Work and school have conspired to use up my time, so I’ve been blogging less often. But I wanted to make a point of blogging this week because I’ve reached an unofficial milestone.

Over the weekend I reached my unofficial 1000 hour mark as an ED Tech.

I say unofficially because I’m using a fairly conservative method of counting it and officially, I reached it close to two weeks ago. So why am I counting my number, that came later, rather than the earlier number? Because this one is more meaningful to me and gives me more of a margin for counting.

Officially, by the timeclock, I reached 1000 hours over two weeks ago. However, this time included by 24 hours of initial classroom orientation and the time to get my CPR recertified and some other training where I wasn’t even in the Emergency Department.

The other factor, was that officially, many of my shifts have been 8.5 hours, with .5 reserved for lunch. However, due to staffing shortages, often many of us techs will work through our meals (and swipe the timeclock for that, guaranteeing we get paid for that time). But it was simply easier for me to ignore those “worked through meals” and only count an 8 or 12 hour shift as 8 or 12 hours, not 8.5 or 12.5 hours.

So, I simply tracked time I was actually in the Emergency Department.

Now I’d like to say that when I hit my unofficial 1000 hour mark I was doing something exciting like working a trauma or even something routine like taking an EKG. However, the truth is, I was sitting at a desk going over some study materials. I was working what’s known as the “BB-Short Stay”. Generally when working here, there’s very little to do (I think I did 18 sets of vitals in 8 hours, and one bed change. But, that’s the nature of the job sometimes.) Fortunately, my next 4 hours of that shift was back in the main area of the Emergency Department and I was able to be more active.

That’s not to say I didn’t celebrate a bit:

Me celebrating 1000 hours with overpriced sushi

So, a final note, the reason for the 1000 hour celebration, is that a number of the schools I’m applying to require a minimum of 1000 “patient contact hours” (one only requires 500 hours and another 750 hours) and now I’ve met that! That’s why I don’t count the classroom orientation or the like because that’s technically didn’t involve any patient contact.

At this point, I can start applying, despite a few classes this semester pending final grades and for most schools, needing to take Microbiology, which I’m doing over the summer.

But this was the single biggest hurdle that I had the least control over. For classes, I could simply sign up. However for the patient contact hours, I had to first get a job, ideally in a place that gave me more contact than simply “taking a set of vitals now and then” and then gain enough hours. Officially my job is only 24 hours a week and I started in late October. Fortunately I’ve been able to pick up a lot of extra hours, hence hitting my 1000 hour mark in only 6 months. My hope of course is that my 1000+ hours of patient contact in an Emergency Department stands out compared to say someone who has only had 1000+ hours in say a medical office where they’re simply taking vitals.

So this bridge crossed!

Slowly but surely getting there.

Standard Disclaimer: nothing here represents any official policy or action of my employee Albany Medical Health Systems and I do not speak for them in any capacity or in any way.

The Value of DR Testing

Just a short blog post today since I’m actually in the middle of a call with a client as we test our failover scenario.

Right now I’m calling it a success even though the SQL Server hasn’t come up yet.

Why am I calling it a success? Because we learned that our current plan has a serious gaping hole concerning how the iSCSI drives failover. Yes, technically we failed to failover as quickly as we expected.

But, we’ve learned that before this system went into production. So that’s a success. This raises our confidence level for next time.

In all honesty, we often learn more from our failures from our successes. For example, before NASA would allow SpaceX to fly a crew on Crew Dragon, they required several abort tests, one of which involved launching a Falcon 9 and then in mid-flight firing the Crew Dragon abort engines. This resulted in the destruction of the Falcon 9 (which was expected) but proved the abort plans worked. Note however that for Orion on Artemis, NASA has decided such a test is not necessary. The decision making process behind this particular decision is worthy of a blog of its own.

In any case, with the current DR test, we expect to have things finally failed over in the next hour or two. Then we’ll update our playbook and have a lot more confidence.

