Lessons from Consults: Bad day

When the LEAST obnoxious thing that happens to you is that you accidentally rub sticky skin-prep fluid all over your stethoscope instead of sterilizing alcohol like you INTENDED to….

It’s not your best day ever.

Grab these, not the little swabs that look exactly like these.

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Published in: on July 29, 2010 at 11:25 pm  Comments (2)  
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Lessons From a Consult Month: Getting it done.

Nothing in the world like working up another team’s patient while standing in a puddle of his urine.

How do I love thee, urban county hospital? Let me count the ways.

1) Urine puddle.

2)

……isn’t that enough for now? Seriously, dude.

Published in: on July 10, 2010 at 11:59 pm  Comments (2)  
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Dr. Gritchhopper. Or, “Lessons From Residency Orientation”

-The worse the communication abilities of the speaker, the angrier they get when you don’t have a clue what they want you to do. And the more likely that they’ll blame you for the problem.

-There are fifty ways to say the same thing.

-Each way takes longer than the one before

-When you work for three hospitals, and two of them do a joint orientation, they don’t coordinate about subject matters. They just have one person from each hospital give a talk about the same topic. During which they say the exact same things. One after the other. Over and over.

-Even after a few years of up-close experience about the awful things people do to each other, pictures of babies with strangulation marks on their necks and full-thickness burns on their hands can still make me feel physically ill.

-I still can’t sit in auditorium seating without pissing off the people in my row. Darn foot-bouncing habit. This is why I never went to class once the lectures were put online.

-The prettier the day, the longer-winded the speaker. And the worse your mosquito bites itch.

-You can take pretty much any one of those stupid “comprehension tests” without having heard any of the orientation lectures. The questions’ wording leads you by the nose.

-There are an awful lot of statistics in the world that I just don’t care about.

-Hammocks make everything better….unless they’re at home and you’re inside in an endless orientation, dreaming about sitting in them in the perfect weather you’re also not sitting in.

-You have a serious problem if your orientation lasts from 8 to 6, three days in a row. It’s an even more serious problem if there is ABSOLUTELY NO INFORMATION disseminated in that time, and none of the MUST DO BY YOUR START DATE tasks get done either.

-There are some jobs that just shouldn’t exist.

-Paperwork is endless and Whac-A-Mole-esque. If you’re not careful, it’ll eat you and everyone you love.

Published in: on June 27, 2010 at 1:29 am  Leave a Comment  
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Lessons from ACLS

I’m studying ACLS this week! (That’s “Advanced Cardiac Life Support”.) Basically, what to do when someone’s heart stops. In a hospital, that’s called a “code”. I believe I will use the following procedure when I am called to run my first real code:

You know, except for that awkward not-really-love-scene-in-a-closet thing.

Anyway.

When performing chest compressions during CPR (Cardio-Pulmonary Resuscitation) during a code, you’re supposed to deliver about 100 compressions per minute. (Note: Spelling “resuscitation” correctly took me four tries….)

Major workout.

But, like all workouts, it’s better with music. Because who wants to learn how to count at a rate of 100 beats per minute?

So.

There are two songs that you can use to control the speed of compressions.

One, interestingly, happens to be “Staying Alive”.

The other, ironically, happens to be “Another One Bites The Dust”.

I guarantee you practically every healthcare provider has one of those two songs running through her head as she gives chest compressions. If she doesn’t, her ACLS instructor was likely a zombie. She was lucky to escape ACLS class with her life.

So, now you can sing along the next time you see someone on TV giving CPR! And if they’re doing it at the wrong speed, you’ll know! That way, you can mock them appropriately!

Let’s practice! (Some of these involve spoilers, I think.) Anyway, I give you: A Parade of CPR Absurdity!!!

Note: Guidelines change faster than the epidemiological spread of zombie-ism. So, when some of these were filmed, it’s possible that they were per the guidelines at the time. Some of them.

Added bonus: If you sing out loud, you can make your dog and/or significant other stare at you with an adorable, quizzical look!

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If you use this as if it were real medical information, I’ll start singing “Staying Alive”. I may or may not accompany myself with chest compressions. Regardless, it will not be pretty.

Lessons From Dermatology: Examination

Via the lovely and wonderful Ashley:

If you don’t know what it is, don’t touch it.

If you do know what it is, you don’t need to touch it.

Published in: on April 17, 2010 at 8:50 pm  Comments (3)  
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Lessons from the ICU: Job Satisfaction

Dear My Favorite ICU Patient,

I know you’re uncomfortable. It really sucks when your heart stops and you have to get CPR, and you have to be intubated. And it does suck when that means you can’t eat for a few days. And I know you wanted to eat something immediately after we pulled the tube. But we were worried that anything you ate would end up in your lungs instead of your stomach, and we’d be back to the tube and back at square one.

Usually, a cup of sherbet is not an unreasonable request. And it must have really sucked when we told you you couldn’t have one until we were sure that you could protect your airway.

I understand your anger.

But, may I suggest something radical?

Perhaps defecating into a bowl and flinging it at your medical team is not the most constructive way to express your displeasure.

I hope you feel better soon.

Love,

Dr. Grasshopper

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Lesson: When someone flings a bowl of feces at you while you’re working, and you still love your job…..that means you love your job.

Published in: on April 9, 2010 at 11:02 pm  Comments (2)  
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