I experienced my first "real" call as an EMT student last weekend when I was on my second 24-hour clinical. I tried out a different station for this clinical, one a little further from home, and had an awesome experience with the staff. They were welcoming and professional. They seemed to take pride in their jobs, and had a real interest in teaching me. I felt more like I was apart of the team, compared to someone they had to drag along for the day. A much better group than I had gotten stuck with the previous weekend.
I arrived, claimed my bunk, met the staff, and made myself familiar with the location of everything in the ambulance. They went over some of the basics with me to make sure I knew how to do everything that would be expected of me. I took everyone's blood pressure for practice, took a blood glucose, spiked a bag, etc. Then we waited for a call. And waited. And waited. Then finally, at about 2 in the afternoon, we had our first call of the day! We arrived to a laundry mat for a 35 year old woman who had suffered from a seizure while doing laundry and fell while seizing. We pulled up to find that the volunteer fire department had already started an assessment of the woman, and was doing an absolutely terrible job of it. The oxygen tank was open but somehow unattached to anything, just leaking air. I quickly hooked her up to a nasal cannula, and tried to make my way through the eight inexperienced fire fighters. I stood there and came to the conclusion that there were enough people trying to "help", and I was more in the way than anything else. So I stood next to my preceptor and waited while they back boarded the patient and loaded her onto the stretcher. It took them a few attempts, but eventually the patient was in the back of the truck and ready to go. I hopped in behind the medic and when it was just me and him, he rolled his eyes, and told me that if I learned anything, I should have learned to do everything opposite of what just happened. I laughed, began hooking our patient up to the monitor and obtained some vitals. I guess I should mention that during this entire time, our patient was completely out of it. She was in what they call a "postictal state", which is what people experience after a seizure. She was in and out of consciousness, and wasn't talking to us at all. Well, sometime during our ride to the hospital she began snapping out of it, and decided to be violent. She began ripping out the Styrofoam blocks that were supporting her head, and in her confused state, didn't understand that the sticky side was getting caught in hair. The paramedic asked me to hold her hands while he removed the blocks without chunks of hair coming with it. I'm about 110 lbs and not exactly going to be winning any strength contests anytime soon. Or any mean contests for that matter (I'm the kind of person that feels sad for a squirrel's family if I accidentally hit one with my car). So you can imagine how uncomfortable it was for me to wrestle this crazy stranger's hands away from her head. The medic finally, very sternly, ordered me to "sit on her hands" if I had to. I held them so tight, I thought I would break her wrists. After what seemed like an hour of crushing this poor lady's hands, the blocks were off, and we were nearing the hospital. We hoisted her from the stretcher to the bed, and that was that.
We had another call that afternoon for an older woman suffering from shortness of breath. She had been having anxiety and difficulty breathing. I guess after dealing with it for the last few weeks, she decided that today was the day to call 911. Her perfectly able husband could have driven her to the hospital that was no more than 5 miles away, but I guess she preferred an $800 ambulance ride instead... I will never understand some people. She was super sweet and told us about her cute grand kids on the ride over. There's nothing much else to say about that call except that no matter how much your EMT instructors assure you that oxygen is the easiest thing to hook up, and there's no way to really screw it up, there IS a wrong way to do it. I guess they just didn't think someone would be dumb enough to hook the mask up to the handle instead of the air valve. I was sitting there like an idiot wondering why I could hear air but the bag wasn't filling up. Duh.
