Bottom of the ladder

Being a pre-med, post bac otherwise, is about as far down the proverbial ladder as you can find yourself. You are highly motivated to do something, but qualified to do nothing. The goal, when in the hospital, is to stay busy. Maybe even be useful occasionally. And to try not to be demoralised by the looks you get when you inevitably reveal that no, you're not a doctor and no, you can't treat [insert condition here]. It's the coats and ID badges, it confuses people.

A recent shift made all this very clear to me. For the first three hours nothing much was happening (in the post-surgery ward), but we were down two staff members, making those people with qualifications a tad overworked. That meant all the "comfort" care-taking fell to me and I was excited. I was busy. Really busy. Fetching juice, water, ice, gowns, blankets, paperwork for admits, answering phones, etc. Then it started, the after-dinner potty rush. None of the RNs or CNAs had time for this, so I spent my night rushing around putting people on the potty and into bed and cleaning up after the process. What's interesting is how thrilled I was to be doing this: it's about as close to doing something actually medically useful as I'll ever get before entering med school.

The it happened. Respitatory distress. A patient's O2 sat was in the 70s and not rising. Everyone was crowding into the room trying something. I was paging respiratory and medicene. Then came the discovery that we didn't have a continuous pulse ox, so I was calling every floor near us to borrow one. When I brought it back, the resp guys were there (the medicene consult would take another 40 minutes) and they let me stay in the room while they did their assesment (the family was kicked out). The patient had had a tracheotomy but was accumulating fluid and had to be constantly suctioned. Medicene came and did their own exam. We found our pulse ox. When I got back from returned the borrowed one, the Ear Nose and Throat (ENT) team was there. And when I say team, I mean TEAM. They brought a small army, all in matching green scrubs and surgical hats. They ate all the cookies, they crossed their arms and looked stern. They bantered with the medicene guys, but in the end, they didn't actually do anything as far as I can tell. The patient was to be moved to the SICU or MICU (intensive care units) where there are more monitors and more RNs/MDs per patient. Patient's O2 sat was climbing slowly. Crisis averted.

Time to put the remaining patients to bed and answer all the lights that had been ignored for the last 80 minutes. I go to help one of my favourite patients, we'll call him Dr. Doolittle, to discover that the charge nurse had kindly brought him a tape player and a book on tape over the last week. She brought him the New Testament on tape. He's Jewish.