How was it?

Well, the first day on the ward was brief but good. I'll spare you the gory details but the patients we saw included:

1. An agitated bi-polar woman with a tertiary wound and hemovac drain. She was in pain and unhappy and not very nice. But then, if I were in pain, I might not be very nice either. She was mean to all the nurses including the wound specialist. Unfortunately, we didn't get to see her wound.

2. A homeless man with a femur and tibial fracture who didn't smell so good. Also, he was still in his clothes and not a hospital gown. He wasn't wearing underwear. Don't ask me how I know that. I asked the nurse how he hurt himself but she didn't know. She says that when the homeless come to the hospital they've usually been hit by a car. That makes me sad.

3. An older gentleman who had recently had a laparoscopic cholecystectomy (gallbladder removal). We almost got to observe the insertion of a foley cath on him but then he went and voided 4 oz of urine and the nurse decided he didn't need one inserted just then. Good for the patient but unfortunate for us.

4. Another older gentleman who was post-op for the removal of a melanoma and a partial parotidectomy. He was vomiting a bit and still fuzzy from anesthesia. Melanoma, ewww.

On Monday we got to hear about the experiences that some of the other students had. Some of them were on an oncology ward and most of their patients were not long for this world. A number of the students were caring for dementia patients. 2 students were working with a patient who died during their shift so they did post-mortem care (they wash the deceased's face and hands, do a quick shave of the face--basically they make them presentable for family). All in all, lots of different things to see and experience.

Also, there was more paperwork. Big surprise, I know. And the handwashing thing? Well, some were more lax about it than others. All I can tell you is that when you are in a clinical setting, your provider, be it nurse, doc, respiratory therapist, etc., should wash with soap and water or use alcohol gel when she comes into the room and leaves the room. If you are ever at the doctor's office or the hospital and they don't wash please, for your own sake, ask them to do so.

More soon!

First day! On the ward!

There have been many times that I've thought about taking down this blog. I usually don't have anything important to say and when I look back thru the archives (not often because, well, I sound like an idiot which brings me back to my point) I am amazed at how ridiculous I sound. I'm certainly not trying to find a cure for cancer or bring about world peace here. But I also know that if I take it down I'll never write in a journal either. I had a number of empty journals laying around because I could't bring myself to write in them. They have since gone to Goodwill where someone else can buy them and keep them around the house to gather dust. But somehow this blog seems like a reasonable medium to jot down some thoughts because sometimes people come over here to read what I have to say. And by people I mean Michael.

But I digress. Today is one of those days where I think it's important to make a note of what I was thinking. Today is going to be our first day of our first clinical rotation. Yesterday doesn't count because we filled out about a million pages of paperwork and took a tour of our new home for the next 9 weeks. But today. Today. Today is the day. And can I just tell you that I am scared out of my mind? They are going to let us do things to people and we are going to try not to kill them. I imagine that med students feel a little like this, too.

Of course we'll start of easy with checking of vital signs and all that but still. What if I look at someone wrong and he keels over? It's not like we're left on the ward by ourselves, certainly not. Our supervisor will be with us the whole time and yet it's scary. Our instructors have spent the last 6 weeks drilling ethics and protocol and liability into our heads because those things are very important but now we're about to put that stuff plus actual nursing skills into practice. This is scary. Very sick people are going to let us take their vitals, help them ambulate, help them use the bathroom, give them bed baths, give them meds and, just maybe, put in a few foley catheters and nasogastric tubes. !!!!!!!!!

So, dear internets, I tell you how scared shitless I am right now but when I go to the hospital today I will exude total confidence to the patients in my care. I will be friendly and will try not to let my hands shake nervously. I will wash my hands a lot and will hope they won't feel too clammy and cold. I will be careful and deliberate in my movements and will strive to be gentle when I have to adjust equipment or parts of the body. I already cut and filed my fingernails and removed my wedding rings and I'll remember not to wear perfume. Okay, deep breath. Wish me luck.

Justice?

Lately, you've heard about poop and shipping unused-but-in-perfectly-good-condition medical supplies so you've got the warm fuzzies right about now, right? Prepare yourself for a little downer...