We had a quiet night and I fell asleep around 9:30. It's really hard to fall asleep at a fire station, because I'm always expecting the alarms to go off. I never want to fall into a deep sleep and be out of it if we get a call. But, somehow, I was dead asleep around 4:30 when the tones rang out and jolted me out of bed. I heard a groan from the other side of the room, and scrambled around to find my glasses and my belt. Of course, I put my shoes on the wrong feet, and had to correct them on the way. Half way there, dispatch told us that it was a class red call, which means that it was serious. An actual life or death call. I was wide awake now. We met an officer at the door, he had gotten to the house first and told us that there was an unconscious 74 year old man lying on the couch, he was completely unresponsive. His family surrounded him, and they spoke very limited English. I am embarrassingly bad at understanding anyone with an accent. I feel terrible about having to ask people to repeat themselves a million times, so I went right to assessing airway, breathing, and circulation, letting the medic ask the questions. We packaged him up quickly and high-tailed it to the hospital. The officer rode with us for some extra help, and I quickly started hooking the guy up to the monitor and the AED pads, in case it was a cardiac situation. Then he started vomiting. There was so much of it all of a sudden, it kind of startled me. Guess whose job it was to suction? I was the lucky winner! I grabbed the suction machine and had the suction part down his throat, when surprise, no suction. The paramedics response was something like "oh crap, the battery must have not been charged, just stick your fingers down there and shovel it out". Afterwards I was so grossed out by what had just happened. But at the time everything was happening so fast, I just did it without thinking about how nasty it was. Weird how adrenaline can give you those kinds of powers. I spent the rest of the ride on puke duty. As soon as we got him to the hospital, the nurses and doctors took over. He stopped breathing and they incubated him. I got to watch. It was so cool! We got back to the station and the medic asked me if I was bored on the call. I was confused so I asked him what he was talking about. He said while I was cleaning the man's throat out, I looked super bored. I told him I was going crazy inside, and he complimented me on my ability to keep a calm face in the midst of chaos. I gave myself a mental pat on the back. I was so hyped up, there was no way I could go back to sleep, so I stayed up until it was time to leave and paid for it later when I couldn't keep myself awake during chemistry class.
Overall, it was a great clinical, and I think I'll return to the same station for my other ones. I have one more 24 and then one 12 hour station clinical, and an 8 hour hospital clinical to complete before I'm finished with my emt class. Wish me luck and lots of trauma! :)
Monday, February 21, 2011
Monday, February 7, 2011
Weeeoooo Weeooo! My first clinical on an ambulance.
It has been so long since I've updated! Between the holidays and school, I just haven't had time to hit up the ER much for volunteering. I'm afraid I may have lost some of my readers with my long absence, but for those who keep up dutifully, here's what I've been up to lately:
I haven't had anytime to volunteer because I have started my EMT-B program! It has been very exciting and stressful. The class is only 3 months long, and so I am already studying for my midterm. The first half has flown by. So far we have learned about medical emergencies: allergic reactions, heart attacks, diabetes, childbirth, etc. I have learned so much, but the material has been a little dry. Next week we start the trauma emergencies, should be exciting. I have that class three days a week, and I am also taking 17 credits at the college. All that paired with the 24 hour clinicals I have to complete each week has made for a crazy schedule.
This morning I finished up my first EMT clinical shift at a fire station. I went in from 7:00 AM on Sunday morning to 7:00 AM on Monday. I woke up at 5:30 to get ready, I was so nervous I had hardly slept a wink. I got into my uniform, grabbed my little notepad, pen, watch, stethoscope, sleeping bag, and all my other gear. I arrived at the station ten minutes early and met the entire crew, only to find out I wasn't actually working with that crew, as they were all leaving and MY crew was walking in. Great. So I reintroduced myself to everyone else, and asked for a tour of the ambulance. After making my self comfortable with where everything was located, I helped wash the trucks, and sanitized the stretcher and other surfaces with clorox wipes. Then we played the waiting game. At about 10:00, the alarms went off and I just about jumped out of my skin. Dispatch announced a location and said the patient was a 30 y/o female with chest pain. I hopped in my little jump seat in the back and rode in silence as my heart was pounding and my heart was racing. Holy crap, this is it, my very first call! We arrived to a little house where a fire engine was sitting outside. We walked in to find another crew completing an assessment on a woman lying on the couch. I took a glucose test and started her up on oxygen, while the medics prepared her for transport. In route, I took a BP (blood pressure) reading, an O2sat (the little finger thing that measures the oxygen in your blood), and applied a 4 lead (measures cardiac activity). I also was told to give her a squirt of Nitro for the chest pain. Then as soon as we had finished all of that, we were at the hospital and taking her though the double doors. The nurses got her situated, and the medics were answering questions. I wiped down the stretcher and put fresh sheets on.
