10/28/2009

0200 Beginning of Month 3

Well it is official my professor's predictions and warnings on the first day of class have come to fruition.

*SAY FAREWELL TO YOUR FAMILY AND FRIENDS BECAUSE FOR THE NEXT 9 MONTHS YOU ARE MINE. I OWN YOU:
I have no life. All my friends are at university or working and when they have free time I am in clinicals. I am not meaning to whine I love class with all my heart and soul. However the only time I am able to talk to my boyfriend is really late at night (right around now) or random five minute bursts

*YOU WILL LEARN TO LOVE COFFEE. THIS IS NONEGOTIABLE.
I am getting less sleep now than I did during college. The only difference is used to stay up late to hang with friends and eat and play games. Now I stay up late studying Calcium channel blockers and Tricyclic antidepressants, Medications, dosages, uses, indications, contraindicates, special considerations, routes, dosages (adult and peds). I have begun to consume coffee to stay awake during lectures in class.

*IF YOU ARE AT ALL SHY YOU WILL NOT BE. BY THE END OF CLASS YOU WILL HAVE BEEN IN EACH OTHERS PERSONAL SPACE SO MUCH YOU WILL NOT BE EMBARRASSED ANYMORE.
I have officially passed into the realm of, my hand is going into your crotch to tighten a strap and you know this, so I will simply mutter move the boys if you need to while tightening. I also do not feel bad popping an angiocath into somebody's arm and fishing a little bit to get a decent vein and flash.

*YOUR HUMOR IF NOT ALREADY SLIGHTLY WARPED WILL BECOME WARPED SOON ENOUGH TO DEAL WITH WHAT YOU ARE GOING TO SEE.
We make jokes about the songs we sing while doing CPR to keep a steady beat. We had a debate about when it is appropriate to sing "Another One Bites The Dust" vs. "Staying Alive". We came up with some definite guidelines that shall never be repeated.

*YOU WILL KILL SOMEONE.
No one in class has done this yet and this is part of the prophecy that we hope does not come true. However as a class and as individuals we have killed several simulated patients in scenarios. In our defense we were trying to do this while looking at an examiner in a chair not acting at all and having no paper on which to write vitals or anything from SAMPLE or OPRST or anything else pertinent. And the patient we killed as a class had a problem none of us had ever heard of and we were only allowed to ask one question before the professor moved on to the next person. It was the worlds weirdest way to diagnose and very hard to get other tudents to follow your line of thought.

Well for now that is it but there will be more when we start respiratory and cardiology and definitely some clinical stories. Of course all the stories will be completely fictional or so generic no one will ever know who it could possibly be.

10/01/2009

What can you do?

I am writing this because... Well I need opinions and I need to get it off my chest.

So you are called to a house for an assault. Her roommate states that your patient stumbled into the house crying, bloody and very confused.

When you open the door to her room you find an approximately 18 year old female cowering in the corner. She is bloodied, her clothes are torn, and she is rocking back and forth slightly. As you introduce yourself from the door she doesn't move or acknowledge your presence. You slowly enter the room watching her and talking to her the whole time. Eventually you are close enough to see her well enough to start your assessment. You can see she is breathing, slightly fast but adequate. You observe quite a bit of blood coming from some deep lacerations to her face and arms. As you keep talking to her, your partner brings you a sheet to wrap around her while you take her to the hospital.

As you slowly move closer she still is not showing any sign that she sees or hears you.
**How do you proceed?

You touch her foot as they are the part of her closest to you. She looks up at you and starts rocking faster.
**What do you do now?

You keep talking to her and reassuring her but you back up a little to give her some space. You bring the roommate in, in the hopes that a familiar face will calm her down and it seems too. You have the roommate help explain who you are and what is going to happen now to your patient.

Eventually you get her in the vehicle and start towards the hospital. She still has not spoken but she is following simple commands and nods in the affirmative and negative in response to questions. She starts crying and grabs onto your hand. You just keep talking to her.
**What do you talk about? (Anything you can think of? weather, sports, school)

When you get to the hospital and the nurses take over and ask you to leave the room she will not let go of your hand.
**Do you reassure her and leave? Do you see if you can stay just a little longer? Do you out her hand in a Nurses and tell her that she will be taken care of?

** How do you decompress?
** What if this was your best friend, your little sister, your mom, your girlfriend, your daughter?
** What would you have done differently?