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Two Weeks And Still Keeping The Job

Well, I've survived the first two weeks of work, and they haven't fired me yet. Quite the contrary, apparently they seem to like me.

Really, the worst part was the first week. I had three full eight-hour days of orientation, and let me say that although being paid was a good thing, it almost wasn't worth the pain of those three days. My friend Scott, a colleague from the Big D who came here for his travel assignment only to be cancelled three weeks in and then rehired in the same unit as a seasonal worker, was in the orientation class with me. We figured out how much we were making for every minute that we suffered through the class, and that was enough to survive the experience. Rarely do people have to suffer such excruciating boredom, and even more rarely do they live to tell the tale.

At any rate, the three days finally ended, and then I was working on my own. My first two patients were quite easy, neither cardiac patients really. They had cardiac history, but they had respiratory issues that kept them in the unit, so it was like working in a MICU. That day went quite well; I even walked one of the patients several times in the hallway so that the boss could see that I was working.

Ah, then this week came along. It wasn't a bad week, by any stretch, it was just really busy. Perhaps the trauma unit up in Madison was a little more busy, but this unit is busy as well. Of course, working in a cardiac unit, there are a lot of patients that I'm not allowed to take care of. These are the patients that have all of the cardiac equipment, such as the LVADs, RVADs, BIVADS, Tandem Heart machines, balloon pumps, those sorts of things that require completion of a competency course and test just to even think about taking care of them. So, I end up getting the patients who have been in the unit for a long time. These are patients that I'm very familiar with, and comfortable taking care of, even with their cardiac histories.

Then again, sometimes these patients can be incredibly busy. My first day taking care of the particular double that I kept all three days, one patient was extubated and reintubated (the breathing tube was taken out and replaced later) during the course of the shift. This isn't normally a big issue, but when you are not familiar with all of the protocols surrounding such events for a particular unit, it becomes more stressful. I kept pretty busy that day.

The next day was only busier. The doctors decided that the patient who had been extubated the previous day needed to have a trachestomy, so we did that, at the bedside. It was really interesting to watch, but it set me back four hours, since they proceeded to replace all of the central IVs as the patient was already paralyzed anyhow. I ran around madly all day, my only comfort being that the boss was there and actually felt sorry for me, thinking that I would have a bad opinion of the place. Really, it was quite the opposite, I really like being that busy, I like all the activity and bustle and cool stuff going on around me. Plus, they let me be the stand-in anesthesiologist, and were even going to let me extubate the patient as soon as they cut the hole in the trachea (the tube in their mouth was being replaced by a tube in their throat), but the attending nixed that idea when she found out. Too bad…

I really ran that day. I only got to use the restroom twice in the 12-hour shift—at the beginning and at the end. I ate lunch at 5:30 in the afternoon, basically devouring a plateful of food in ten minutes. It was fun, though. Even better, I started to see a trend emerge around me. I started to notice that there are a lot of really smart folks on the unit, including the doctors, the PAs, and the nurses. They are a sharp bunch. Plus, they really back each other up. I'm not even a part of the group, and there were people asking me the whole day if I needed anything. I felt pretty inefficient, as I do the first week of any assignment until I start to get a real good feel for the place, but unlike at the Swiss Cheese up in Madison, they backed me up and I wasn't worried. It's a good thing when a unit cares enough for their patients that they wouldn't put them at risk by allowing someone to become overwhelmed.

The third day was much less busy, all the hard work had been done already in the previous two days, I was more in a holding pattern. These are long-term patients, once you've done the busy work, then you can ride that gravy-train for a long time. But the best part of the day was that the unit educator came around and offered to put me through their equipment classes. So, hopefully I'll be able to go through all the classes about the devices in use here. Apparently, the co-inventor of the artificial heart is on staff at this hospital, so it is a good place to learn about heart devices. This is turning out to be a big educational event for me.

Hopefully, it will stay that way.

Until next time, be safe.

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