My Ray of Hope

I'm in my ICU Rotation this week...and that means there are only about 16 patients to take care of and we have to make sure they're doing OK every 4 hours...so 6x a day....it has been the best rotation YET!

 

My instructors this time are really patient with me...but the credit also goes to the rather impatient preceptors because if it weren't for them, I probably would still be very slow and seemingly-incompetent at what I do =P Today, my instructor allowed to draw a blood gas sample on my own...he wasn't even there to watch me. This isn't the one where you have to poke someone in the wrist though, there's already a catheter in their wrist and all you gotta do is draw blood from it...there are no needles involved. So it's relatively easier from a practical point of view, but equally dangerous from the patient's point of view. I feel that my instructors have more confidence in me and I feel like what I'm doing is actually doing some good for other people...feels prety good

 

The other housemates are getting ready to go to a party right now...there's a Halloween party at the school club in McMaster...No I'm not going, I'm working tomorrow and I'm not ever going to show up hungover...EVER!

 

Anyhow, the ICU is where the sickest patients go....and there's nothing much happening, yet the days are going by faster and faster...My days now usually start off with receiving report from the Night shift at 0630, then checking my patient's Chest X-Rays, blood work, and ventilation parameters. At 0730 I would be in the Unit reading over charts and thinking of how to tackle the day's workload...then at 0800, the staff RTs will arrive in the Unit and I can start implementing any ventilation changes, suctioning, and giving puffers. At around 0900, the Medical residents start their rounds and this can go up to 1200 at least...they spend about 30-45 minutes/patient...for ~15 patients...so yeah it takes a while to finish.

 

Anyhow, I'm gnna do some readings before I go to bed tonight, See y'all tomorrow! To Joshua, Melina, and Dad.....HOCKEY ON SATURDAY!!!!

 

 

We got the platinum award, again!

well boys (adhi and iman),

I'm proud to let you know that our Lunch Lady franchise got the platinum award again this year. (that's for highest sales).
Well, actually this other franchisee in Ottawa has higher sales than ours, but the HO has not come up with a new standard so they are still using the old one and as such we are still qualified as platinum award receiver, ha...ha... Maybe next year they will do a Double Platinum Award for the ottawa guy :-)

We also got the School Participation Award and a Chatty Cathy award for me (that's for being one who wrote sharpest complaints thru emails or something like that according to your dad. ). :-(

We'll celebrate next weekend along with Dad's birthday at Momiji?? That's a good excuse to celebrate, isn't it


mom

My Bad Ending

Another Code Blue today.....at 1800...one hour before my shift ended...

There were probably 20-30 responding to the Code and we tried CPR for about 15 minutes, but the patient was declared dead...the lady went for about 15 minutes being really pale and stuff....and it smelled bad in there and I had to do 2 of the gazillion cycles of chest compressions...i think it was a pretty traumatic death though...i mean we suctioned up bright blood during intubation and that means she probably has a broken rub or sternum from the chest compressions....if they do an autopsy they'll know what happened exactly. I didn't even find out the patient's name...just where she spent her last days

anyway, that's my update so far..

My first Code Blue (For real this time)

So today.....I actually responded to a Code Blue....

My preceptor and I were on our way to check on some ICU patients when all of a sudden the PA voiced: Code Blue, CT Room, Tower Level 0......Code Blue, CT Room, Tower Level 0. We were with another preceptor-student pair at that time and decided that I will go to this Code since the other student is almost done her year and figured I needed to see this more than she. So we ran down 2 flights of stairs, through the hallway, and finally went into the CT Room. uhmmm I have to say at this time, I was excited (don't know if that's a good thing or a bad thing) but I was running then I realized I'm going faster than my preceptor...So I slowed down a bit and turned around, she said "Don't wait for me! Go to the bedside, get to the head and get a Bag going!" So I ran in.

When I entered, a doctor was already "manually ventilating" (aka bagging) the patient and CPR was underway. So I found the Code Blue cart and began digging around for intubation equipment. I turned around and saw that there was already a Laryngoscope on the bed so I figured someone already had all the intubation equipment ready...this was not the case. My preceptor soon came into the room and I told her, "Should I prep for intubation?", "Please do" was her answer. So I got everything ready - unfortunately I was quite slow b/c I wasn't sure where all the equipment was and the environment in general was so busy. Another staff RT entered and she quickly looked through all the equipment I have prepared, soon after, it was passed to another staff RT who was helping my preceptor bagging the patient...so yes at this time, there were 3 staff RTs and 3 student RTs in the room, in addition to the multitude of Doctors, Residents, and Nurses.

