I wasn’t quite sure what to write in this journal so since a bunch of you have asked what my clinical days are like here ya go,

Well today was actually a great day. I spent most of my day at the hospital preparing, birth’in and providing aftercare for a pregnant lady and her newborn. My patient, who happens to also be a nurse at the hospital was ready to give birth and due to certain medical conditions warranted a C-section…OOH OOH OOH that means I get to scrub up and go help out in surgery. First step after the initial 20 trees worth of paperwork and shaving the patient, the epidural insertion. That is always cool to watch; since there is a possibility that Jess, our lovely Seelie Court pod carrier may be reading this, I will refrain from any graphic descriptions or representations. Once the epidural was placed and the meds had taken effect, the surgeon came in and she made her incisions. It was amazing to see that little body come out of that lady’s abdomen. It was more amazing to watch the newborn take her (oh yeah, it was a girl 6# 6oz) first breath of air, to use her lungs for the first time since interuterine life. The surgeon removed the baby from the placental cord and handed her off to me and the other awaiting nurses. We cleaned her off, suctioned out the yuckies from her nose and mouth and made sure all was good (12 fingers and toes, etc). Once she was evaluated and deemed in good shape, I started her life off right with a intermuscular injection of vitamin K and prophylactic eye antibiotic gel. Life’s rough isn’t it? While I took care of baby, the surgeon delivered the placenta and closed the mom up. Afterward, when the surgery is all over and we are back in the recovery room the baby began to have a bit of cold shock which is potentially threatening, but we managed to keep her warm and out of danger.

Ok, now there are some funny bits to this story. You guys know me and what I look like (there is support for Juli McCarthy’s dubbing of me as the Kilted behemoth). Most of you have even seen my white uniform with the red polo and white lab coat that goes over that. Well, in surgery you must wear surgical scrubs which are very short sleeved and not big guy friendly. It did feel kinda cool, as each time I’d flex my arm to do something it felt like the sleeves were gonna bust because of my biceps. Anyway, so here I am walking into a surgical theater (OR) and the patient looks up at me in a medicated daze as sees a 6′ 2″, 300# German, Filipino with massive tattoos depicted everything from native american peace images to skulls breaking through my skin. All this she sees while I’m wearing a big poofy blue surgical bouffant, blue surgical shoe covers and purple nitrile gloves and mask. Poor woman. So while in the OR I managed to have a coughing fit for a couple of minutes. That always happens at the most embarrassing moments for me. So here is this huge biker/Barney cross breed looking guy (no kilt) helping with the c-section and baby care. That had to have looked really weird to the mom. We’ll just tell her anything she saw that was strange was a side effect of the epidural.

Now even funnier, since the OR can accommodate two students at once my clinical partner came in with me…..Sister Marie Theresa. That’s right she’s a nun! It sounds all too much like a joke…”A nun, a biker, and a pregnant woman walk into a operating room….” Poor Sister, the whole operating room staff was enthralled with the fact that she’s a nun. The anesthesiologist who is very nice and went out of his way to teach us some very cool things was just ribbing poor Sister something horrible. For instance, Sister had asked a question about the placement of the patients arms on the surgical table. Well, I knew that it was to aid in blood pressure control and to maintain good access to the IV lines and epidural. Well, the anesthesiologist told her, “Well it’s a religious thing, we’re trying to ask for divine intervention.” Sister was like “Oh….WHAT!” Everyone just bust up laughing at this poor nun. However, she is very good natured about it and took it well. The best part is Sister’s accent, she is from Scotland who spent the last few years in Korea administering to the poor. Can u imagine how she sounds? Can u get a stranger mix of students in a OR room? All in all it was a great experience, we got to do it all including ink print the little one’s feet on a ID card and baseball cap (new thing for the new fathers). When the time came, the father did not want to cut the cord, so I got to do it. That was also kinda cool, because after I cut it then I had to do the cord assessment to make sure everything was internal ok with the baby. Each cord should have two arteries and a vein. If not then potentially serious defects in the baby could have occurred unnoticed. But all was well with this little girl. Mom is doing well too.

Ok, now when I was going down to the hospital cafe for lunch one of my instructors started yelling for me. A visitor for another patient had fainted. When I got there this poor sixteen year old girl had fainted against the wall and slid to the floor when her sister who had just given birth was describing the…well lets just say the yuckies. So I did my emergency assessments on her and my instructor and I decided she needed to go down to the emergency room for follow up. Of course on the way she throws up…argh…why do they always throw up when I’m around? Better yet, don’t answer that. Anyway, I got her into the ER and ran back upstairs to fill out the incident report and ran it back down so the girl could be admitted. She ended up being ok, just dehydrated with a long history of getting a nauseated stomach from yuckie type talk. Of course, in true sixteen year old girl mind-state what was her biggest concern…the new shirt she just threw up on. ARGH!