The rest of my shift, we got paged for three other calls, but they ended up in refusals before we even got there. One was for a young woman who was attempting suicide by laying in the road of a cul-de-sac in a small, residential neighborhood. A major highway was less than 200 feet away, so we concluded that she was only wanting a little attention. She ended up getting a little embarrassed that 911 was called by a neighbor, and refused treatment. We had another call that lead us to a church. It was one of those churches where the gospel choir sways, and the members dance in the aisles with their hands raised high. I guess the power of the lawdy lawd almighty overcame one young woman, as she had felt a little weak and passed out. She refused treatment to a crew who had arrived before us. The last call of the night that I was hoping wouldn't get canceled was for a bar fight right after the super bowl ended, but we turned around before we even got there. There were no calls after that.
Even though I had woken up much earlier than normal that morning, I was wide awake most of the night. It didn't help that the radio was in my room, pretty much right next to the bed. And so, although the station I was at wasn't receiving any calls, I got to hear every call for the entire county that night. It was fun, at first, then it got really old at about 3 in the morning. Overall, it was a quiet night, but I got some homework done and got to watch the entire super bowl. I even won the bet on what color the Gatorade would be when they threw it on the coach.
I haven't had anytime to volunteer because I have started my EMT-B program! It has been very exciting and stressful. The class is only 3 months long, and so I am already studying for my midterm. The first half has flown by. So far we have learned about medical emergencies: allergic reactions, heart attacks, diabetes, childbirth, etc. I have learned so much, but the material has been a little dry. Next week we start the trauma emergencies, should be exciting. I have that class three days a week, and I am also taking 17 credits at the college. All that paired with the 24 hour clinicals I have to complete each week has made for a crazy schedule.
This morning I finished up my first EMT clinical shift at a fire station. I went in from 7:00 AM on Sunday morning to 7:00 AM on Monday. I woke up at 5:30 to get ready, I was so nervous I had hardly slept a wink. I got into my uniform, grabbed my little notepad, pen, watch, stethoscope, sleeping bag, and all my other gear. I arrived at the station ten minutes early and met the entire crew, only to find out I wasn't actually working with that crew, as they were all leaving and MY crew was walking in. Great. So I reintroduced myself to everyone else, and asked for a tour of the ambulance. After making my self comfortable with where everything was located, I helped wash the trucks, and sanitized the stretcher and other surfaces with clorox wipes. Then we played the waiting game. At about 10:00, the alarms went off and I just about jumped out of my skin. Dispatch announced a location and said the patient was a 30 y/o female with chest pain. I hopped in my little jump seat in the back and rode in silence as my heart was pounding and my heart was racing. Holy crap, this is it, my very first call! We arrived to a little house where a fire engine was sitting outside. We walked in to find another crew completing an assessment on a woman lying on the couch. I took a glucose test and started her up on oxygen, while the medics prepared her for transport. In route, I took a BP (blood pressure) reading, an O2sat (the little finger thing that measures the oxygen in your blood), and applied a 4 lead (measures cardiac activity). I also was told to give her a squirt of Nitro for the chest pain. Then as soon as we had finished all of that, we were at the hospital and taking her though the double doors. The nurses got her situated, and the medics were answering questions. I wiped down the stretcher and put fresh sheets on.
