The Life and Times of a Busy Woman

Tuesday, February 21, 2012

Puppet Master

I want to preface this post by saying that there may be a lot of crude humor.  I work in the medical field, specifically the EMERGENCY medical field.  If something makes you uncomfortable, I'm sorry.  Humor, crude as it may be, is a coping mechanism for the amount of stress we endure.  I would like the chance to defend my point-of-view, if you would like to comment (even anonymously).
So, this week has been chaotic, to say the least ... but I'm used to that.  But, I do have to say that today was the best day at clinical that I've had in a while ..............

Okay, so at the beginning of the semester, we chose outrotation sites to take the place of 2 clinical shifts.  I'm on an inpatient oncology unit for my semester, so any chance to get out of it was definitely taken.  I signed up for the ER and ICU for my days.  I will get to practice clinical skills under the supervision of an RN.  I felt like a puppet master since I orchestrated today's events (mwahahaha) for the ER.  I cursed myself so I would get a good learning day ... and I enjoyed every minute of it!

I called my friend, "E," at the ER that I would be going to (5 weeks ago!) and told her when I would be there.  That ER has a couple sections and is bigger than my ER.  The sections are the "typical ER" and then the "Critical Side" - aka the Crit.  The Crit consists of 4 critical care rooms and 2 trauma rooms.  E would be working.  Better yet, I spoke to her a couple weeks ago and she recommended that I talk to another friend of mine from that ER and tell her when I would be there.  This particular friend, "B," is what we call a S**T magnet ... especially when she is on the Crit side.  As a rule, she stays away from the Crit because all hell usually breaks loose.  Today was no exception, but I'll get to that.  She requested the Crit side when I spoke to her that day, for today's assignment, and agreed to take me on.  (Note:  Nursing students on outrotations don't usually get to pick who they're with or what role they get ... this is the first time that I've used my contacts to my advantage).

I was all excited last night, made sure that I had everything ready to go (School scrubs, stethoscope, pen, watch ... and trauma shears).  I wouldn't normally add trauma shears to my pocket, but this is B I'm talking about.  Anything could happen and that's what I was counting on (that, and the fact that "you can't fix stupid" when it comes to the general public).  I've seen so many things as an ER worker, I could go on for DAYS.  But back to today ....

Woke up before my alarm this morning.  My hair cooperated, breakfast eaten in a leisurely fashion, coffee in hand, and drove to the hospital.  As I got closer to the hospital, the song "Stayin' Alive" by the Bee Gees came on the satellite radio.  I nearly spit out my coffee.  It is a known fact that they recommend this song for CPR compressions, and encourage people doing chest compressions to sing it in their head or aloud if that helps.  Other songs, such as "Another One Bites the Dust" also works, but we try to stay positive.  When I got to the hospital, I posted, "To my medical friends: not sure if it's a good or bad omen that "Stayin' Alive" came on the radio as I drove in town this morning ..."  I got multiple responses, including "Great day for a Code" and "Oh Dear God" (the latter response from E). 

I presented to the ER early and the staff looked at me like I was nuts.  "Oh, I'm just waiting for B or E," and stood at the nurse's station waiting for change of shift.  I'm familiar with that ER, at least the lay of the land, but not all the night staff know me.  B came flying across the ER from the locker room towards the Crit side, I fell in step and we flew into CC3, where crap had been going down for a while (I just wasn't allowed in till B got there).  Now, I can't go into what happened, but a lot did.  A LOT of learning happened, too ... and I'm excited about that!  I also learned a new phrase about a Crit drip drug known as Levophed - "Levophed, better off dead."  As in, if they need Levophed, they're pretty close to death.  It does work in reversing that issue, but only if done properly and quickly.

After that patient was doing better and admitted to the hospital, we got some downtime to restock and catch up prior to the next patients.  I also was able to get familiar with where supplies were to be able to grab when necessary.  Of the next two patients, one was not so bad, the other was another Levophed case.  B was amazing, though, and even though she's a Magnet, she is one of the best nurses to take care of those cases.  She has years of ICU experience that help her perform tasks smoothly and competently.  The doctors take her recommendations and judgement very seriously.  ER and ICU nurses don't typically get along, but the skills learned in an ICU can greatly affect competency under pressure in the ER. 

Then, my day got even better ....

Today was mid-semester evaluation day.  I'm not sure how other schools do this task (if at all), but we have an evaluation paper with 12 sections on it about different things we should be doing (Technology in Health Care, Diversity in Health Care, etc).  We have to write how we think we're meeting the objectives and/or how we can improve by the end of the semester.  I'm critical of myself, but tried to be positive and also give some areas of needed improvement.  Apparently, my instructor agreed with me about my remarks and gave me a significant progress "grade" (it doesn't really count until the real number at the end of the semester).  Plus, she went on to ... THANK ME ... oh my gosh!  I wanted to look around like, "Who, me?"

This is an instructor whom I've had for multiple semesters who does. not. like. me. PERIOD.

She has never had a kind word to say, and usually criticizes me for my experience and how I'll have such a hard time being a nurse because of it.  [Yeah, I know that is a real positive environment in a school, but that's a subject for a whole OTHER post.]  So, this "thank you" really caught me off guard.  I'm not a perfect student by any means, and sometimes find myself doing the minimum just to survive a class, but ...

"If everyone came to clinical half as prepared as you, our days would go a lot smoother."

Really?  Know what I do to prepare?  Sleep, put on uniform scrubs, grab my stethoscope, pen, watch, coffee, and drive to the hospital.  That's it.  If it's a med I don't know, that's why all med rooms have books and the electronic MAR has a "reference" option.  I'm not telling her that, but I wonder what my cohorts aren't doing?  They seem to be working while we're there, and if I ask if they need anything - they don't.

She went on to say that she was thankful that I'm able to work more independently than others, and also thankful for all the extra tasks that she's been able to give me with other patients that students are having a difficult time with, when she's not able to help them (there are 7 of us and 1 of her).  I just thought that was part of teamwork ... you're welcome?

I do not know what came over her, but honestly thought I'd see pigs fly before she ever said something nice about me - to my face, no less.  Haven't seen any UFOs recently ...

Tomorrow is 6 hours of torture, i.e. two 3-hour lectures.  It is my least favorite day of the week.  Thursday will be one more trip to the Psych Ward before Spring Break.  I have my evaluation done for that class, too.  I'm hoping my instructor agrees with my self-assessment, but I'm not holding my breath for any "Thank You's."