Ok…so that was before lunch.

Finally get lunch, sit down with some fellow students and of course they point out that I’ve got vomit on my surgical scrubs that I’m still in….eh…kept eating lunch. The rest of the afternoon was pretty uneventful. It consisted mainly of paperwork, paperwork, and oh did I mention paperwork. It also consisted obviously of continually reassessing the patient evey 15 minutes to half hour. Nothing too interesting happened except for the fact that I, the 300#, tattooed, Filipino/German that’s 6′ 2″ and the Scottish Nun now had to teach this woman how to properly breast feed her baby. Oh yes, now that was a sight I’m sure to anyone watching. Now of course, in the spirit of Murphy’s Law or least in the realm since nothing really went wrong it was just difficult, the new mom had enormous nipples (I mean they were huge) and the baby’s mouth was tiny. So put your thinking cap on and imagine me and a Scottish nun trying to teach a woman with huge swollen nipples how to breast feed a newborn. The rest of my day consisted of paperwork, assessments, and clinical conferences with teachers and students.

That was my day….how was yours?

Hi all,

Well, it is midnight and I have to be at Good Samaritain Hospital in a few hours to work on the Labor and Delivery floor. MMMMM….did you know when kids are born they look like they’ve had cottage cheese spread on them? Ok, I’m going to bed but at least I have started this live journal. Which is something that I have been wanting to do for awhile (even though I will blame Gabrielle, stating it was her constant peer pressure—I love you hunny bunny).

nite all,
Karl

Since I was sick a few weeks ago I missed on pediatric clinical rotation at Hope Children’s hospital. I had a nasty little fever and since I was supposed to be in the neonatal intensive care unit I didn’t feel it was appropriate to go. So I had to make it up. Well my instructors couldn’t get me another day at the hospital due to contractual restraints, instead they sent me to the LaGrange Community Nurse Clinic which is a free clinic for individuals and families that are low or no income. It was a pretty cool experience. I got to see some disease process that I didn’t get to see at the hospital. It was also a neat experience because when you are at the hospital, you kinda have everything you need and there is all sorts of support you can call to help your patients out. At this clinic, which is run entirely through grants, donations and their resale shops, the nurses must be more creative and have a good set of critical thinking skills. For example, one patient, a newborn was diagnosed with failure to thrive where he is underweight and developmentally challenged came into the clinic with his mentally retarded mother. The newborn was not feeding and so the doctors surgically inserted a G-Tube in which food is directly placed into the gut. Well, the child is supposed to feed four times a day, but since the mother had to work and the father is not around, except for the occasional booty call, the kid would miss out and only get fed three times. Now, a little history the mother has two previous kids. One kid has whats called Happy Puppet Syndrome, which involves severe mental retardation and muscular problems that causes a permanent smile and for the arms to be flexed at the elbow. It makes the patient look like a happy marionette. Her second child is also developmentally challenged and has a mitchondrial disorder that prevents his gastrointestinal tract from working properly. So what do you do when you have a mentally challenged mother, who keeps getting pregnant, who is low income, and keeps bearing children with severe medical issues. Anyone who says nursing isn’t a hard job is obviously a dumb ass.

I had lots of differnt patients today ranging from baby immunizations (ok, now that is tough—you try giving a 3 month old 5 injections into his thighs), Otitis media (ear aches) that turned into a ruptured eardrum, to a sixteen year old girl that was a 28 premie (she has been challenged mentally, has significant hearing loss bilaterally, and is developing arthritic problems) who is dehydrated, underweight and cannot keep food down. Keep in mind, these people don’t have money or resources. They can’t just go get some groceries or medicines, they can’t even buy things on a credit card. One little girl was referred from the dental clinic because the dentist was afraid that her tonsils were too big. When I looked, OMG! Her entire throat was blocked, her tonsils were not only actually touching each other but smashed up against each other. Fortunately, we could treat her with antibiotics and surgery was not necessary.

You know when we hear free clinic, it is easy to jump to the assumption that the patients are all illegal minorities or drug addicts. However, the majority of my patients this day were caucasians. I would encourage all of us to find some time to volunteer in whatever capacity, for whatever charity to help out our own people in need.