Friday, January 18, 2008
I'm in the midst of my geriatric rotation. We're on a telemetry floor and so there's lots of talk floating around about how to read the EKGs: Is it a second degree block or is that atrial flutter (I was really tired during report and I wrote "atrial flooder" in my notes.)? Could it be a winky-bock? (No, that's not how it's spelled, but I like it better that way) Is that two P-waves? I can't keep it all straight and all of these things might be the same thing. I was just happy to be able to point to an EKG print out and describe the mess of lines at one part as "artifact" (that's stuff that is not meaningful and happens when a patient is wiggling around excessively, say). When I'm bored I go hang out w/ the EKG tech and ask 'em questions:
( "So, uh, do you get hypnotized watching all of these patterns?" And this one got a really good answer and I suddenly really liked the fellow and my respect for EKG techs multiplied by, like, 150. "No. Because I put a lot of the leads on the patients myself and I know what heart meds they're on, and I know w/ Mrs. K. here that when her heart rate drops to 35 it's OK unless it stays at 35 and I know that 110 is a normal rate for Mr. H. over here." In other words, he was connecting these squiggly green lines on the screen w/ the patients behind them and he was paying attention.)
I hung out and got to be "Nurse Leader" tonight w/ a fellow student. That meant, essentially, that we got to help other students and nurses on the floor w/ their patients, but it mostly meant that we spent a lot of time looking stuff up using the other student's HUGE number of resources. She had books; some flippy ones that were in her pockets and some bigger ones that were in her backpack. Most of the books had handy and colorful tabs on the side labeled as "IV" "pediatrics" "procedures" "emergency" and other handy things. She had a palm device (um, a Palm device maybe) w/ a poke-y stick that she tickety-ticked w/ and all kinds of useful info came up: Yes, Haldol can cause neuroleptic malignant syndrome. Here's a third degree heart block EKG, right here, see? SHUT UP: cranberry juice can interfere w/ coumadin? It made me aware that I'm under-info-packed out there on the floor. I have a barely-used flippy RNotes crammed into my backpack and sometimes I'll bring my drug book.
It was a good night, though. Monday was a hard night. After I took care of my patient, went to dinner and came back her family told me they didn't want students taking care of their family member anymore. Um, OK. They wanted someone more efficient, apparently. Sigh. I went home and fretted about all of the things a student nurse, mom and all around busy person frets about and cried and now I'm feeling better, but mostly it's because it's a three day weekend and I might have time to relax and clean the house and do some extra-curricular reading on heart arrhythmias. See, I know how to have a good time!