neat, so he reluctantly climbed up in the chair and I wheeled him over to radiation, asking him about his favorite action heroes along the way. By the time the tests were done, he was all smiles, and showed off his new collection of Disney stickers to the nurses we passed on the way back to his room. I later found out that he didn't have pneumonia and left with directions to get some children's cough medicine. He was my favorite patient of the night!

As the clock stroke midnight, Katie and I decided it was probably time to go. We were tired and getting giggly. We were getting so silly over nothing, I'm sure some of the nurses were rolling their eyes at us. Oh well, we left and may come back next weekend for a later shift. Midnight until 4 AM? I'm going to check with the volunteer coordinator to see if it's allowed, but I don't see why not. The nurse's say things get interesting at around 2, so we shall see!

Saturday, November 13, 2010

Death, Bike Crashes, Flexor Tenosynovitis, Oh My!

Tonight was by far the craziest night in the ER I have been a part of so far. There were so many things that happened. I think I'll type them in a list format. I feel like it's easier to read, and an easier way to organize all my jumbled thoughts.

1. Dr. C (I don't want to use full names in case this doctor is ever googled. Even though I would never portray any of the staff in a negative way, I would still feel weird for them to be reading my private thoughts about their work!) invited us into one of the patient rooms to shadow him and a nurse during a procedure that involved slicing open a disgustingly large abscess on a man's upper thigh. They started out by numbing the area, this was done by sticking needles straight into the giant lump. After that, they sliced right down the middle of the abscess, puss exploded out of it. This man was clearly in pain, and to add insult to injury, the doctor had to insert his finger into the mess and swab the inside, making sure it was fully drained. This was absolutely repulsive. I consider myself to have a very strong stomach, but even this made it churn a little. This poor man was probably over 250 lbs, had sleeves of tattoos and a mean looking eyebrow piercing. He looked tough, but when they stuck that needle into his leg, he hollered like baby. I later went to talk to him when he was cleaned up and waiting for his discharge papers. He was super nice and appreciative of the doctor's help. He even apologized for yelling. Ha! I told him no worries, I would have been yelling too.

2. A man came in after he went for a drunken bike ride and crashed. It was quite the bike crash! He claimed to have just "fallen over", but his faced was all bloodied up, his nose broken and swollen to the size of a golf ball. I thought he had gotten in a fight, but when I heard it was a bike crash, I almost had to laugh. I guess drinking and biking can be as dangerous as drinking and driving. They should start a campaign in schools about that. He got cleaned up and was sent to cat scan just to be sure his brain wasn't hurt in the accident. During the CT, they found a small gap that looked as if it could have been caused by cancer. They admitted him upstairs to have a oncologist take a closer look.

3. Dr. C found Katie and I to ask us to look up a condition for him. He wrote down "Infectious Flexor Tenosynovitis" on a note card. He wanted a definition, the four Kanavel symptoms, and a photo. I'm not sure if he actually needed us to do this, or if it was his way of making us feel involved. Either way I really appreciated it. He later let us in the patient room of the man whom he had suspected of having this infectious flexor thing. He asked us if we thought that's what it was, according to our research. It sure looked like it, and he agreed. Infectious Flexor Tenosynovitis is caused from an infection in the finger. The finger swells up and the patient is unable to bend it. This man had let it go a little too long and his finger was HUGE! On the side of it, there was this nasty open scab looking thing, it looked like something was eating away his flesh. Yuck. The man was younger and tried to smoothly flirt with Katie and I. I can't speak for Katie, but I know I'm attracted to men with sausage fingers and gross flesh eating infections. Oh, and he worked on a shrimp boat for a living. Super attractive... Not!
 
