October 16, 2007

Happy Tuesday

Do you ever catch yourself diagnosing people and they don't even know you're doing it? Scenario as of yesterday:
Miranda and I driving in the car:
Miranda: Look how big that guy's adams apple is! (Pointing with mouth slightly agape)
Me: Bejeezus! Maybe he has a thyroid problem (Staring at the humongous growth)
Miranda: I bet it's a goiter (she says with certainty)
Me: Yep, it's a goiter alright (I reply with certainty)
Miranda: Maybe we should scream out the window and tell him
Me: (Laughs hysterically at the thought)
Miranda: (Laughs hysterically too)
Me: I hope he gets that thing fixed. Ick.
Goiter guy thinks we're checking him out, winks at us and drives away. Maybe we made his day.

This occurs all of the time. What else also occurs is people calling me and asking me what is wrong with them and expecting me to know what to do.
Friend: I have this achy pain that shoots through my thighs sometimes. What is it?
Me: Well...it could be any number of things. Have you done anything to strain it lately?
Friend: No
Me: How often does it happen?
Friend: Only after I run up the stairs several times a day
Me: (blank stare)
Friend: Well...do you know what's causing it and what do I do?
Me: Um... get a house without stairs

I was on call in labor and delivery last week and we had a pt who was demanding to have an induction THAT day. She was only 36 weeks (not full-term)and not in labor. She said was in so much pain she couldn't take it any more. She was crying and seemed really depressed so I decided to go in and talk to her.
Me: Hi, I noticed you were upset. What is bothering you today? (Note how I'm using the "therapeutic techniques") Ha!
Pt: (sobbing) I'm hurting and I can't take it anymore
Me: Where exactly are you hurting?
Pt: (pointing to her fully round belly) Right here.
Me: What kind of pain is it? Is it stabbing, aching, shooting or cramping pain?
Pt: No, I just feel REALLY full all of the time. I can never get comfortable and I am constantly going to the bathroom to pee.
Me: Um, Uh...
Pt: (sobs more, complete with hiccups. Boyfriend is mopping her brow with a cloth)
Boyfriend: Isn't there something you can do? She said she can't get over feeling full all of the time
Me: Um..She's pregnant
Pt: I just want to have this baby today! (Sob, sniff, sob, sob)
Me: You are only 36 weeks and you are not in labor yet. You do know that at 36 weeks, your baby isn't fully developed and isn't ready to come out?
Pt: I had my last baby early. He was only 4 lbs and he's fine! (yell, sob, sniffle, gives pleading look at boyfriend to do something) Boyfriend shrugs and continues mopping her brow.
Me: (blank stare) Can I get you some ice chips?


Yesterday I had to return to the dungeon. I was there 8 hours. I hate Mondays. We have our next exam next Friday (26th), I hope I pass this time. I just discovered that although our final is on Halloween, we still have our last clinical the day after. So much for throwing a party. I'm so ready to start my precepting hours so I can get my hands on some real patients. In L&D and post partum we haven't gotten to do a lot. It's been kinda boring...nothing like I thought it would be. So, more than likly L&D isn't the field I want to venture in. Do you see how much I change my mind? During my on-call hours I did get to see a delivery (not the one mentioned above. They sent her whiney butt home). I cried when the baby was born, probably more than the mother. I'm a big ole baby, I can't help it. It was emotional, and beautiful and messy as hell. Giving birth is a bloody business. More bloody than the leg removal I witnessed. Oh, and the placenta...it looks like a liver. It's very vascular and I couldn't stop staring at it. It was almost as big as the baby. Groovy. The baby was 9lbs and 10 oz. Talk about a big ass head. When the head popped out, it looked like an adult sticking out of her vagina. I cringed inside at the pain she must feel. The girl didn't even flinch. Damn, who said women didn't have balls?

Sigh. I'll probably just start in Med-Surg (the melting pot) and choose a specialty from there. Also, I decided to wait until after Christmas to get a job. For one, I don't want to work this Chrismas, and two, I want plenty of time to study for the NCLEX, which I think I'm taking in January. I still have no clue as to what review course to take, there are just so many. Kaplan, Hurst, Saunders, Lipincott. So many choices, not to mention they're about $250-$350 bucks per course. Most people say that nothing can prepare you for the test, so if that's true maybe I'll just rest on my haunches and do nothing. Does that sound like a good plan, choosing to not have a plan? But, is not having a plan in essecnce still having a plan? Maybe I'll choose not to plan to not have a plan ,but then is that still a plan? GOSH DAMNIT it anyway! I hate plans. And by the way, who ever came up with the word - plan? Plan is a dumb word. It's about as dumb as corn or pork. (inside joke -wink-)

9 more days, la la la. 9 more days, la di la la. I technically have only 9 days of school and clinical left. I can't believe this is finally happening. It doesn't seem real. I'm ready. I was ready 3.5 years ago, but I'm realllllly ready now. We've done all of our skills, we have none left. That is a great feeling. I still have 2 tests to take, 3 papers to write, Wellness day to plan and 3 more clinical days...all in 9 days. Wow, we.......are.......so.......screwed. Ah well, I can do this. I will get through this and when I'm finished I will look back and feel tired, because that was hard freakin' work. I will graduate with honors. Can you believe it? I recieved a letter from Phi Theta Kappa (National Honor Society) and was invitied to wear the tassles. I am honored and will wear them with pride because I have worked my little booty off, and aside from the tassles, I also deserve a gold dipped, diamond encrusted, sparkly ass cap and gown too, as we all do. In honor of our graduation, the 3rd year class is to throw us a graduation lunch this coming Friday. We planned this the year before for the graduates and it was a nice way to say farewell. It feels good to be on the recieving end of it all for once.

I had better start writing those papers now since I have the day off. Don't want to procrastinate to the very end. I do have some semblance of pride in my work ya know. Now, If you believed that then you'll also believe that I have an ocean front property in Arizona.

Please ready Aidan's site for a new update. Have a great Tuesday!