In about two hours I’ll be setting off for the Emergency Department. When I prepared for my first shift well over a month ago now (it seems like a lifetime) I was nervous, but I made it through it and ended up feeling fairly confident in short order. Today I face another first. It’ll be my first shift on the Pediatrics side of the Emergency Department. (if you want to be hip on the slang, we all just calls it Peds, but pronounced peeds). There’s a door between the two sides and over it, it says, “Two Departments, One Team” but the truth is, generally, at least for the Techs one pretty much spends their time on one side of that door or the other. For example, all the techs I’ve worked with so far on the adult side haven’t spent much time on the peds side (and probably not since their orientation) and the few techs from the peds side I’ve met have been in very brief encounters. But, as the sign says, in theory it’s really one team, so I need to be oriented on both sides of the door.
So today and Saturday are my two shifts in peds. I’m looking forward to it, but as I noted above, I’m definitely nervous. I’m not entirely sure why. Yes, there are differences, but at the end of the day, the work is going to be similar.
So, in 14 hours I’ll have my first shift done and be that much closer to having my orientation done. I can’t wait. Even if I am nervous.
“We’ve got a Level 1 Trauma coming into A1, can you run up to the blood bank and grab some units of whole blood?” I hadn’t done this before so another ED Tech came with me to show me the ropes. We went up stairs, handed over the paperwork and they handed us two coolers (one with packed red blood cells, the other with platelets and other factors). I carried them downstairs. It was a humbling feeling: in my hands, I literally was carrying the liquid of life. Without this fluid coursing through our arteries and veins, we die. (and ironically if the iron inside the hemoglobin gets out of its proteins and starts to float around in our blood freely, that can be seriously dangerous too). I didn’t yet know what the trauma was or if we’d even need the blood, that was a decision the doctors would make, but I knew this could make a difference.
I was reminded of the above yesterday as I sat on the bench at the blood drive watching the blood leave my arm and flow down a small tube into a bag just beyond my sight. I have O+ blood, the second most preferred kind (after O-). In addition, I have not been exposed to CMV (cyomegalovirus). This means my blood is a preferred type for pediatric patients since I don’t have antibodies to CMV (most adults have been exposed at some point and probably don’t know it and as such have antibodies).
I don’t know exactly where my blood will end up, but I do know it’ll help someone. In fact it will likely help multiple patients. To me there’s a certain joy, even thrill in that.
It doesn’t take much to give blood. It can take about an hour of your time (more if you do a double-red, but then you only donate half as often) and a small, fairly short, painless prick in your arm. Then they give you snacks!
As I recall, in the above trauma, that specific patient ended up not needing the blood. But I’ve seen other patients since then who have needed blood. I’m glad they’ve been able to get it. It makes a difference.
If you want to give someone something this holiday season, consider giving the gift of life. Give blood.
(and small footnote, before anyone criticizes the American Red Cross’s policies, some which I think are overly stringent and even discriminatory, please note it’s actually the FDA that sets the rules and the ARC has argued for changes. So make sure your frustration and anger is directed a the right group.)
Include the usual disclaimer that I do not speak for or represent my employer Albany Medical Health System.
A couple of weeks ago I asked “Am I in the Right Place?” The question will always be in the back of my mind and I think that’s a bit healthy. I think any time anyone gets too sure of themselves, especially when lives are involved, it’s a bad idea. That said, I’ve now done 3 shifts in the Emergency Department (ED) and the answer to my question is “yes.”
In 36 hours I’ve learned a lot. I’ve done at least 2 dozen EKGs and only had to repeat one of them at doctor’s request. I’ve done more than my share of Covid Swabs. I’ve done a psych sit. And one of my fellow techs let me practice a straight stick blood draw on her. According to her I did well (she commented on her lack of bruise the next day). I’ve also done chest compressions. I’ve also sat around with nothing to do. That’s rare and one savors those moments.
I’ve had sore feet and one night as I got into my car my lower back froze and I couldn’t move for a few seconds. I’ve gotten dehydrated because I had forgotten my water bottle one day and it was too long between getting some water. I’ve snacked on the run (fortunately however, as an orient, I’m in theory guaranteed an actual food break which I’ve taken advantage of so far, but once I’m beyond orient status that may no longer be available).
I’ve worked to 2 12-hour shifts back to back and then gotten up on the 3rd day to make it to A&P Lab after only 6 hours of sleep.
But, though I’m only 3 shifts in (and about to run my 4th) after the first night I was confident I’m in the right place. I’m gaining confidence in my skills and abilities and I’m earning the trust of my colleagues. And at the end of the day, I’m enjoying what I’m doing. At least so far. We’ll see what I’m saying in 6 months or 12 months.
But at the end of the day, so far, yes, I think I’m in the right place.
And now the obligatory disclaimer that I do not speak for my employer Albany Medical Health Systems and my views are entirely my own.
