…huh May 31, 2008
Posted by keepbreathing in Uncategorized.6 comments
I was just on Yahoo! and I noticed that among their top ten searches, “staphylococcus aureus” came in at number ten.
I have no idea what to make of that. I didn’t even think most people could spell it, let alone would bother to search for it.
How to make your boss have a stroke May 30, 2008
Posted by keepbreathing in Career Advice, hospital, humor, medicine, my life, respiratory therapy, work.6 comments
One of my hobbies is to get people going. If you know exactly where the line is, you can walk along it for a few minutes without stepping over it. This gets people pretty worked up, but when they discover that you’re just kidding they usually see some humor in things. And the agitation is good for them: the increase in blood pressure, heart rate, and respirations is sort of like exercise. I view my hobby as a public health service: getting people going is good for them!
So the other day when I ran into my boss standing near our hospital’s infection control officer I had to see what I could do. I walked inconspicuously past, then stopped and smiled.
“Hey boss.”
“Hey, RT. How’s it going?”
“Just fine. My patients are eating so I figured I should too, (insert phony conversational laughter here.) Say, infection control, have you seen that guy in CCU with the crazy infection? What is that?”
The infection control officer frowned for a moment.
“That’s a weird case because we don’t really know what he has. It’s some unknown new pathogen. We’re hoping we can figure it out. It would be awful if that spread around.” I nodded knowingly and crossed my arms, putting on The Serious Face.
“Well I’m doing my part. I believe that exposure is the better part of immunity.” The boss became perceptibly nervous as I said this, shifting her weight between her feet and looking uncomfortable. The time was right to deliver the killing blow. I took a deep breath and carefully controlled my expression.
“That’s why I never ever wash my hands.”
There was an awkward pause. I stood straight and focused on not smiling. The Boss began to laugh nervously. The infection control officer seemed extremely startled and there was a glorious moment of complete awkwardness as the two of them stared at me in disbelief. Finally I couldn’t control myself any more and I burst into laughter. Once the two of them realized I was just kidding they began to chuckle nervously, and I reassured them that I was merely joking and made my escape before retribution could begin.
Another notch in the gun, so to speak. I’ll just have to steer clear of the boss and hope she doesn’t manage to get me back.
Nosebleed May 29, 2008
Posted by keepbreathing in Uncategorized.8 comments
I gave myself a nosebleed. I had an itch and I was trying to scratch it when I made a slight miscalculation. Instead of lightly scratching a minor itch, I accidentally rammed my fingernail into the soft flesh of the median of my nose. I don’t know why I am sharing this with all of you; I suppose I am hoping to impress you with the breadth of my manual dexterity skills.
From the RT perspective, I found myself staring at the blood as it came out and taking note of the color. It was lovely: none of the dark blue or even purple blood indicative of imbalances, but the bright red blood of healthy functioning organs.
Is that weird?
Tech troubles May 24, 2008
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I may be less posty than usual this week. My computer has picked up some sort of virus and has been very sick. In medical terms, it’s in the ICU on BiPAP and not looking especially well. I’ve busted out some new antivirus and deep-scanning stuff and hopefully I can remove or quarantine whatever offending code has caused my troubles here.
More posting later.
100,000! May 22, 2008
Posted by keepbreathing in Uncategorized.9 comments
I have just rolled over 100,000 hits since the initiation of this blog! I can’t believe that people actually read the things that I write.
Thanks for reading, readers. Tell me, what can I do to keep you here? What do you like and not like? Inquiring minds want to know.
Bad, worse, and much worse May 22, 2008
Posted by keepbreathing in Uncategorized.12 comments
Bad: somebody you know is your patient on the ventilator.
Worse: they are a respiratory therapist, they are wide awake, and they are watching you.
Much Worse: the ventilator completely and utterly malfunctions and you are forced to manually ventilate while somebody helps you change the ventilator out.
Oh yes. It was an interesting day.
Six things that burn me out May 20, 2008
Posted by keepbreathing in my life, respiratory therapy.5 comments
Today I will be stealing a meme from MonkeyGirl. She’s been feeling a bit burned out lately and as such has invented her own thingee. She calls it “Six Things That Are Causing My Burnout.” Since it sounds like an easy game to play here’s my list:
1. Management. The bosses here are constantly playing a two-faced little game: they’ll tell us that they know how hard we are working and how much they appreciate it, and then they’ll turn around and demand that we do more work. “Good job, guys! We know how hard you work. But it’s not enough, so here is some more work for you to do.” Thanks, management! I know your job is hard too but please stop giving me unsafe loads.
2. Patients who don’t give a shit. Listen, people: I can only do so much to cure you! You need to participate in your own well-being! Contrary to what you may think we do not possess a magic pill that will cure your fat lazy ass. You need to get off the couch, quit smoking, cut back your beer consumption, get a job and take care of yourself. I see no reason that I should work hard to save you so you can continue to live your pathetic farce of a life. At least help us help you.