The drunk driver who killed my aunt last year just 2 weeks after her 58th birthday was supposed to go to trial this week. Since then, the prosecutor, victim's advocate and my 3 cousins agreed to accept a plea bargain involving 10 years in prison and charges of DUI blah-dee blah but nothing about involuntary manslaughter. The judge has approved this so I guess this man, Travis Day is his name, is headed back to prison to serve out his 10 years.

No one asked me for my opinion, and it's irrelevant really, but it feels like justice has not been properly served here. I don't know all the reasons for accepting this proposal and I am not close with my cousins (regrettably) so I'm not in regular contact enough to find out what they're thinking but I'm thinking that this is not right. This man, by his own reckless actions, killed an innocent woman and he gets 10 years in jail and that's it? How is that okay?

Right now I could care less about overcrowded jails and long court proceedings and what would have happened if the jury let him off anyway--I care about justice and I just not feeling any right now. It's not like this reckless, drunk, repeat offender is someone who slid through an icy intersection and just, by accident, killed someone. No, he got drunk, drove on a suspended license and then rear-ended my aunt pushing her car into the way of oncoming traffic. The volunteer fire personnel on the scene told my mom that they were sure she died instantly. Small comfort, tho, for my mom, my grandmother, my other aunt and uncle, my cousins, their children and my aunt's significant other. Did I mention that her dog that was with her in the car was also killed?

Accidents happen, I get it. But while I'm sure he didn't wake up on December 27, 2007 intending to kill someone, he nevertheless got drunk and got behind the wheel. He caused an accident that could have been avoided. 10 years doesn't seem like a long enough time to pay for his crime. Is this guy sitting in jail feeling remorse for what he did? Does he even care that he killed someone?

Waste not, want not...

I don't know about you, but I really don't like to waste things. I try to recycle or repurpose stuff as much as possible and that means bringing home banana peels and plastic clamshell takeout containers to compost and recycle. I scrape out every last bit of peanut butter out of the jar and I will save 1 Tbs of milk just to use it the next day in my coffee. Yes, I am that person. I hate wasting things. And on occasion when I do I feel horribly guilty about it.

During the last 5 weeks, we have talked a lot about medical and surgical asepsis (clean vs. sterile) and that means going thru a lot of single-use products like gloves, syringes, cannulas, dressings, IV tubing, catheters, etc. In America, the land of plenty, there are often plenty of health care supplies around and manufacturers are getting rich off of the single-use products they supply because we want everything to be as clean and/or sterile as much as possible. And asepis is very important, I don't want to diminish that (some of you will recall that I sprayed Lys0l on the dishes before eating off them during a vacation to OCMD), but that approach to asepsis comes at a cost to our environment and our wallets.

Meanwhile, in underdeveloped countries and even some very rural portions of our own country, there are people who are reusing syringes and tubing by boiling them in water and sharpening the needles on a strap. Gloves are washed and reused until they're riddled with holes and then the fingertips are cut off and they're used for wound drainage in lieu of tubing. Often there aren't enough dressings to go around and wounds are left open to the air. In America, once a prepackaged sterile surgical set is opened it is no longer sterile so any remaining unused items are discarded in the trash. The wastefulness is outrageous.

Today, in lieu of going to lab, we went to MedShare. MedShare specializes in collecting medical supplies and equipment from area hospitals in GA and CA and ships them to underdeveloped countries all over the world. They also fund medical missions. An online database of the supplies they have on hand is kept and governments, aid groups, etc. can request a shipping container of the items they need for the discounted price of about $20K-22K, supplies which are worth hundreds of thousands of dollars. They only collect usable items that work (it's not a dumping ground for broken equipment) and their warehouse is full of hospital beds, walkers, crutches, lights, drapes, dressings, syringes, respiratory equipment, etc. You name it, they probably have it. They get so much stuff and this is from only a very small number of hospitals. I think they told us that in the 10 years of their existence they have kept over 1 million cubic feet of medical waste out of landfills. Really, it is amazing. Their overhead is very low; they are getting more support from health organizations by the day; they're being good stewards to those in developing countries while being good stewards to the environment.

So, for those of you who have made charitable giving and/or involvement a goal for the year, I invite you to send a little something to MedShare. I plan to give a little money and a little time. At the very least I hope you'll visit their website.