The rest of my shift, we got paged for three other calls, but they ended up in refusals before we even got there. One was for a young woman who was attempting suicide by laying in the road of a cul-de-sac in a small, residential neighborhood. A major highway was less than 200 feet away, so we concluded that she was only wanting a little attention. She ended up getting a little embarrassed that 911 was called by a neighbor, and refused treatment. We had another call that lead us to a church. It was one of those churches where the gospel choir sways, and the members dance in the aisles with their hands raised high. I guess the power of the lawdy lawd almighty overcame one young woman, as she had felt a little weak and passed out. She refused treatment to a crew who had arrived before us. The last call of the night that I was hoping wouldn't get canceled was for a bar fight right after the super bowl ended, but we turned around before we even got there. There were no calls after that.
Even though I had woken up much earlier than normal that morning, I was wide awake most of the night. It didn't help that the radio was in my room, pretty much right next to the bed. And so, although the station I was at wasn't receiving any calls, I got to hear every call for the entire county that night. It was fun, at first, then it got really old at about 3 in the morning. Overall, it was a quiet night, but I got some homework done and got to watch the entire super bowl. I even won the bet on what color the Gatorade would be when they threw it on the coach.
Sunday, December 12, 2010
Calling all podiatrists!
I find that there's sometimes a theme in the ER, last weekend it was pediatric cases, this weekend it's feet! Within the first twenty minutes of walking into the hospital, I had seen two broken feet, and a toe that had been severely mangled. First girl was about 17 years old, she had fallen off the roof while trying to hang Christmas lights. She had broken it, but instead of calling her mom right away to take her to the hospital, she walked to her boyfriends house, and then about a mile to Wendy's. After eating a nice hamburger, she decided it was time to call her mom. The doctor called us in to look at the foot. I was a little shocked when I looked down and saw only her big toe and her pinkie toe. She had been born with Edward's Syndrome, a genetic disease caused by an extra 18th chromosome, that had caused deformities in her fingers and toes. Poor girl, she had an awesome attitude, and was laughing about her clumsiness all the way out.
Second foot case, a young man had come in with his girlfriend. He had hurt his foot while trying to teach his girlfriend's son how to ride a bike (aw). Apparently, his girlfriend called him a big baby when he kept asking her to drive him to the ER. Eventually she gave in, and lookie there, a clean break in his third metatarsal. His girlfriend felt terrible, he'll probably be milking it for the next month, I know I would be.
Third and final foot case of the night, a woman in her forties comes in by ambulance, absolutely screaming her head off. She's babying her foot, which was wrapped up so I couldn't really see much, but the medics were rolling their eyes at the dramatics, so I assumed it wasn't too serious. She's in a dangerously short night gown, smells heavily of smoke and I think there was little alcohol on board. Apparently she was getting ready to go to bed, when her dog got out. She ran after the dog, and somehow her toe got stuck underneath the door? The pad on her toe was a little skinned, but no bone showing, and no damage. The doctor called Katie and I in when he went to stick her with the numbing medicine. He went with the standard, "This is going to pinch a little." She immediately starting crying, banging her hand on the bed, and yelling for her mommy (I'm not kidding). I had to stifle my laugh, as the doctor literally had not even touched her yet. She kind of became a pleasant person after the nerve blockers kicked in, and her boyfriend eventually came to pick her up. He came in wearing a suit, Katie and I cracked up at how different he was compared to what we had been expecting. They wrapped her up, and sent her on her way with some Lortabs.
Most disgusting case of the night, a 92 year old woman comes in via ambulance, complaining of abdominal pain. She seemed a little out of it, but actually looked pretty good for her age. Her hair was done, she had a french manicure, her toes had been painted pink. The nurse asked if I would assist her while she tried to hook her up to a catheter. I gave her a look like, "Yeah...if I have to". The nurse started taking off the woman's pajamas, taking off her diaper, and surprise! This woman had extremely loose stool (to be medically correct). It was everywhere, I had to keep my eyes on the television as she was being cleaned up. My gag reflex was having a moment of doubt. After she was cleaned up, and the catheter was in (ouch), it became Katie and I's job to make sure she drank the contrast needed for a CT. She would drink a little sip when we initially came in, but refused to drink anything else until we left and came back later. We figured out the woman didn't have a good sense of time, so we would stand outside her room, count to ten, go back in and get her to take a sip. Then we would wait a few more seconds and repeat. As long as she thought we were leaving for awhile, she would take a sip. High-five for tricking the elderly!