Moral of your story: test your DR. Assume things will go wrong the first time because they will, but far better to have that before you go to production. This is not the first time I’ve had a failover not go as planned, but prior to production.

Update to my Race

For the first time in I’m not sure how long (I suppose I could check, but I won’t) I skipped blogging for two weeks and am late this week (I almost skipped it actually). But I decided I’d take time out to blog and when I realized what my last post was about, I figured it would be a good segue for this post.

Yes, I’m still running the race. I’ve hit some marks along the way, but still a ways to go.

For one, I’m now at over 800 hours of work in the Emergency Department proper. I’m closing in on my goal of 1000 and expect to hit that by May 1st. I’m excited. That said, during my study time with one of my classmates who is also applying for PA School, I realized that the number I had remembered for the number of average hours for most applicants to my top schools of choice was a lot higher than I had remembered. So instead of beating the average, I’ll come in below it. Alas, that can’t be helped. But I’m going into this later in life and so who knows how that will impact things. Also, I’m hoping that my hours in the ED will count more heavily than some candidates who may have had jobs with less involved contact.

Another goal post I’ve hit along the way is finally getting my “Red Badge”. Simply put, in the ED I work in there’s two colors of badges, blue and red. Blue is the basic, call it “entry level” badge. You get it when you’re hired. Red means you can work traumas without supervision from another tech. I had actually qualified, except for a written test, over a month ago, it’s just a matter of scheduling to take the written test and finally things lined up last night. As a result of passing this, it means I can be assigned to what’s known as the A-Zone without needing another red-badged tech with me. And sure enough, right after passing the test, I got my first assignment as a lone tech in the A-zone.

Now I’d love to regal you of stories about how in my short 4 hour shift I had some amazing trauma come in that I played a key role in. The reality is more mundane. It was a pretty quiet shift as shifts go. Ironically, so far my hardest shift so far was probably last Tuesday, where I ended up doing compressions on two different patients, assisting putting in a Blakemore tubing and more. It was one of my busiest shifts and I had already extended it from 4 hours to 8+ (staying until after 3:00 AM Wednesday morning) and almost stayed until 7:00 AM. From reports afterwards, things didn’t get any better. Not entirely sure what was going on that day that made so many people need the ED, but it was a busy time.

I’m starting to see the end of this part of the trip. I have about 5-6 more weeks of school and I will be quite glad when this semester is done. That said, now I have to pop-off and take an open-book online quiz for BioChem.

Running a Race

I’l probably expand upon this when I have more time, but I’ve given some thought to an analogy that describes my current life this semester:

It’s like the show from the late 2000s (and apparently back called Wipeout. The goal is to run the course as quickly as possible while avoiding obstacles, many you can see and plan for, but some might pop-out unexpectedly.

The race I’m running is to get in at least 1000 hours of patient contact time so I can apply to most of my choices for PA School (one I am considering actually only requires 500 and a few more). In theory I can apply BEFORE I finish the hours (most allow programs you to apply as long as you’ll have enough before the end of the year). That said, I’m not content to say “Oh ok, I barely squeaked in 1000 hours”. Nope, I want them NOW! I’m getting there.

The obstacles are my classes. I pretty much know when tests and quizzes will be, but I have to plan my schedule around them. And then I have my IT work which mostly I can shift around the workload, but occasionally something pops up that needs fairly immediate attention. These are the obstacles I can expect, but not when.

Fortunately, come May, I’ll be down from 3 classes to just 1 over the summer and things should get easier.

But in the meantime I’m running as fast as I can, trying to avoid wiping out! And that’s one reason my weekly blog posts have been shorter and later than in the past.

What Inconvenience?

On the way into the ED at where I work, there’s a player piano in the lobby. It’s nice, adds a bit of ambiance.

That said, the other week it apparently stopped working. These things happen. What struck me as interesting was the sign that was put up.

Piano will remain silent, until necessary repairs are made.
Sorry for the inconvenience.