About 5 minutes (felt more like 15 but that can't be...) into CPR, the docs finally decided to intubate and an Anaesthesiology Resident tried intubating twice with no success. The Resident then asked for a different type of artifical airway, but we don't have these things on the Code Blue carts, they're on the Difficult Airway carts...so 2 of the Student RTs ran all the way up to ICU to grab some. He then asked for a smaller sized tube - something that I should have prepared but totally forgot about - hoping it'll be easier to intubate with. So I grabbed a smaller sized tube and prepared it. After failing to intubate again, the doctor stepped in. He had some trouble getting it in as well, but after a 2nd try, he got it. The placement of the tube was confirmed by my preceptor and he was prepared to move into Emergency Dept. Remember those 2 student RTs who ran up to ICU? they came back....all sweating, flush red, and looking like walking stock carts...AFTER intubation was successful...so at least they got a good run out of it and the patient did not die...at least not on our watch.

Oh and also...remember in the beginning when I was with another pair of student-preceptor? well their patient also crashed in the CCU....it was a gigantic mess this afternoon...2 patients crashing at almost the same time...

Ahhh.......so there...I got my first real Code Blue where CPR was actually happening and the patient had to be intubated, ventilated, and ICU-bound...pretty scary stuff, but I think I did pretty okay considering this was my first Code...I kinda just stood in the back, trying to stay out of ppl's way, but I was trying to help out as much as I can by prepping equipment etc...next time I will run to the bedhead and take over bagging the patient so the physician can control the situation freely....

New pictures

Hey everyone, just want to let you know that I have posted the pictures from our East Coast trip on Facebook. I am still missing all Maine pictures so if anyone's got em, please post.

My first real work

So today was my first 12-hour shift...it was AWESOME!

So I started "work" at 0630 this morning and I woke up at 0500 to make sure I'm not late. When I finally got to the hospital though - around 0545 - the parking attendant for the parking lot that I usually go to wasn't even there yet! So I went looking around for an electronically-attended parking lot and I found one...for a much cheaper rate too! Early-birds (before 0930...pfft I'm so early, I should get 50% off the early-bird price) only pay $7 for the daily maximum. Remember the last place I usually go to cost $10 for the whole day...one small problem though...they don't take bills and I only had $20s in my wallet =_='' So I scoured the car for some change and came up with about $4...that will last me one hour....so then I decided to not do it at all b/c as soon as I walk into that hospital I'm not walking out until 7:00 PM. So reluctantly....I went into the hospital's parking lot...for $20!! T_T but tomorrow I know what to expect =P I will trade my $20s for change and keep it in the car for parking every day. Anyhow, my work day lies ahead of me...and I couldn't stay to mourn my parking money...so at 0620, I was already in the Department and the Shift Report took place for the next 30 minutes.

Shift Report is like a briefing that the Day staff get from the Night staff regarding patients who are under the care of Respiratory Therapy Department (whether they be in Wards or Emergency Dept.) and all ICU Patients...the Day staff will brief the Night staff also at 1830.

So...some highlights from my day..one of the chronically home- ventilated patients had to come into the hospital by ambulance because she wasn't doing too well at home and my preceptor was paged to the ED to wait for her. Turns out our patient was known to the hospital because we weren't the only ones paged...when she finally arrived, there were a total of 5 RTs (2 of whom were students), 3 Residents, and at least 2 Nurses....there was a welcoming party for this woman!! and when she came in...she was surprisingly doing quite well...I was almost expecting a Code to happen...but no such "luck".

Another thing we did today was I learned how to test these really old ventilators that the school does not even teach us anymore...we are taught a number of modern-day ventilators, but this hospital still runs about 10 of the old, annoying kind...it was still using dials and monochrome screens =_='' I was so used to touchscreens and multicoloured screens and digital information readouts....I had one needle-based pressure readout =_=''

Alright that's long enough, I will now go eat some oatmeal and get ready for a day off tomorrow!! =D gd night y'all!!