just when you thought it was safe...
I'm starting to look at anesthesia programs in the area.
So far, I've come to the conclusion that I'm not going to get in anywhere. Applications are due either in November or January and either way, I'll have (still) zero experience so who would accept me?
Kaiser Fullerton's program requires a minimum of two years in the ICU and so does SUNY (not that I wanted to go back to New York, but at least Brooklyn is tollerable)
Ay caramba. It's looking like next year will either find me going back to NYC or giving up on the whole thing altogether. I'm not the sort that likes those odds (of hanging around and waiting to get into a different program) because there's no guarantee I'll get in anywhere, for years. So, by the time I'd be even slightly competative, I could have just been done with the whole program at Columbia.
This whole thought depresses me.
Then, I wake up and find an email from the director of the anesthesia program at Columbia, mistakenly, somehow CCed me along with the group of people she was emailing about some accreditation bullshit...could it get any more pathetic over there?
So, now, a sort of count down begins in which I worry about having to leave again, my elderly dog's advanced age and me not being here if something happens to him, about the miserable weather there, and not having a car, and how rotten and fatiguing it is for me to ride the subay...
Either I give up, or I resign myself to this.
I'd love to apply somewhere else, but I'd have to re-write my essay, ask for more letters of reference, and holy hell...is it worth all that? It's excruciating to go through the application prossess (not to mention, it costs an average of a hundred bucks per application)
This sucks.
I just don't see myself in the ICU for years and years. It's interesting, but I really don't love bedside care and find a lot of stuff that bugs me about patient care. I hate watching people wither away on ventilators, or going in to find that my patient of last week has coded and died on my day off...
I can't see myself doing this for more than a year or two max.
So...how was YOUR day?
It was a fat lot better than it was for Mr. K, I can tell you that much with certainty.
This morning, day number two in the ICU, I was told to follow Angel, the EKG tech and assist him and do the EKGs. It turns out Angel's supervisor and one co-worker had called in sick so he was swamped with stuff to do, so he wanted to fly thru those EKGs as quickly as possible (explaining stuff to me was slowing him down, though I tried to help him and speed things up.)
We did 4 EKGs (truely ECGs) in about 10 minutes down in the regular med-surg floor.
The last one we did was Mr. K, whom I thought looked pretty good for someone requiring an ECG. He was thin, about 60 y.o. and awake and oriented times three.
Ten minutes after I returned to the ICU they announced a code blue over the hospital PA system. My preceptor/nurse manager sent me down to observe a code. No problem, I've seen a couple of those.
I arrived at the blue light on the med surg floor to find it was Mr. K. with 15 or so people in his room, his room mate now gone, and a big orderly doing compressions on him. The anesthesiologist kept looking at me in the corner, asking for this and that, and I'd leave the room and ask a nurse on the unit for whatever he'd asked "they're asking for --- in there and I'm not on this floor, sorry"
Here's the kicker--this code, I shit you not, went on for two hours. Yes...CPR for two hours. This cardiologist would not let go.
The nurses were looking at each other and shaking their heads "what's left of that brain, even if you do get a normal sinus rhythm?" they said. The anesthesiologist got them to transfer the patient to the ICU so he'd die there, or so he could start a central line...it's still being debated.
At 10:42, they finally gave up, and called it, and the nurse I've been watching for two days said "go get his wife."
As you can imagine, she was a mess. 41 years of marriage, and her best friend, she told me, not just her husband, was now gone.
"I've never seen them work so hard to try to revive someone" I told her, in an effort to help her feel like there was nothing else that could have been done.
Truely, when your number is up, it's up.
So, today I got to learn all the things you get to do when someone dies on your unit, including transporting the cadaver to the morgue, and putting him in the icebox next to the other cadavers in body bags. The smell was nothing like the cadaver lab in gross anatomy. My preceptor was telling me "now, on nights, when this happens, you'll have to call security to come and open the morgue because there's no one here afterhours" and I wondered what it would be like creeping into that cold room with all the cadavers in their silent vigil at the wee small hours.
Ah, I don't know what I'm rambling on about.
It's just another day.
I guess what slapped me in the face was the thought (all the way home) "did I smile at Mr. K and was I as nice to him as I could have been? or was I wrapped up in trying to learn this ecg thing..." I was one of the last people to see him alive--what a heavy thing.
I could have touched his hand and been more compassionate.
There's always room for more compassion, damnit.
I could have taken an extra 30 seconds to smile and say something more to him before leaving his room.
I don't know why this is bothering me so much.
His daughter and mother wanted to know everything he had said and done leading up to the MI. All I could do is tell them what I'd seen, and that it was very quick, and he didn't suffer (hah--a massive MI must feel like your heart exploding--but they were suffering enough.)
I wish I'd taken his hand and smiled at him.