3. Massive workloads. It’s not as bad as it was over the winter but we are still being burdened by excessive workloads. A lot of it is out of the hands of us or management, but nevertheless we have got an enormous workload around here.
4. Documentation. We have moved to computerized documentation. In theory, it saves time. Some days it truly works. But the problem is that nursing has no easy way to access our information: they must find a PC terminal, log in, find our flowsheets, track down whatever parameters they want, and copy them to their own flowsheet. As a result we are forced (by practical necessity and the fear of a nurse scorned) to document not only in our PC system but on the old flowsheets. Also, every single thing we do–every O2 change, every arterial puncture, and every minute spent with a patient for assessment/treatment or even a quick look–must be entered into the system to generate Relative Value Units that justify our continued existence. I spend two minutes with a patient and five minutes documenting those two minutes. A lot of it is needed, but a lot of it is bullshit.
5. Denial. Denial burns me out. I am surrounded by it every day. The family of our patient who has been in fulminant ARDS, on and off the oscillator and APRV for the last two weeks, now with peak pressures in the high fifties, believes him to be on the road to recovery. The few halfhearted attempts by the physicians to convince the family that grandpa is going to die have failed, and so we live in a little world of denial…the family denies that grandpa will die, the doctors deny that they have not laid out the facts, and us lowly grunts deny that we are animating corpses. This happens every. single. day.
6. Tragedy. I spend a lot of time in our trauma ICU and our medical ICU. The trauma patients terrify me. These are mostly people who were living their lives as normal when things went horribly wrong. Many of them get better…many more do not. I see a lot of head injuries and they scare the hell out of me. Our medical ICU is no better; it is full of slowly dying middle-to-later-aged people who got sick one day and got sucked into the endless spiral of critical care. I can not imagine what it is like to be them, and I am painfully aware of the fact that we are all just a few steps away from being one of them. I often wish I had a simple job that did not involve these things.
That being said, there’s a lot that I like about my job. Perhaps I’ll make a six things that don’t burn me out list just for parity’s sake.
I’ll tag anybody who reads this and wants to play. Go!
Stupidity knows no bounds May 19, 2008
Posted by keepbreathing in Uncategorized.5 comments
I was asked to perform a laboratory draw on a patient in the ER the other day. Lab draws are done by us RTs as a last resort: typically we are called only when nursing is totally unable to obtain blood from a vein. There are exceptions (the odd lazy nurse) but mostly a lab draw means that somebody has no veins.
So I was asked to get blood from a patient in the ER. I walked into the room and was stunned to see a blue whale very large patient laying in the bed. Her head was back, her eyes were closed, and her mouth was a lovely shade of black from the charcoal shooters she’d been drinking. A slender old lady hovered around her bed and berated her whenever she moaned.
“What is this?” I asked the nurse.
“Overdose,” she said. “Took too many of something but nobody knows what.”
I approached moby the patient and explained to her what I was here to do. She moaned.
“I ain’t got no mo’ veins left. They cain’t find nothin’ on me.” She moaned. “Cain’t you jest git me sum pain medicine? I hurts all ovuh.” The elderly woman laughed one single, sharp ha!
“Shut yo’ mouf! You took too many pills and that’s why yo’ here anyway.” The patient moaned. I grabbed her arm and palpated for a pulse. It was distant, but present. I selected the larger of the two needles available for my arterial puncture and shot into the wrist. The patient didn’t even flinch and blood spurted into the butterfly tubing. The nurse pulled back, sucking blood into a giant syringe as I held a death grip on the needle.
“Y’all done got that IV in me?” The patient punctuated her question with pity-me-moans. “I really need some pain medicine.” The nurse rolled her eyes, the elderly lady sighed, and I tried to feel some sympathy for the pile of carbon that was demanding pain meds in the middle of her trip to the ER for an overdose.
Stupidity…knows no bounds. I try to feel bad for my patients but some of them just have it coming.
Timing May 17, 2008
Posted by keepbreathing in Uncategorized.5 comments
The ER where I work has music piped in overhead. It plays at a soft volume, but if you stop and listen you can hear the strains of modern alt-rock over the roar of the ER.
I was walking out of the room of an elderly patient who we had just spent 20 minutes resuscitating. As is common with CPR and the elderly, she did not survive. I threw the ambu-bag into the garbage and squirted some hand sanitizer onto myself. As I stood washing my hands I listened to the music.
The song of the moment was “How to save a life.”
What are the odds?
See: May 16, 2008
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Interesting stuff out there tonight. From”Not Totally Rad” we have a flouroscopic series showing a sword-swallower in action. It’s fascinating to watch: I had a hard time with the first ten seconds or so but then it seems to clear up some.
And over at the RT cave, Rick Frea has an intriguing ethical problem that is encountered all too often by those of us in the breathing business.
