"Let's Roll"

Too tired to do much more work on this academic quarter's project on Home Health Care tonight.  My college has an excellent AAS program in Respiratory Care (contact me personally for details).  But this particular class in my senior year doesn't quite meet my standards.  The college is understaffed (surprise!).  Our dedicated department chief is teaching nearly every class for us seniors.  His solution is to assign pathology and health care industry topics to small groups of students, which we are to research and present to the rest of our class according to a standard rubric.  That works pretty well, and it's certainly all I could expect at $86 a credit hour at a state college.  But I sure would prefer to have a professor with expertise in cardiopulmonary pathology teaching our Path class -- instead of us teaching each other.  Still, I've researched these curricula within an inch of their lives, and this is honestly the best curriculum available in my state.  You can pay more, and spend more time, at some of our state's newly minted 4 year programs.  But this Associate's Degree Program is jammed to the gills with practical and academic content, and the new 4 year BS programs are basically our two year program plus a lot of entry level college core material.  I already have both a bachelors and post graduate degrees, so the last thing I want is academic fluff.

All the same, I sure wish we weren't teaching Pathology and Current Health Care Work Environments to ourselves.  On the other hand, since we are supervised while we do it, we are giving ourselves a lot of quality content.

Hauling off to bed now.  Have to leave at 0515 to catch a 12 hour shift at the teaching hospital where I work on a Limited Permit, an hour's drive from home.

Namaste,

Maize

"He can't hear a word you're saying"

Last week they called for Respiratory in the Emergency Department.  Since I'm a newbie who is mostly supposed to be doing floor care, I'm usually not available to run along for these -- even though they represent great learning experiences for me.  But this time I had finished all my treatments and charting, so I ran.

The patient was a big guy, apparently a drug overdose (party too hearty?).  He didn't respond to commands, but he was far from unconscious, flailing and moaning, and pushing the mask away with both hands.  It took a long time to get IV lines in, to get him sedated, to get restraints on him.  It became clear pretty quickly that we would have to intubate him.

The hospital was jammed that weekend.  There was only one ventilator left in the whole place (all the others were in use), and someone went off to find it.  So we were bagging this fellow for a long time.  The lead therapist's hands were getting tired, so I took a turn at the head of the bed.  The patient began to stir, then to toss his head, as the sedation was wearing thin.  I talked to him quietly, telling him where he was, what we were doing to him.  I told him to try not to be afraid, to try to relax as much as he could and to let me help him breathe with the bag.

The woman who was lead therapist on that response is someone who doesn't like me much.  I'm not her style at all.  She rolled her eyes and said, "Oh, for God's sake, Maize, you are so irritating.  Will you shut up and bag?  Believe me, this guy can't hear a word you're saying!" 

I'm a wise-ass by nature, but never at work.  Unlike my former work environment, smackdowns don't help the process in healthcare.  What I wanted to say was, "It's fun to pretend he's a person".  But I said, "Oh, we don't know that for sure.  I've been where is he now, and I could hear every word."  The other woman folded her arms and leaned against the cabinet.  "I guess no one can tell you anything, right?"

I kept bagging.  And I kept talking to the patient.  Eventually someone came along with more propofol, and the missing ventilator.

As someone who is new to allied healthcare, and as someone who has been a hospital patient from time to time, I object to the practice of treating a patient as if he were a pizza that had just been delivered to your workplace.  No one knows better than I do that we have a ton of stuff to do for a ton of people in not nearly enough time.  But it doesn't save time to act as if the patient is invisible.  I speak to my patients when they're awake, when they have tubes down their throats, when they're paralyzed, when their sedated -- and even when they're dead.  (I have a feeling they are still nearby somewhere.)  I'm learning a lot of things I can do to help, and I plan to keep learning.  But I'm still convinced the first and best thing I can do for a patient is to see them as a person -- a hurt person, a sick person, an unconscious person, maybe a dying person -- but a person.

Namaste,

Maize