Wednesday, February 3, 2010

I Do More Before 11 a.m....

So today I defibrillated someone (successfully), taught another person how to use their inhaler, took peak flow readings, conducted a chest pain assessment, a respiratory assessment, diagnosed an otitis media, performed a prenatal assessment, did a peripheral vascular exam, and carried out a Rinne/Weber test. All in 6 minutes or less each. All on actor patients or models (as in dummies, not Kate Moss).

But my proudest achievement of the day: a 6 minute speculum and bimanual vaginal exam. WHO knew it was possible?? I swear every time I have done those things in the real world it takes me about 20-25 minutes! I got the 'one minute' warning bell with the speculum still in and somehow managed to take the speculum out, get new gloves on, get the lube out, and talk my way through palpating the cervix, adnexa, uterus, etc. in time.  All I can say is thank goodness that was on a plastic dummy not an actual woman.

Yes, today was the mock-OCASE. I can't remember what it stands for but it is basically our clinical skills exam. My mind did go blank at a few key moments (like midway through the respiratory exam I forgot to auscultate for an apex beat, I left out the modified Allen's test during the vascular exam--even though the examiner was like "what other tests would you like to do???",  and nearly forgot to ask the prenatal how many weeks gestation she was!) Egad. Aside from the wardrobe malfunction during CPR (administered on the floor) where I am pretty sure the HEAD OF THE EMS saw my underwear due to blouse coming un-tucked and blazer riding up my back, I think overall things went pretty well.

I am going to watch an episode of "Bodies" now to reward myself for a job well done.


OMDG said...

Yes, but if you had adjusted your clothes so as not to flash anyone, your CPR wouldn't have been up to par.

Doctor D said...

Worse wardrobe malfunctions than plumber-butt have happened during CPR. The good news is that in a real code everyone is too busy to pay attention.

Also if your examiner thinks and Allen's test should be a part of every cardiovascular exam then he is the one who should fail, not you.


Fordo said...

Way to go!

Did you get to observe your classmates as well? Or was it only you and the examiners in the room? I'm curious if you did better because of previous clinical experience.

Albinoblackbear said...

OMDG--True. It shows the dedication to my craft.

DD---Woah woah woah...I didn't show 'plumber-butt'! I *may* have flashed some undies but there was no crack.
My CVS examiner was totally trying to stump me--he was being evil--which was why I forgot the modified Allen's.

When I relayed the wardrobe malfunction to my anat partner he found it quite hilarious that at some point during a very stressful exam I actually wondered "am I at least wearing nice underwear today??"

Fordo--No we were all in separate cubicles so I only heard self-reporting from classmates as to how they felt they did.

I definitely have an advantage with history taking--like my first station today was chest pain assessment. Ok, as an ER nurse I would do 30, 40 of those in a day when I worked in a big tertiary hospital. If I can't do one of those with my eyes closed, backwards and upside down I should be ejected from medical practice! :)

simmers said...

You shouldn't feel the least bit surprised about your speculum timing. What, you ask, do I know about speculums (besides once having one in my cutlery drawer to shock company)?
Well...just ask the guys in your group. When it comes to a new vagina, it's not unheard of to complete your task in under 6 minutes when it 'usually' takes 25.

Just think of it as getting in touch with your masculine side.

Anonymous said...

Wait... Kate Moss isn't a dummy?

Rogue Medic said...

All I can say is thank goodness that was on a plastic dummy not an actual woman.

How did you know that was my dating motto? ;-)

Either the panties should have the school logo or you should have a G-string with a bunch of folded money tucked into the waist band. Of course, a real G-string is all waist band.

WV - nonrear? These Irish word verifications are awfully suspicious. Must be the Leprechauns.

Albinoblackbear said...'re right. And I suppose that some would spend considerably less than 6 minutes even if it was a plastic vagina. Hmmm...never thought of it that way.

Please tell me Leena had something to do with your acquisition of a speculum. If not, I don't think I want to know...You know, you could potentially use it in the kitchen (the metal ones) to check how cooked a chicken or turkey was, perhaps?

CH--I was going to say that I don't know if Kate Moss is a dummy or not but then I read this quote by her when recently asked about her clothing line, "I'm not really a fashion designer. I just love clothes. I've never been to design school. I can't sketch. I can't cut patterns and things. I can shorten things. I can make a dress out of a scarf.”

Deep. And explains so much.

Whatever, I guess jokes on me, the woman probably has an employee whose sole job is to slice rice cakes into bite sized pieces for her.

RM--why is it that I completely missed the obvious opportunity for innuendo when I posted about a plastic vagina??? Does that mean I am getting old, prudish, and curmudgeonly?

I dunno, the cash on the waistband might give off the wrong idea...I'm thinking of printing "mens sano in corpore sano" on the back of every pair from now on for future test days.

Rogue Medic said...

I can shorten things. I can make a dress out of a scarf.

She can shorten things?

Oh, wow. I am in awe.

For her a scarf is practically a mumu, so making a dress out of a scarf is no big deal. Can she make a scarf into a dress for someone larger (and possibly smarter) than a Barbie doll.

Old, prudish, and curmudgeonly?

Ooh, Baby. Type dirty to me.

Write it on a label? Nah! Go for the tramp stamp in Latin. Or in Gaelic. To double the irony, go with Lasciate ogni speranza, voi ch'entrate. ;-)

Bostonian in NY said...

Sounds like a fun day...remember that you're learning to do the ENTIRE exam in one shot, which is not realistic at all.

and a 6 min pelvic with spec exam??? It usually takes me about twice that to figure out the damned stirrups and find a clean spec...never mind finding that cervix in my typically 300lb gyn patients.

Albinoblackbear said...

Rogue--I know, she's got some mind-blowing talents... ;)

Tramp stamp. Love it.

BINY--I know, I just chuckled at the unrealistic expectations my 'performing pelvic exam' virgin colleagues are going to have. "What you mean when you slide the small speculum in it doesn't always immediately present you with a perfect shiny cervix 4 inches directly in front of your gaze??"