Over a week ago, I had someone tell my wife that they were excited about my applying to PA school and they’d love to be my patient if I make it. While I appreciated their faith in me, I reminded my wife that if my career choice goes in the direction it does, my preference would be to work in an Emergency Department and as such, that person might not want to be my patient. This reminded me of a time when a friend was giving me a tour of the med-flight helicopter he worked on and showed me the logo that was on the ceiling above where a patient would be laying on a stretcher and joked few people saw it the way I did. In fact he added, many in a position to see it from a stretcher were often not in a good enough shape to really see anything.
Last week on social media I posted a bit about a specific concern I had in the process. It was more a comment than anything else. I generally don’t post such things looking for support or the like, it’s often more a stream of consciousness. Well the amount of “attaboys” and “you’ve got this” was uplifting and encouraging. Now the truth be told, most of the folks posting didn’t know the specific details of concerns and while I appreciated the sentiment, it didn’t change the actual reality. But that’s ok.
Here’s the thing. I might not succeed. I might hit a roadblock. I might find a class that simply stumps me. I might find my time in the ED to be such a negative experience that I decide to go back to being a fulltime DBA. Most of all, even with all the prep work, there’s no guarantee my primary (or even backup) schools of choice will accept me. Simply statistically, the odds are long. (Fortunately it’s not as simple as a roll of dice, there’s a lot more to the process than simply that.) But at the end of the day, knowing people have my back, for better or for worse, helps hugely. It’s not so much “how can I fail when I have so many people cheering me on” as much as “whether I succeed or fail, people will support me”. That makes the effort that much easier. And for that I’m grateful.
So, a year from now, I really hope to be able to tell folks, “yes, I was accepted” but even if I’m not, I’ll know they have faith in me. That’s helps more than I can express. Thank you.
First this question came to mind when I arrived for the second day of orientation. Technically there was no sign for where ED Techs should report to, so I made the assumption that it would be the same classroom as Patient Care Associates. But when I went to the classroom it was dark and no one was there. I fretted a bit, but not too much, after all I was early.
Fortunately my assumption was right and I was soon seated among a number of other students. Turns out only one other was also a Tech, who happened to be assigned to the ED, but all the others were PCAs in various departments.
The second time the question came to mind was while waiting for the class to start and I’m reviewing the material and start reading the requirements and wondering, “umm, I’m not sure I really have the experience they expect. I’m sure I’ll be found out shortly.”
Fortunately, again the answer appears to have been yes, I was in the right place. This became more evident over lunch when 4 of us started talking about our backgrounds. Yes, some clearly have more experience in the medical field than I have. But some are starting at about the same level I am, or perhaps with even a bit less experience.
So yes, I’m in the right place. At least so far.
This is not to say it won’t be easy. There’s a lot to learn. Some of it I’ll learn tomorrow, some will come later. Like any job, I suspect the learning will never be over. So it’s two days into my new job and so far I’m still loving it.
And today I’m officially a step closer:
I make these look good?
And now for the first time I have to add that the above are my own words and do not reflect the opinions or views of my employer Albany Medical Health Systems.
Actually, unlike the song, I feel like I do need education and I’ve been getting it. Ironically in A&P II we’ve been covering the adaptive immune system just as I’ve been going through my intake steps for my new position. I mentioned last week that I had go get a number of shots. As of today in the last week I’ve had the current flu shot (last Monday), the new covalent Covid vaccination (Wednesday), a TDaP vaccination (yesterday) and the first of two Hep B vaccinations (also yesterday). So it’s been just “another shot in the arm” for me several times now. Oh and the second of two injections of tuberculin to test for tuberculous.
I’m not sure if my immune system is hating on me right now or loving me. Hating me because I’ve asked it to respond to a foreign substance 6 times in the last 7 days, or loving me, because right now, there’s a series of T cells forming (or having formed in my body) with the net result that I’ll have a bunch of additional T memory cells floating in my blood stream and lymphatic system just waiting in case the real thing (for pretty much any of these things) come around. I don’t know anyone who really enjoys getting a shot or even the reactions we often get (for the record my reactions to all of the shots so far have been very mild).
That said, I am happy that at least for now, it looks like my days of being a human pin-cushion are over. I have one more Hep B shoot in about a month and then after that I’m good for awhile.
Just one more step to get into the world of working in the Emergency Department.
I start orientation on Monday and can’t wait. In the meantime, my immune system can deal with it. I know I am.
“,,, so you won’t be able to flush or wash your hands until I turn it back on,” the nurse said. I understood why, but honestly, the sound of some rushing water might have helped with the task at hand: filling a specimen bottle with at least 40 ml of urine.
I had forgotten until a few minutes earlier when she had mentioned it, that a urinalysis was required as part of the intake process. I’m generally against drug tests for most jobs as I think they’re irrelevant and don’t necessarily have a bearing on the candidates ability to do the job. It’s part of the reason I actually ended up in consulting right out of college. The software company I could have basically walked into a job with had been acquired and now required drug testing. Now, I was not at the time taking drugs and have actually never taken illegal drugs, not even any form of cannabis when it’s been offered. So it was never a fear of being caught. It was simply a resistance to what I feel is an unwarranted invasion of privacy for a tasking involving sitting in front of a computer and creating code.
