Wednesday, March 5, 2008

Week 8 and Still Alive

I haven't posted in quite a few weeks, but it's for good reasons - not getting my ass in trouble. I've been somewhat conflicted about whether or not I'm "allowed" (from a HIPAA/legal standpoint) to post about patients and specific stuff that I experience while in the hospital. Of course I'd never use a patient's name or even initials or any possibly identifying information, but who knows. I'm sure I will post about other things that don't directly pertain to being with patients, but right now it's probably the most interesting thing I'm doing. But anyway, I wanted to post about what's been going on anyhow. I talk far too much to be quiet now!

Today I was on the surgery/operating floor. As a student nurse, there is really nothing I can do in an operating room - there are too many guidelines and rules (as there should be when someone's insides are on their outside) and so it's too risky to have us poking around. But! I got to insert a Foley catheter. And it was glorious! It was on a sedated patient, which is perfect for a first time catheter insertion. I was able to take my time, and the RN I was with even set the whole thing up for me. Let me tell you, urethras do not, at first glance, look like they should have tubing the size of my pinky finger shoved inside them. I could say more about inserting a catheter into a real human being and how real people's undercarriages are different than a mannequins, but I'll spare you all the details. Moving right along...

I had my first ever experience with a true life monster - and it was a CRNA (certified registered nurse anesthetist) of all people! Okay, CRNA's are supposed to be the best of both worlds - a registered nurse (caring, compassionate, understanding of holistic care) and also an anesthetist with the knowledge to skillfully put someone painlessly and safely through a surgery. This woman was truly a nightmare though - but first I'll briefly describe the patient situation. The patient was an older aged woman who spoke only Spanish. However, the CRNA ( I will call her Rudolph [get it.. RUDE-olf? ha... ha..]) was convinced the patient "knew more English than she's letting on." While the patient was being read the consent forms by a translator, the CRNA came to the foot of the patient's bed and said to a doctor, "Jeez, have you seen her belly? A few too many tacos and burritos if you know what I mean!" I ignored her, having been warned by the RN I was with that she was a little rough around the edges. The patient's IV was started and she was given Versed (a sedative and situational amnesia-inducing drug commonly used before the "real" drugs are given for general anesthesia) so she was awake, but not alert by any means. To save time and make a long story short, here's a list of all the crap Rudolph did to the patient.

1. Screamed at her with a god-awful goat voice and her mangled version of Spanish. "Mas! Mas! Andale! Open su boca! No, not su ojos, su BOCA! Can't you hear me?" and so on.

2. Damn near slapped her face to wake her when the surgery was over, and screamed "Réspire! Réspire!" which quite possibly isn't even a proper Spanish word at all.

3. After turning the patient on her side as was necessary for the surgery, the patient's top arm was very awkwardly crumpled and shoved under her body, so I moved it and set it more comfortably. Rudolph snatched the patient's hand and shoved it back where it was, and yelled at me "Trust me, I know what's comfortable for a patient! And wherever the patient puts their hand is where they want it!" How a fully sedated patient knows where they "want" the body parts they aren't even aware of is beyond me.

4. After shouting "Open su boca!" to the woman prior to intubating her, when the patient didn't respond, the CRNA then so forcefully held open her mouth and shoved the tube down the woman's throat that I was sure she hurt her. When the woman was moved to the side position for the surgery, blood trickled out of her mouth and needed to be suctioned. This made me ill, and I bit my cheek to keep from crying seeing the way the patient was being treated. So I asked the CRNA why there was some blood trickling from the patient's mouth. She gruffly said "Oh I don't know! It was probably her dentures.. or something... Who knows with these people!"

5. She also yelled at me unnecessarily a few times, but it's beside the point (yet also says something about the type of person she was.)

I don't mean to be scaring anyone, but I needed to get this crap off of my back, and there's also a part of me that really wants the world to know to be ever so careful in choosing their surgical team (yes, you do have somewhat of a choice in your surgeon and anesthesiologist!) I watched another surgery earlier in the day (an open heart surgery... it was incredible!) and the "heart team" as they're lovingly called were very competent and pleasant (as was the rest of the second surgical team I was with aside from Rudolph.)

Turns out I have plenty to talk about I guess. Next week I'm learning to start IVs and give IV medications. After learning those skills, I'll have all the basics of a real nurse! Hopefully I'll never lose my innate skills (empathy, kindness, etc.) and become jaded and racist like some people I've met - I'm looking at you, Rudolph!


parenting noobs said...

Gosh! That's motivation to stay healthy! What a bitch!

Adeel said...

CRNA should get some job she likes & is good at! oh and probably get a heart transplanted! total bitch!

dr. a

Felix Chesterfield said...

My neighbors are nurse anesthetists and they have nothing but good things to say about the CRNA jobs at United Anesthesia.