Estoy flebotomista.

Blood.  Either we need to draw blood, or we need access to blood.  It's something that we can get paged about from time to time.

We don't get paged immediately....usually.  For the most part, multiple nurses have tried sticking the patient, and if it's available the actual IV team has been called without success as well.  So they call us.

Which, I know, incredibly ironic.  I guarantee you any nurse would be better at starting an IV than myself.  And doubly guarantee you that any phlebotomist would be better at drawing some blood than myself.

The only thing that I have that they don't....I can't give up.  There's no one to pass it off to, and there's no question that the patient needs the access.  So I walk into a patient's room.  They look at me.  They are tired, frustrated, worn out, hurting, SCARED. And I tell them that if it takes 20 more sticks, I won't give up on them.

I usually grab an ultrasound machine and find a vein that's a bit deeper to go after. Which may be cheating, but honestly, if the nurses couldn't get one of the remaining few superficials....no way I'd be able to either.

Much Love.

Estoy caminando.

Was going to blog yesterday.  I got as far as pushing the power button on my computer.  And was next waking up 20 minutes later, computer on my lap blinking up at me waiting for its next command.

So I put myself to bed instead.

Working my way through a week of nights. I don't really like doing nights at St. Vincent's.  When you're on nights, you're basically the only one on the trauma/surgery service for the whole hospital (depending on who the senior is that night).  It's getting better each night, as I gain more experience with each night.  But I'm still walking around the whole night holding my breath, and jumping each time the pager goes off immediately assuming it's a trauma coming in.

In my experience thus far, the moment I get called to a trauma, happens to be the exact same moment all the patient's on the floor tend to have their problems. So even if I haven't gotten called to a trauma yet, I'm trying to frantically get as much done as possible, to prevent floor pages.  Although, thus far....it hasn't worked. Last night had started off rather quiet, strangely enough.  Hadn't heard anything from anyone really all night.  Had even been able to go and round myself on all the patients on the surgical floor.  And then a trauma comes in and literally within two minutes I've got about 5 pages backed up on my pager.  Just the worst timing ever.  A whole hour with no pages, and everyone decides to start paging me the second I can no longer respond.

Okay. Can't. Keep. Eyes. Open.

Good night!

Estoy ilesa.....por el momento.

I've emerged from another week still intact.  It makes me smile; to have survived another week.

A friend asked me how I was this week.  My response: I am well.  Some days are bad.  Some days are worse.  But I'm hanging in there.  Once in a while I do something right.  Few and far between, but occasionally it happens. 

This past week was difficult.  Niu was on nights meaning that I was doing the intern job by myself during the days.  Math tells us that my work load was doubled this week as compared to last week when both Niu and myself were working days.

Every morning, post verbal lashing by the chief:
I'm trying to write the daily notes that really have to be written before the attendings start asking where their patient's daily notes are, which of course was 30 minutes ago.
At the same time, nurses are approaching to discuss concerns they have for their patients.
At the same time, one attending shows up on the floor and wants to round on his patients.
At the same time, another attending is either calling or texting wanting to discuss his patients.
At the same time, my pager is buzzing and the pages are backing up.
At the same time, multiple patients are ready to go and pending discharge paperwork/orders.
At the same time, the rest of the team is demanding for my communication as to what's happening with the floor patients, and that all consult requests get passed on to them.
At the same time, the 'list' has to be updated as often as possible.
At the same time, patient's are requesting that their various personal physicians be contacted to be consulted on their care while in the hospital.
At the same time, medical students are floating around asking what they can do next.
At the same time, a trauma code gets called and we all rush to the ED.
AND of course, all the while trying to take the best care of these patients as possible.

5 seconds waiting for an elevator is 5 precious seconds wasted.
You don't drink anything all day long, because two minutes to go to the bathroom is two precious minutes lost.
You have no clue if the day is bright and sunny or if it's a horrendous storm outside.
Any paperwork that doesn't have to be done at that exact second, gets done late at night when I've finally passed off the pager to Niu to carry it for the night.