4. On a more depressing note, an older man passed away in the ER tonight. I'm still not quite sure how I feel about it, as this was the first time I was there to see someone come in alive and leave dead. In a weird way, it was somewhat peaceful. I've always thought of a patient dying as this hugely chaotic scene with doctors and nurses running around. That may sometimes be the case, but not with this man. He came in from a nursing home, was eighty-nine years old, and had a ton of problems. They had him hooked up to all sorts of things, it was a sad sight, this frail old man with an endless amount of tubes and wires coming out of his body. His nurse went in to check on him, then came out and told the doctor that he wasn't breathing. I stopped making the bed I was working on, and waved Katie over to eavesdrop. A few nurses went in, one came out looking at me and made wide eyes while running a finger across her neck. Clearly the gesture for "he's a goner". I was a little curious, so I asked a nurse if I could go in the room. She said no problem, and I told Katie she had to go with me. It wasn't a big deal, he just looked like he was sleeping, didn't look any different than he had an hour ago. It was clearly his time, and I hoped he was in a better place. I'm not sure why, but I kind of expected for the attitude in the ER to become solemn for some reason. However, the nurses kept joking around, the doctors continued rolling their eyes at rude patients. Life went on, as this man lay lifeless, waiting for someone from the morgue to come get him.

These are the kind of nights I really enjoy.  I learned a lot, and saw some new, interesting things. I was a little reluctant to leave and definitely excited to come back next week!

Saturday, November 6, 2010

Gimme some drugs man

It always surprises me how incredibly rude patients can be to health care providers. As I've mentioned before, many people that come in to this ER are either high or drunk (or both). While these people do provide a certain level of entertainment, sometimes they can be mean and desperate for more drugs. This is never a combination someone wants to be faced with, the situation can go from frustrating to scary pretty quickly.

One man that came in tonight was leaving as I walked in, he refused to stay after his nurse told him that she was unable to provide narcotics for his leg injury. Well, this guy just wasn't taking no for an answer. He created a huge fuss on his way out, screaming obscenities, and waving his cane this way and that. The nurses had tried to help him, but he kept assuring them of a prescription to narcotics in his name, as if they would just take his word for it. They looked up his file, finding absolutely no prescriptions for him in the state of Florida. He wouldn't let them touch his so-called leg injury, or even examine it. Nobody could force him to stay, and so he left, threatening to take his business to a different hospital. Yeah... good luck dude.

I did feel bad for the guy. I've never dealt with nor have I been around somebody who has had to deal with addiction, but I do know how serious it is, and how strongly it can take hold of somebody's life. Addiction can turn even the nicest person into a monster, I've seen the show Intervention. As sad as I was, I was also a bit bewildered from the fact that people are actually that dumb in the world. Did he honestly believe he could just walk in and ask for narcotics?

Crazy guy: Narcotics please, I promise I really do have a prescription.

Nurse: Hmm.. okay, but only if you pinky promise.

Was he seriously naive enough to believe he could depend on the ER to be his drug dealer for the night? People never cease to amaze me sometimes.

Friday, November 5, 2010

Candystriper down!

Tonight I went from volunteer to patient in 2.5 seconds. I walked in all jazzed up for the night because most of the rooms were full of patients and I had heard talk of a man with a brain injury needing to be tied down because he was out of control. Fascinating! I went around and made a few beds, checked in on a couple of patients, and said hey to all the nurses.

I noticed that one of the rooms had been closed off and a big blue sign had been stuck on the door, reading "neutropenia warning, consult with nurse before entering". Hmm... I had no idea what this meant and most of the nurses are happy to share their knowledge, so I asked the nurse assigned to that room what this neutropenia thing was all about. I learned that neutropenia is a fancy term for "low white blood cell count". Her room was blocked off because she was receiving chemotherapy, which keeps mutated cells from dividing and becoming cancerous tumors. Unfortunately, while the chemo keeps the mutated cells from dividing, it also keeps white blood cells from being produced. White blood cells are our bodies' fighting machine. They fight off infections and bacteria. This woman that had neutropenia was closed off from the public because she didn't have the immune system to fight off illnesses, and this left her extremely susceptible to even the weakest of germs. Side note: If anybody in health care reads this, please let me know if I'm right about this. I like to think I have a decent grasp on medicine, but I know I have a TON to learn. I'm probably driving the nurses crazy with all my questions, I just hope I'm understanding what they're explaining to me.

