09 September 2010

Each day has a theme: Eye Day to Abscess Day

My first day of rotations, don't I look cute/ terrified?
"it wasn't their swords that took the land
It wasn't their power that gave them victory

But it was your great power and strength
You were with them
because you love them"
Ps 44:3


Day 2: (eye day)

I started the day off getting my #2 #2… (2nd DRE) Eeew. Then moved on to a male GU exam and a pelvic exam. Fun.

I got to play with a woods lamp.  And then do an eye exam on my own (after watching the Dr do one)

We were slow just after lunch so I played with a suture kit and sewed up some gause.  Then the afternoon raced by with a bunch of patients, some semi-acute things (heart attacks, strokes…) and some not-so acute things.

I diagnosed otitis externa, which I had never seen before.

Then I got home, realized I forgot about Tango class (I didn’t think about today being Wednesday.) Then my internet broke (again) and now I’m going to bed at 9 pm because I hate life. Basically.


Day 3:
Pelvic Exam.  X 4

My first LAC!! Got to do 4 stitches (I was nice and let a 1st year resident do a few…but I totally had to teach her how to use the instruments to tie because she used the “two hand tie technique,” which should really be called the “waste suture material and tie like a granny that sews technique,” It was neat to have that skill!


Day 4:

LAC day!!

I got to put 12 stitches (2 internal) and 10 external in a lady with a huge lac on her leg. We did a few horizontal mattress sutures and some simple interrupted.  Then I did a digital block and stitched up a guy’s finger ALL by myself! No help.  And it looked good!

I also saw a MCL tear (diagnosed it by my self)

Saw a kid with (possibly) low platelets. Nosebleeds, petechiae, but ear pain and headaches.  I had to leave before the bloodwork came back. Which is the sad part of ER, we don't get to follow up on patients.

Then I did another pelvic exam, a lady with elevated liver enzymes (ast/ alt with 4 digits!) acute hepatitis, and saw some kidney stones. Oh, and an exploded lightbulb in a guy’s hand…

Day 5 (week 2)

Monday was abscess day. EEEwww….an abscess is kinda like a big pimple. Except they can get HUGE. And just like pimples, they are really painful. Which is what brings people to the ER with them.

But before I had to deal with any abscesses, I got to watch a code blue, which is full out CPR with Defibrillation. Only it was the end of the code. They had tried everything, but the man's heart was failing. They did an Echocardiogram (Or ultrasound, the same machine they use to look at babies inside their mom's belly) to look at the heart and the doctor decided the heart wasn't going to make it. Then the heart lost all of its electrical activity. (imagine what it looks like on TV when the machine recording the heartbeat, an EKG, makes a flat line and a long continuous beep). That was just how it was.

I didn't know what to think.

I didn't know what to do. So I just stood there. A nurse ran down the series of events with me, explaining how codes usually run. Then they started to cover the body with a sheet and take out the tubes and I just watched. Then I walked away, unsure of what to think, how to react.

What are you supposed to do when you watch your first person die?

I wandered to the bathroom, then back to the part of the ER where my preceptor was located. She threw me a patient's chart and asked me to see them. So I did. And decided I would think more about the dead man and his family later.

A bit later that day one of the new PAs walked me through cutting open an abscess. Yuck. I really wasn't sure about it, but he talked me through step by step, so I felt good about it at the end. And later that day I got everything ready and did one by myself with him watching. I also got to sew up another finger laceration. I'm getting pretty good at those! Sweet stuff!

That night I had small group, and we went out for FroYo! Yum! I got to share with them about my day…abscess day…and talk about the code blue. It was good to share with girls and process the day's events.


Tuesday I worked 11am-11pm. Except Tuesday didn't really have a theme. Maybe I'll call it coffee day because the PA I was working with walked to get coffee and I went with her. I had no idea there was a starbucks inside the hospital! So I got a caramel macchiato, yum!

I got to drain another abscess, sew up another big cut on a finger (except the man was in a lot of pain so I had to give him A LOT of lidocaine!), do another few pelvic exams, and see a bunch of patients.

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