Take a Deep Breath Christy.

Somehow....
The notes get written.
The nurses concerns are addressed.
Rounds with the individual attendings happen either physically by walking to the rooms or via phone.
The pages all get returned.
The patients ready to go get discharged.
The consults and patient plan changes get texted to the team.
The 'list' gets updated.
The various inter-physician communications occur.
The medical students get the attention they need/want.
The traumas get attended to.
The patient's are cared for.

AND THEN. As an added bonus, yesterday, I did my first surgery all by myself.  Granted it was about one of the simplest surgeries out there, an axillary lymph node excision biopsy.  But from the cutting of the skin to closure of the skin, I got to be the surgeon chief (ACGME term).

HaHa, perhaps if my friend had asked me how I was doing after that my answer would have been a bit different: I am well.  Some days are good.  Some days are better.

Either way, it's all just one day at a time.

Much Love.

Estoy una cordero entre lobos.

I drove back to my apartment in NY last night.  There was spoiled milk in the refrigerator staring me down from across the miles.  I decided I finally had to put an end to that, and can now report that there is one more milk jug in the recyclables.

This rotation in Bridgeport is completely different than my last in the ICU.  Day one was, of course, the absolute pits.  Kind of like when someone yells at you ‘think fast’ having just two seconds before tossed a ball in your direction.  Well I got the same ‘think fast’, but instead of tossing one ball they had just chucked 30.… at my head.  I don’t think I caught a single one of them.  Safe to say I landed flat on my backside.  But I was back up and there even earlier the next day, and the next, and the next, and so on and so forth.

I’m not really enjoying the morning rounds, nor the evening sign outs.  These are the times when the chief resident really lays into us interns.   And he doesn’t stop until he has explicitly and sufficiently exclaimed how incompetent and useless we are.  It’s worse when the medical students are there providing him with an audience.  The other morning it lasted a good two hours.  Granted he would pause now and again to take a breath.  But when he paused, the 2^nd year apparently thought it his responsibility to carry on.  I shake my head.  It’s really rather ridiculous.  I mean he tried an analogy to food during that prolonged tirade and accused us of serving salty potatoes.  I had to work so hard to keep from laughing at that, and for the rest of the day remembering it would make me chuckle.  ‘Sir, yes sir! No salty potatoes, Sir!’  In all realty, in the midst of it, I just look him in the eyes and remind myself that Jesus loves him so much that he died a most horrible death for him.  And gentleness.  Gentleness is what I feel.

I also know. That they know.  That half of what they are asking of us is impossible.  But when they were in our place, the impossible was expected of them.  And therefore it is expected of us.   Eventually, with the faster and more efficient we become, the more impossibilities will become possibilities.

The house at which I’m staying at in Bridgeport can best be described as a ‘frat house.’ Niu is the other intern rotating with me this month, and she and I are the only girls in the house. The guys staying in the house are all very nice, but that hardly makes it any more comfortable for me.  I make an effort to engage them in some sort of superficial conversation when the opportunity arises.  Honestly, I don’t expect anything to come of any of these conversations, but like I said I only know them superficially and have no clue what sort of doubts/fears they may be struggling with if any. And if superficial conversations help them ask a question, then it’s worth it.  If not, like I said I don’t expect anything, then I can at least pray for them specifically by name.  And who knows, maybe that’s just what they need right now.  Either way, in the end, I am very thankful to have a place to sleep at night that is right across the street from the hospital.

The combination of having to watch where I step both in the hospital as well as in the house, is providing me with a personal experience in which I can relate to Luke 10:3. Not that I am a lamb.  And not that any of them are wolves.  But it just feels like it sometimes.  It makes me even more thankful the love of Jesus conquers all.

Luke 10:3 Go your way; behold, I am sending you out as lambs in the midst of wolves.

Much Love.

P.S. I love salty potatoes! ;)