Saturday, August 29, 2009

They Appreciated My Patronage By Slashing My Luggage to Bitsies

I have arrived safe and sound. The journey from Canada to Ireland was not without some of the expected twists and turns..and a couple of unexpected twists thanks to some awesome American Airlines baggage destroyers handlers and theiving thorough customs inspectors.

BUT! Overall life is good. I will post more tomorrow once I meet my roommates...eek!

Tuesday, August 25, 2009

Who Knew?

Who knew moving to a new country and starting school there was going to be such a tedious process? I have to keep taking a breath and reminding myself that I wouldn't be going through all this stress if I hadn't gotten into medical school. I guess I ought to be down on my knees thanking the admission GODS that I am spending my final days in Canada standing in line at the car registration place instead of drinking wine spritzers on a deck somewhere surrounded by the adoring faces of my friends and family. Yes. That is how it ought to be....

It is weird, I feel like I am jumping into a black hole. No idea what to expect from school or life in Ireland. My apologies for the dearth of posts lately but I have been staying in my mothers basement (which looks like it has been occupied by a schizophrenic who is conducting a garage sale there...) and she has DIAL UP (horror of horrors) and her phone was recently on the fritz. Frustrating? Yes. Life threatening? Almost. Speaking of mothers, I believe there is a direct relationship to the distance one is moving in relation to the degree of smothering that occurs.

More packing and unpacking to do. Two days until D-day.

Monday, August 17, 2009

My Last Shift as an Educationally Unadulterated Nurse

I finished my final contract up North on Thursday. Suffice to say it has been quite an interesting summer up there. The majority of the docs were very supportive and excited about the fact that I was going to medical school, and thus gave me as many teaching opportunities and hands on experiences as they could.

Last week I did my first subcuticular sutures with a facial laceration (under the direct observation of one of the MD's). I was brought back to one of my first shifts as a nurse in the ED when this patient came in who had been hit in the face with a broken beer bottle. His cheek was basically hanging in a flap about the size of a coffee-table coaster, off to one side. He came in from the bar hollering some story about how he had just been breaking up a fight between a man and a woman, how he'd been minding his own business, etc. etc. Amazing how he didn't work a burning bus and saving a poodle into the whole chain of events...regardless, his face was a mess.

I tried to watch the ED doc fix up this man's face. It involved many many subcuticular sutures and the whole laceration was very large and seemingly complicated. I had to keep leaving the room for fresh gulps of air because looking at this guy's cheek-hamburger was just a little much for my young nursing eyes. I was fascinated and totally impressed at this physicians ability to restore this man's face, but the 'everything-going-red-in-the-corner-of-my-vision-is-that-the-spins-now?' part was forcing me to step outside from time to time. When it was all finished, he had one line of sutures falling along his laugh line, from just beneath his eye crease to the corner of his mouth. It looked fantastic. I recall thinking--I really wish I had the skill and stomach to do a repair like that.

Fast forward 6 years--HEY! I did it!

It was by no means as beautiful and artistic as Dr. S's repair many moons ago. But I suddenly realized that I was doing a procedure that I could hardly watch in the past*. It was an exciting night for me and I was very pleased with how the final product turned out**.

These confirmations that I am doing the right thing by choosing to go into medicine are coming faster and with greater frequency than before.

During my last shift as an unadulterated-by-medical-school-nurse one of my colleagues commented on the fact that I was entering a different phase in my career which had no turning back.

It is true. I've thought about how from now on I will have one foot on the lily pad of nursing and one on the lily pad of medicine. I think there will be times where this divide is going to make for some interesting interpretations of my role with patients and co-workers. I wonder how I'll feel the first time I ask someone to do a task that I am normally expected to do. Why would I ask a nurse to put in a cath when I can do it myself? Or put a dressing on when I can do it to my liking in less than one minute?

I know these issues are a long way off as when I return to Canada to work in the summer I will be working with the constraints of my nursing license during the day, and trotting around behind docs as a med student by night. Still, I wonder how others have made that transition.

I was in the shower the morning of my last shift. I could feel a small lump in my throat as I thought about all the wonderful colleagues and friends I would be saying goodbye to. Life, so far has been nothing if unpredictable and though I do plan on returning to the ED I once haunted, who knows when and how that will happen.

Nursing has done me well and I have learned many many valuable lessons about standards of care, the focus of the different professions within health care, the opportunity for nurses to develop unique bonds with patients and family members, and the importance of having strong and super-smart nurses on the floor with you.

I have had the chance to visit remote parts of Canada and India because of nursing...I was able to work 6 months a year and travel, ski, cook, and climb the other 6. Overall it's been a sweet gig and I cannot pretend that I will not miss many aspects of it.

And so, in less than 2 weeks now, a new chapter begins. I hope that I will be able to continue with some interesting content on this blog...but if past performance is any indicator...the postings will start rolling out as soon as the studying is supposed to start (note last summers daily blog postings as I was meant to be studying for the MCAT).

Thanks for coming along for the ride.

*This bodes well for when I get into the OR, but that is another story altogether.
**Photo taken and used with patients permission.

Friday, August 7, 2009

Just When I Thought I HAD Seen It All...turns out I hadn't...

Yes indeed dear blog readers.

Blister guy came BACK to the ED today.

His chief complaint: "infected blister?"

I call him to triage.

"So...what brings you in today?? Since we saw you here yesterday for your blisters..."

"I wanted to come in 'cuz my blister popped, thought I should get it looked at."

*She walks into med room and hits head as hard as possible against narc cupboard in an effort to wake herself up from the reoccurring nightmare of 'worst abuses of emergency departments which I pay for with my hard earned tax dollars'. Yet she doesn't wake up. And then she hears screaming and soon realises the screaming is coming from her own mouth.*

I wish I was making this up. :)

Thursday, August 6, 2009

I Can Now Retire as an Emergency Nurse--I Have Officially Seen It All

I've learned not to roll my eyes at a chief complaint when I pick up a chart in the ED. Whenever I have done this it always comes back to bite me in the ass.

Like the time I rolled my eyes when I saw the cc was "sliver". When I called the patient in I could not hide the 'are you kidding me?' in my voice when I asked him about the 'sliver' that brought him to the department.

He calmly rolled up his sleeve to reveal a piece of wood thicker than my thumb just under his skin from his wrist to elbow. Yeah, he worked in a lumber mill and a piece had gone flying off a piece of machinery and into his arm.


Lesson learned.

So today I picked up a chart and see "blisters on both feet" as the chief complaint.

I am starting my mental diatribe but then caught myself--assess the patient, he probably slipped and fell into some hot oil and has full thickness burns to his feet or something...

But no.

He had a blister on each foot from walking. Right on the heels.

I had to ask why it was an emergency.

"Because it hurts to walk on them so I called the nurse line and they told me to see a doctor".

*She throws in the towel and walks away, shaking her head*.

Tuesday, August 4, 2009

A Non Sequitur Completely Random Quote That Made Me Laugh

This was written in the 'comments section' of one of my favorite blogs:

“The problem with both karaoke and nudism is that it’s usually the wrong people.”