Sunday, October 23, 2011

Catching My Breath (Just For A Minute)

I really should be studying. And I am going back to the books after I write this post. I’d planned to write this week but I simply needed a couple of days to just breathe.

This past Tuesday was the mid-term exam for Organic Chemistry. It was not my finest hour. For that matter, I think most of the class took a bath with this exam. It was challenging, and I thought it was fair, at least initially, but now I’m not so sure. I’m sure the questions (there were 50) that I missed were ones I missed legitimately, but I don’t know where I went wrong. Since I have to go over to school tomorrow to take care of some business (making an appointment with a tutor to go over a paper I have to write for Biology and setting up an appointment with my advisor for next semester’s course load) I will probably stop in and see the professor tomorrow afternoon to get a look at my exam.

In all of the conversations I’ve had with people about Organic Chemistry as an academic subject, I can say almost without exception that everyone I’ve talked with has pretty much said the same thing: it sucks. And it does; academically, this is the most difficult class I have ever taken in all of the years I have been in and out of school. It is even more difficult than either the advanced mathematics courses I took years ago when I was working on my bachelor’s degree or the rigors of going through Paramedic school with all of that anatomy and physiology crammed into 18 months of the program.

With all of that said, it’s clear that I’m going to have to step up and work even harder than I already am to earn a reasonably decent grade in the course. I still have opportunities to do that; between all of the homework assignments (40% of the course grade), a symposium project due the week before final exams (20% of the course grade) and the final (exams are 40% of the course grade), not to mention the labs (based on a separate grading system), I have the potential to come out of it at least a little less pummeled than I would be if it all were to end right now. And I am going to do everything I can to make that happen.

Once I sign off of this post I have to continue preparing for a Statistics exam I have this Tuesday as well as work on the Biology stuff I have going on.

On other fronts, I have been doing a bit more clinically-oriented stuff at work over the past few weeks. During the tour I worked in Boston yesterday I responded with one of the Newton ALS units to an unresponsive in a vehicle. Turned out to be a 77 year-old female who in fact was dead. As it was, there were bystanders who called it in – the person who actually made the call said that she’d been there for quite some time before anyone noticed that something was amiss. Regardless of her status, the effort was made, and when I arrived maybe two minutes after the ALS unit and the engine company CPR was in progress and she had no shockable rhythm. So the full court press was turned on. As it happened, one of the Paramedics on the truck was having trouble securing her airway; her glottic opening was really anterior so it was tough to get a look at her vocal cords. I offered to look and he let me, and I found that with a little bit of changed positioning, cricoid pressure, and some gentle persuasion I was able to pass an endotrachael tube that worked. That I was able to get the tube where it belonged was a bit of a surprise because of her anatomy – afterward I said it was a “Hail Mary” attempt at intubation that happened to be successful. In the end, however, it didn’t really matter because within a few minutes of us arriving at the ED with her she was pronounced.

Last week I started off the tour with this crew and a cardiac arrest as well. That one was witnessed, the ACLS guidelines were followed nearly to the letter, and it was a save situation; the patient regained pulses and started breathing on his own as they backed the ambulance into the ED entrance. Not this time, though.

This past Thursday  (in Goffstown) I worked with a brand new EMT. A young woman – Stephanie is her name. She is a really nice person, she is extremely intelligent and learns quickly, and she knows her role. All of that said, she is new at this business. And for her I had to dial back the speed just a little bit. We got sent out at 4:30AM for a chest pain. She wanted to drive, so I was okay with that. Got us to where we needed to be, maybe a little slower than I would have liked, but I had to remind myself that patience was in order. Arrived on scene, 64 year-old female, onset of pain about an hour before we arrived. It woke her out of a sound sleep, and she reported that it hurt more on inspiration. But it radiated down her left arm, so I had to think of the possibility that this was a cardiac event, and I dealt with it accordingly. Serial 12-lead ECG’s were unremarkable for ectopics, her blood glucose level was in the “normal” window, and her vital signs were all good. She was pink, warm, and dry, alert and oriented properly, and she did not look like she was 64 years old. It was obvious that she took good care of herself because I would have put her between 7 and 10 years younger. With all of that said, I still did what was necessary under the Acute Coronary Syndrome guidelines. And I had Stephanie do a lot of the work because she needed to experience what it was all about. There were some things that I couldn’t let her do (like start an IV or give some drugs) but she could do just about everything else. And she did fine. Plus she had lots of questions afterward, so I didn’t leave work Friday morning until about 8:15. And I needed to be in Manchester for the 9:00 refresher class.

So even though I took a couple of days to sort of lean back and rest on the fence post, I was still busy. And I’m back at it again. It never ends, does it?

1 comment:

Elizabeth @ The Garden Window said...

That sort of workload and stress would have most people on their knees begging for mercy.... you have my whole-hearted admiration!