So anyway, this nurse was explaining all these concepts to me. Our conversation began to shift to the guy with the brain injury that was wrestled down before I had gotten there. I was hanging on every word when I began to feel a little dizzy. I brushed it off, since this sometimes happens to me when I stand up too quickly, and so I figured it would pass like it usually did. Boy was I wrong. All of a sudden, boom! The lights went out, and the next thing I remember is waking up in a hospital bed. Katie, my volunteer partner in crime, was sitting next to me, looking frightened and asking if I was okay. One nurse was pricking my finger, and another fed me some apple juice through a straw.

They soon determined the cause of my near death adventure (I managed to stay away from the white light this time around). My blood sugar took a quick spike after I consumed a large amount of Halloween candy (oopsie), which led to an even quicker crash. I literally did crash- right onto Katie, who somewhat broke my fall. Super awkward. The nurses made me sit there for awhile to recuperate, and after twenty minutes, Katie and I were already joking about it.

Me: Couldn't have picked a better place to pass out.

Katie: (Laughing at me) Yeah, and you don't even have to pay the gazillion dollars to get your blood sugar checked in the ER.

When the nurse came back to check on me, she told me that if I felt better, I could get up and keep volunteering since my blood sugar was back to normal. I wanted to stay, but I was a little shell-shocked and couldn't swallow the possibility of this happening to me again in front of a larger audience. I felt as if I had been through enough embarrassment for one night, and so I decided to head home early. Katie walked me to my car, and made me promise to text her when I got home safely. I think I'm just going to forget this night ever occurred, and hope it never happens again!

Alarming situation

Tonight we almost set the ER on fire. Okay... not exactly. Lately, Katie and I have been volunteering on Saturday nights from 5-9 PM. Normally things are slow until about 8, so tonight we decided to go from 8-midnight instead, hoping for a more eventful night. Despite the full moon, the waiting room remained empty for most of the night. It never really picked up, and the people that did come in only had minor bumps and bruises. Nothing serious. Yawn. I spent the majority of my time stocking gloves and hanging with Katie.

It probably seems morbid that I get excited about ugly cuts requiring stitches, and a man coming in with a missing ear (that's an entirely different story), but I just enjoy the rush of nurses and doctors buzzing around with equipment, talking medical jargon that I have yet to understand. The hospital I volunteer at is a level three trauma. This means that we mostly see drunks and druggies, much less serious than the Freddy Kruger victims that end up at the level one hospital an hour away. They're usually loud and obnoxious, the nurses like to crack jokes. Good times. However, tonight we weren't so lucky, no party animals stoppin' by.

In fact, the most entertaining part of the night didn't even revolve around a patient. It was one of the nurse's birthday, and everyone pitched in to buy her a small cake. Instead of appropriately lighting the cake and singing "Happy Birthday" in the nurse's lounge, they decided to do it in the middle of the nurse's station. This posed an awkward situation because about eight rooms face the nurse's station, and these patients can look out and see how much fun we're having, wasting time, and carrying on while they're withering in pain. None of the nurse's seemed to notice, or maybe they just didn't care. Either way, the cake was lit, with trick candles of course. The birthday girl blew and blew to no avail. Those darn things just kept lighting up again. Oh, the irony of a respiratory specialist unable to blow out her own birthday candles. Anyway, things quickly went from comical to alarming when one of the doctors pointed out the smoke threatening the fire alarms. Fortunately, the candles were doused with water before the hospital was put under code red.

I could only imagine the chaos that would have ensued, had the fire alarms gone off. Sprinklers would have shot water all over panic-stricken patients. Fire rescue would come rushing in, only to find that the mayhem was caused from measly birthday candles. I only wish my night could have been that exciting.