It was that last bit that struck me: Sorry for the inconvenience. I can see “sorry for the disappointment” or something similar. But now I’m genuinely curious about who is inconvenienced by this small mishap.

Again, my views reflect my own, not my employer, Albany Medical Center, and anything I say here should not be interpreted as speaking for them.

This is Secure?

Just a very short blog this week. This time on security.

It’s said that locks only keep honest folks out. There’s some truth to that. Every lock can eventually be overcome, it’s just a matter of time.

That said, I want you to consider the photo below of a small wall mounted “secure box”. I won’t even call it a wall safe, mostly because it could be overcome with a screwdriver. But why even bother with that?

I took one look at this, guessed it was probably a 5 digit combination. It took me three tries to open it, but that’s only because I botched my first try and decided after trying the second most obvious combination to go back and retry the first most obvious combination. It worked.

As my late father would say, “I’ll give you three guesses to the 5 digit combination, and the first two don’t count.”

To Sleep, perchance to Dream…

Ay, there’s the rub.

As I mentioned last week, I’ve been putting in a lot of hours in the ED. Between that and my school schedule, sometimes sleep is at a premium. This is the one area where I most recognize my age. When I was less than half my age I could easily pull an all-nighter and then be raring to go the next day. Now, not so much. Now I need to make up that sleep.

Fortunately, with my school schedule and consulting schedule, I’m allowed that precious time known as “a nap.” Sometime in our youth we start to resist naps. I suspect because we don’t need them and there’s too much of the world to see. Then at some point we look forward to them. Or at least recognize the need for them. For me there’s still too much of the world to see and things to to, but alas, I need my sleep.

I’m also fortunate for an ability I’ve gained over the years, even if my family at time will laugh at me for it; the ability to fall asleep almost anywhere at almost any time. I’m at the point where if you put me on a plane, it’s Pavlovian and I’ll fall asleep before pushback.

So yes, sometimes I’ll work until 3:30 AM and have class at 9:00 Am, but fortunately I can squeeze in some makeup sleep later in the day. And I’m glad for that.

I am curious to see how things will be once I’m in PA School. But that’s for another time.


But I would walk 500 miles
And I would walk 500 more
Just to be the man who walks a thousand miles
To fall down at your door
The Proclaimers

Ok, I haven’t quite walked 500 miles, though a few days it’s felt like it. But I have reached sort of a milestone. I’ve worked over 500 hours as a tech in the Emergency Department. The PA programs I’m looking at require some sort of minimum number of “patient contact hours”. One only requires 750. The primary programs I’m looking at require 1000 hours. This has been the biggest single worry I’ve had in meeting my prerequisites. While there are a number of classes I need to take (and I’m almost done with those), this is the one that would take the most amount of time and was the hardest to line up.

But here I am, at the end of January and I’ve hit the half-way mark. This means that I’ll be well on my way to hitting the 1000 hours long before applications are due. So that’s good.

But, there’s more than that. Honestly, I’m loving it. Yeah, there’s a lot not to love. There’s cleaning up after patients. There’s being stuck in a zone with very little happening. One can get tired of doing their 20th EKG of the day and 17 nasal swab. But overall, I’m really liking it. And I think I’m getting better at it. I even “gave an order to a doctor” the other week.

Ok, let me be clear. Techs really don’t “give orders” to anyone. Sure we can ask another tech for help or even ask a nurse for help. But typically we’re the one being asked to do things. And we have no medical authority to “put orders into the system.” That said, we’re often closer to the patients and what’s going on with them than the doctors. This makes sense. We see the details, they see the big picture.

In this case though, several of us, including one of the residents, were cleaning up a patient that soiled herself. As I wiped, I noted she was raw and said she couldn’t feel when she was urinating, which meant she’d wet herself again without warning. This would only make things worse for her. When we were done, I turned to the resident and said, “I think you need to put in an order for a Foley (catheter).”

“Oh, you think so?”

