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Wednesday, February 3, 2010

I've been completely busy with studying, clinicals, and assignments that have been due. I have a week until my second exam, and I am coming close to being done with all of my assignments, but I will continue to stay busy for the next few weeks until this course comes to an end.

Clinicals have been going well. Right now we have been taken care of one patient, but starting next week we will have 2. By the end, I will be taking care of 3-4 patients, so we gradually work our way up. Yesterday, I got to insert my very first foley catheter on a patient. It didn't go as smoothly as I had rehearsed in my head a hundred times before, and when my instructor asked me how I thought it went afterward, I said I would give myself about a 6 out of 10. My instructor disagreed. She said I had a very difficult patient, it was my first time, I knew all the steps I needed to do, I did NOT contaminate my sterile field (this is a VERY sterile procedure, by the way), and I looked confident and stayed calm despite the circumstances, including the patient saying we needed to hurry up because she was getting nauseous again. She said that should would have given me an 8 or 9 out of 10 and that I did a really great job. She also said out of the 16 students my instructors have between their 2 clinical groups, I will probably be the only one with the chance to insert one since they're pretty hard to come by up on the floors. Usually these are more commonly done in the ER.

Today, which is not a normal clinical day for me, I had to come in special for observation in the Endoscopy suite. Endoscopy is a scope that is inserted down the throat and can go to the lungs (bronchoscopy), stomach (gastroscopy), etc and has a camera at the end to see whats going on. I observed two cases and a fellow student observed two. The first one I observed was a bronchoscopy with fluoroscopy (an imaging technique that uses an xray and a fluorescent screen) and a biopsy of the lung. The second case I observed was a gastroscopy. Both patients were under general anesthesia. The first case, the patient was also intubated. On the second case, it was a nurse anesthetist, and she was really nice and really encouraging towards the field of nurse anesthesia. This is something I had an interest in before, but found myself gravitating away from, mostly because I have felt like I would never be able to achieve this goal. At this point, it really is too early to consider it as an option, but its also too early to disregard it as well. We will see what the future holds in that regard, but it was nice to see someone encouraging rather than discouraging, and friendly none-the-less. The doctor on the second case was especially friendly and extremely helpful in the fact that as he did the whole procedure, he explained everything that we saw from the moment the procedure started until it ended. He also joked with the staff and it was a breath of fresh air to see that not all doctors are uptight and egotistical (no offense, John. You're not uptight or egotistical either!!). It renewed my sense that there are caring doctors out there, which really seem to be few and far between nowadays. All the staff in the endo suite were really helpful and I really enjoyed my time there.

After I observed those two cases, I had to switch with my classmate so she could observe some cases before the suite closed up. So we switched places and I got to go to same day surgery recovery. I saw a few discharges and also checked the vitals on a patient receiving an outpatient blood transfusion. The staff there was very helpful and friendly as well.

We have 4 more clinical days left of this rotation. I really like my clinical instructors and the 7 people in my group. I've been very lucky to have a great group of people each rotation so far. We'll see what the next 4 days bring.

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