Everything you read here should be considered fiction. Patient rights will always be respected. Any resemblance to persons living or not is purely coincidental.

Monday, April 2, 2012

EMT Class week 22 - Practice and Clinicals

Not much to report from class last week, we are running through stations to get ready for our practical exams.  Given that our first written exam is on Wednesday, I would rather do more prep for that!

Taylor and I hit the "big city" for our ED shift yesterday.  All I can say is - whew!  I'm glad we're done!

Nothing like being in a place where you really have no idea where (or if) you fit in, what to do, and where to find things.  We started our 10 hour shift at 0900 with a quick orientation by the the ER Tech.  Here are the rooms, the board, no you don't write anything down on the chart - just jot vitals on a piece of paper, etc.  And here's your vomit bucket filled with thermometer, BP cuff, PulseOx, and stethoscope.  When you're not needed, stand here.  Simple enough.

Yep, not so much.

Mr. Medic's suggestion rang in my ears, "You will be in the way.  Leave the docs alone.  Nurses you will just have to see how they react.  ER Tech is probably your best bet.  Try to shadow/emulate them.  And keep an eye out for that little old lady/man who comes in without any family or friends.  Spend some time with them.  Ask them SAMPLE and OPQRST.  The nurses will be happy someone is spending time with them and you will get a good history taken."

So Taylor and I are plugging along, grabbing vitals as asked.  The first room goes empty and the ER Tech starts to clean and make it up for the next patient.  "How can we help?"  Irene gives us the scoop - "Grab the disinfectant, wipe down the bed, pillow cover, counters, tray, floor if needed, coil up any cables, any sterile, unopened equipment goes back, opened goes in the trash.  New sheet on the bed, new pillow cases on the pillows. Trash taken out as needed."

Boom.  We've got an assignment.

Any patient gets discharged, we are on that room like white on rice.  Cleaning with passion.  Not much different from working on the ambulance, really.  Running to catch vitals when asked.  Grabbing coffee, water, sodas, sandwiches for patients when asked.  Otherwise just standing in our assigned space, waiting.  Sunday is not a very busy day, apparently.  There were almost always 4 rooms empty at any time out of the 20 total.  Seemed pretty busy to me compared with our regular receiving hospital which has 5 beds!  Taylor and I chatted quietly when we had the chance.  The hours passed.

Abner arrived.  82 years old, shortness of breath.  History of asthma and pneumonia, coughing, can't catch his breath.  All alone.  Dan was his nurse, and had a bunch of patients.  "Can you give me a hand?"  We were trying to get him to the loo.  When Abner stood, I noticed the watery mess on the sheet.  Then the smell.  I mouth "I think he had a BM" to Dan, behind Abner's head.  Oh boy.  Short, slow walk to the toilet.  We strip him down and begin to clean.  Caught myself gagging and started breathing through my mouth, and trying to keep a smile on my face (apparently the smiling counteracts the gagging reflex...)  Abner is embarrassed.  "I'm so sorry.  This is humiliating."  I assure him that there are no apologies necessary and we are happy to help.  Dan keeps rushing out for more supplies - wipes, a clean gown, an adult diaper.  I'm looking around for an exhaust fan switch - there is no fan.  He keeps talking.  Never stops.  His devoted family (none of whom are inclined to get off work to come care for him in the ER) his deep faith.  Getting old.  Living with a broken body.

We get him cleaned up, put together, and into another room.  I check in on him.  He asks for a blanket, something to drink, something to eat, a phone to call his daughter.  I help.  I listen.  I sit with him while the ER doc goes over the instructions.  Probably not over the pneumonia, here's some more antibiotics.  Daughter can't come pick him up for two hours.  Nurses move him to the hall 'cause we're running out of beds.  A roll-over accident is coming in by ambulance.  I make sure he has all his stuff and is comfortable.  I check in every few minutes and go chat whenever his eyes are open, just so Abner's not under the impression he's been forgotten, shoved into this back hallway.
"You have sown so many seeds of kindness today.  You will reap a bushel."
"I need all the help I can get." I replied "But being a heathen all my life tends to keep one out of God's graces. Well, maybe not a complete heathen, really a rebellious ex-mormon"
"I don't believe that.  You've sown your seeds of kindness today."
"That's probably the nicest thing anyone has ever said to me.  Thank you."  And I meant it.

Abner's daughter showed up after work.  We got him into the wheelchair with all his belongings.  The daughter looks exhausted.  Guess I can't just judge her too harshly - we all have lives to live and our own issues to deal with.  She wheels Abner out the door.

We're on to the next patient.

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