My first week in review.

Lets talk day 1, shall we?

I am, obviously, new. I know where nothing is.  I am just getting to know my preceptor, just learning where clean holding IS, and haven’t even had time to browse it.

(I was at my last job for 2 years. for 300 nights I went to the same clean holding, grabbed the same things, and still couldn’t find everything on the first try. and then you have a new clean holding with supplies that look different. It is challenging)

They are getting ready to intubate a guy. He just came in with Resp distress, and bipap wasn’t cutting it.  I went in to watch, which is what you do on day 1, watch.  The med student starts to put in the tube, they give him a boatload of sedation, and starts to put down the tube.  He tries once, misses, pulls back and just as he puts it down his perfectly visualized cords, the guy starts... throwing up stool.

Have you ever seen someone throwing up stool? it smells, it is a weird consistency, and he was putting out A LOT! we had 2 suctions going, the dr stepped in to try to get the tube in and the guy goes into PEA and we start the nastiest code I have ever seen.  Every.Single.Chest.Compression (at a rate of 100/minute, mind you) was splattering this stuff out of his mouth while we tried to get a tube down him.  Once the tube went down him the stool started bubbling out of it (that is bad.)

I am standing there… holding up his gut so we can try to find a pulse with the doppler, and people keep asking me to get things, find things.  I know where nothing is, and fortunately other people were around to get it, but it made me want it to be 6 months in when I actually know how to find things.

We eventually got him back, and they started putting in central lines and arterial lines and dialysis ports (his magnesium was… like 9.  higher than I have ever seen it. normal is 2.5)  Eventually the doctor went in, told the wife what was going on and she said to stop.  pull the lines, pull the tube, let him go.  It took him less than 60 seconds after the vent was turned off to die.

They asked me if I had ever been in a code, to which I just laughed.  Yes, I think I have.   Leave it to me (known at pcu as the Code Queen) to have a code on day one.

Once I got home I took off my scrubs and found little splatters on my clothes, which is a perfect example of why work clothes only get worn at work.  nastiness.

Day 2 I had a patient with a bowel evisceration (she had parts of her small bowel sticking out of her incision).  I  thought it was kind of cool, my preceptor was freaked out, and the doctor didn’t much care, but still. Day 2.

Day 3 was boring.  Which was good after days 1 and 2.

I start nights next week.  I am kind of scared what is going to happen to my patients.