The last interesting case of the night, a woman in her eighties came in with her husband after shortness of breath woke her up. She had a harsh murmur, heard over her "aortic area". She was hilarious. A nurse came in to draw blood and when she stuck her with the needle, the woman screamed at her. The nurse was startled, looking a little wide-eyed at her. The woman started cracking up, saying she was only joking. She was really patient, and let me practice a blood pressure reading on her. I even got to listen to the murmur through the doctor's stethoscope. I hope nothing serious was going on, she was so nice!
Second foot case, a young man had come in with his girlfriend. He had hurt his foot while trying to teach his girlfriend's son how to ride a bike (aw). Apparently, his girlfriend called him a big baby when he kept asking her to drive him to the ER. Eventually she gave in, and lookie there, a clean break in his third metatarsal. His girlfriend felt terrible, he'll probably be milking it for the next month, I know I would be.
Third and final foot case of the night, a woman in her forties comes in by ambulance, absolutely screaming her head off. She's babying her foot, which was wrapped up so I couldn't really see much, but the medics were rolling their eyes at the dramatics, so I assumed it wasn't too serious. She's in a dangerously short night gown, smells heavily of smoke and I think there was little alcohol on board. Apparently she was getting ready to go to bed, when her dog got out. She ran after the dog, and somehow her toe got stuck underneath the door? The pad on her toe was a little skinned, but no bone showing, and no damage. The doctor called Katie and I in when he went to stick her with the numbing medicine. He went with the standard, "This is going to pinch a little." She immediately starting crying, banging her hand on the bed, and yelling for her mommy (I'm not kidding). I had to stifle my laugh, as the doctor literally had not even touched her yet. She kind of became a pleasant person after the nerve blockers kicked in, and her boyfriend eventually came to pick her up. He came in wearing a suit, Katie and I cracked up at how different he was compared to what we had been expecting. They wrapped her up, and sent her on her way with some Lortabs.
Most disgusting case of the night, a 92 year old woman comes in via ambulance, complaining of abdominal pain. She seemed a little out of it, but actually looked pretty good for her age. Her hair was done, she had a french manicure, her toes had been painted pink. The nurse asked if I would assist her while she tried to hook her up to a catheter. I gave her a look like, "Yeah...if I have to". The nurse started taking off the woman's pajamas, taking off her diaper, and surprise! This woman had extremely loose stool (to be medically correct). It was everywhere, I had to keep my eyes on the television as she was being cleaned up. My gag reflex was having a moment of doubt. After she was cleaned up, and the catheter was in (ouch), it became Katie and I's job to make sure she drank the contrast needed for a CT. She would drink a little sip when we initially came in, but refused to drink anything else until we left and came back later. We figured out the woman didn't have a good sense of time, so we would stand outside her room, count to ten, go back in and get her to take a sip. Then we would wait a few more seconds and repeat. As long as she thought we were leaving for awhile, she would take a sip. High-five for tricking the elderly!
The last interesting case of the night, a woman in her eighties came in with her husband after shortness of breath woke her up. She had a harsh murmur, heard over her "aortic area". She was hilarious. A nurse came in to draw blood and when she stuck her with the needle, the woman screamed at her. The nurse was startled, looking a little wide-eyed at her. The woman started cracking up, saying she was only joking. She was really patient, and let me practice a blood pressure reading on her. I even got to listen to the murmur through the doctor's stethoscope. I hope nothing serious was going on, she was so nice!
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!
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!
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!
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.
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.
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