“Yes, she can’t tell when she needs to urinate and ends up urinating without warning which ends up getting her skin irritated.”


Sure enough about 30 minutes later a nurse was putting in a Foley.

I’ve said we often do the scut work. Which is true, and a few people have thought that I was saying that as a complaint. It’s not. It’s an observation. We’re doing the little stuff that needs to be done that the nurses and doctors don’t have time to do or often won’t notice. That said, actually they often do notice. A nurse will go in to do something and see the well stocked IV cart and thank one of us. Or they’ll ask for something and we’ll already have it in our hand, knowing they’ll need it. Again we’re thanked.

Last night for example, I spent probably close to two hours restocking IV cabinets. I’m not sure the last time that day they had been restocked, but some were pretty barren. When I was done, it felt good knowing that the next time a nurse went into the room to start an IV or do some other procedure, they’d have the tools they needed right there.

Then of course, there’s the big stuff. Helping out with a stroke page or a “leveled” trauma. This is where the experience comes in and I’m definitely 500 hours more experienced than I was just over three months ago. I still don’t have my “red badge” so I can work trauma’s on my own, but I’m getting the experience. And it feels good.

All this is a means to an end, getting the required hours to apply to PA school. But it’s also been great. I’m very grateful I’m getting the experience in an ED where my day can vary from restocking carts to handling not one, but two trauma patients in the same evening. And that was just one shift. In other shifts I’ve helped with multiple traumas.

Hopefully not just the quantity of hours, but the quality of the work will help my application. But no matter what, I’m still enjoy it.

Disclaimer: my works do not in any way reflect my Standard Disclaimer: my writings do not reflect the views of my employer, the Albany Medical Health System. In addition, any errors in the above descriptions are my own and nothing here should be taken as medical expertise or advice.

Winter Finally

I’ll have to admit, I actually tend to like the winter. Though I haven’t enjoyed it as much lately as I probably should. In fact, I should be more specific. I enjoy certain weather associated with winter. I don’t necessarily like the season unless I get that weather. Bluntly, I like snow.

I like the quietness during a nighttime snowfall. I love the white blanket over everything. I’m also one of those rare birds that actually likes driving in the snow. Of course since I have a Subaru with all-wheel drive, that probably contributes to it.

What I don’t like are the cold, dreary, wet days without snow. Those are the worst. I’d rather have it be 20F and snowing, then 33F and raining.

So, overall, this winter has basically been a bust around here. In fact, over the decades, we’ve had more winters that I didn’t enjoy than when I was younger. It’s not so much because I’ve gotten older, but because they have for the most part gotten more mild.

So I can genuinely say, I’ve appreciated the snow that came over the weekend for us. Finally some real snow. Snow that if I were more inclined, I could make a snow man out of. Or I could make a snow fort out of. Or, had I made the time, driven in when the roads were still covered.

So, I’ll enjoy the snow we got.

The picture that should appear with this post is back from 2003!

Being Lazy, or is it Efficient?

My main client the other week decided to update an ETL I had created for them over a year ago and add another couple of imports to it. This basically meant creating some PowerShell code and SQL code and schema to import the data.

I had started to write stuff out by hand when I suddenly remembered a PowerShell Script I had previously written and later wrote about for Red-Gate’s Simpletalk.

I won’t rewrite the post here, but basically if I give it the name of a CSV file, it’ll attempt to create the table schema, an import stored procedure and some of the object information for PowerShell. I still have to make some edits usually but this saves me a lot of work.

And it’s a good thing because after creating and testing the two imports that they requested last week, on Friday they scrapped that approach and decided to combine the data into a single file which means I needed to ditch all that work and start from scratch.

I wrote all the necessary PowerShell, SQL, and did the testing in less than 30 minutes. It was fairly trivial and fairly efficient. Or perhaps I was just being lazy.

But the time it took me to write the original script to create the scripts has definitely saved me time and as a result saved my customer money. So in the long rung, it’s well worth it!

And that’s all for this week!