freaking best day of clinical EVER.

It was all Luck, but I definitely got the better deal this morning. Upon arrival to the ICU, I was ushered into a room of a patient who did not tolerate cardiac surgery well. One peek at the client's cracked open chest and the bypass machinery was all I needed. The charge nurse must have been a bloody good telepath because even though I feigned fascination, my heart was elsewhere.

Heh.

She suggested that I make my way to the other side to observe another cardiac case where one couldn't directly visualize the heart. I left my classmate to observe where we were and made my way to the other side. My nurse had two patients whose combined diagnoses and treatments summed up my entire semester of learning: droplet precautions, influenza, acute renal failure, ventilator (PEEP), central line inserted into the femoral artery, NG and OG tubes... the list goes on and on. Plus, I could not have asked for a more patient or opportunistic teacher.

I was pushed into a room (and some poor med student) to watch an extubation. I was asked to discontinue a nasogastric tube. I have good form. I'm a compassionate soul because I got the client tissues. Oh, no. I just have Professor Seabury forever in my brain. If I thought that time I shot hot coffee out my nose hurt, imagine HCl, a much stronger acid, burning my mucosa. Nooooo thank you.

"Have you ever done a blood draw from a central line?"
"Not on a human."
"Gown up."
"Wha--?" and miraculously, a gown flew at my head at an alarming speed. Remember that skill I was nervous to perform as my skills final? yeah, that was it. But A put me at ease, even when I thought out loud about how it was disconcerting to feel the warmth of the waste blood I withdrew for the first time. The Sim Man doesn't prepare you for the heat. Both she and the phlebotomist got a kick out of
that one. Ha ha, bodies are warm. Got it. It was a rush, like meeting a celebrity. I suppose I'm lucky I didn't say to the central line, LIKE OMGZ, I SAW YOU ON THE INTERNET. But by the end of the day, I had done it three times, so the butterflies were gone. Oh, yeah, Joseph Gordon-Levitt and I have had lunch three times. We're old friends now. No big deal.

Actually, huge deal. I think if I met Jospeh Gordon-Levitt for lunch three times, I'd still geek out a bit. I might be a little better at hiding it by then, but I love him.

Later, I administered medication through an OG tube, another of our lab skills. A asked me how to check for placement. I gave the textbook answer: aspirate gastric contents and check the pH level with litmus paper. A laughed and asked me when the last time I saw litmus paper was. I panicked and said, "Miss Sladik's eighth grade science class." A doubled over with giggles this time. Okay, then how do I check for placement? Auscultate over the epigastric region while administering an air bolus quickly, listen for a swoosh. Yeah, buddy. A appreciated my technique and adherence to proper procedure. Well, yes. I would like to practice in a safe and responsible way and exude professionalism. But also, I lack the creativity to be properly lazy.

We ran back to the med room and each prepared an IV med. my line didn't have a single bubble. I wish my clinical prof could have seen it. She probably wouldn't believe it. We go to hang both bags, and the pump is whining about a bubble in another line. I went to work right away, flipping the bag upside down and flicking the bubbles back toward the bag of solution. If nothing else, growing up with four brothers made me an excellent flicker. Still, it was slow-going. A asked me if I wanted to see a trick. Always, yes. She clamped the tubing beneath the offending bubble, attached a syringe to a Y site between the bubble and the clamped portion, sucked out the bubble, detached the syringe from the Y site, pushed up the plunger to dispose of the air bubble, reattached the syringe to the line, and shot the collateral solution back into the line, so the client didn't lose any medication.

I was thoroughly impressed. So much easier than flicking a bubble back up three feet of tubing, I'll tell you that much right now. I was so engaged, that I didn't realize it was time for me to go until I was 35 minutes late for post-conference. I rushed out of there, forgetting my Hoops and Yoyo mug in the break room. Oh, shucks. I'll just have to go back.