But this job is different. This job involves both being directly involved in the health care of others and it involves being exposed to drugs. I feel it’s a reasonable compromise. So there I was being handed a sealed specimen bottle standing in a bathroom. Outside all my items, phone, keys, pen, etc. were locked in a cabinet, I’m assuming to ensure I couldn’t sneak in any clean samples. She walked out and I gave deep thoughts of places like Niagara Falls. Fortunately it worked. Less than a minute later I was handing this woman I had met only 20 minutes earlier a warm specimen bottle full of my pee.
Protocols
She had with her a kit that included another container of sorts. She opened it and the specimen bottle. I started to leave the bathroom and she told me I had to stay “since I have an open specimen bottle”. I realized in this case, unlike the lack of running water to keep me from cheating, this was most likely to make sure there was a witness to prevent her from tampering with the sample.
Once it was transferred and sealed in the new container we left together and she started filling out some forms on the computer screen while we waited for the urine to travel up the test strips and react with the reagents. Think about how the Covid test trips we’re all familiar with work, a Control line and before that a Test line (the Control being after to of course ensure the sample has travelled past the test). This container had 3 strips built in so I asked about them. The 3rd one actually had 4 tests on it, but she said she ignored one. I asked why. It turns out it was for THC, since it was no longer banned in New York. So, I suppose I could take up pot if I wanted to. But I have no interest. I also had fortunately not eaten any poppy seed bagels recently!
After all the strips all reacted she moved it to the edge of the counter and rang a bell. She explained she needed a second witness to sign off on the sample. In this case I assume it was to ensure I wasn’t bribing her to pass my sample. Not 2 seconds later we both hear a rather loud, “GOT IT!” from down the hall and up walked another nurse. She saw our somewhat surprised faces and admitted, “I love doing that.” I joked in return that I had apparently passed my audio test (which strangely enough is about the only thing they didn’t test yesterday!)
The Rest of the Afternoon
I’m not ready to call that the highlight of the day, but it was just one part of that day’s intake process. I also managed to get a flu shot, the first step of 2 TB skin tests, scheduled for a Tdap vaccination (in addition to hopefully at the community college getting my Covid Bivalent booster this week), the second of the 2 TB skin tests, get fingerprinted, get entered into the HR system, fitted for an N95 mask, and start the paperwork on parking.
I had arrived around 1:00 PM (a bit early for my 1:15 scheduled appointment with the health center) and was done with all of the above by about 3:15 PM. Not too bad. There was some waiting, but overall a rather expedient process.
N95 Mask Fiitting
This was one thing I wasn’t familiar with before yesterday. I knew the general principal: make sure the mask is tight and the nose bridge is well-formed to your face. However the fitting process is actually a bit more complex. I did find out after arriving that if I had wanted to keep my beard, they have a a PAPR and I could have been fitted for that. But honestly, I figured it was time to get rid of the Covid Beard for a bit so had shaved the day before.
The actual fitting is interesting because the mask they give you is hooked up to a machine with two tubes, I’m presuming to measure air inflow and out. You put on the mask, fit it to your face and then, as the machine instructs do a series of exercises, including bending over for 30 seconds and breathing, loudly reading some text, turning your head side to side and then up and down. Apparently my initial attempts at fitting weren’t quite right so the fitter came around to my side of the bench and moved the masked down and adjusted the nose piece a bit. She explained after why. So now when I’m wearing an N95 mask, I’ll have to remember to place it a bit lower than I thought was proper. I was also instructed to refuse an assignment if the type of mask I was fitted with was not available. So for those who are geeky enough to care, my mask type is a 3M 8210 Reg – White. I even have a sticker to put on the back of my ID badge once I receive it.
Beardless Again
Next Steps
So, Wednesday I go back to have the TB test checked and then next Monday go back again for the TDap booster, another TB Test, and I think the first of two shots for my Hep B regiment and then back next Wednesday for the final TB check. Then on the 17th I start actual orientation at 8:00 AM. (due to orientation it looks like I will be missing an A&P lab and two A&P lectures unfortunately). Finally, I think my actual start date on the ED floor will be October 25th. I can’t wait!
I was originally going to write a bit on the death of Queen Elizabeth II and reflections of mortality in general but thought I’d talk about a bit more about a more personal change.
It’s not news to my readers that I’m working to get into PA School. If all goes well, this means eventually I’ll move completely out of being a DBA and purely into the medical world. But this is not a quantum leap (which I have to say, I was pleased with the premiere of the new series last night). Things are not happening over night. I still have course work and patient contact hours to get in. The process is somewhat gradual. But, due to a biological need to sleep, it does mean I need to balance my obligations and in some cases turn my back on certain things.
I was reminded of one of those yesterday: PASS Summit. I’ve written about my previous experiences here and here and more. I’ve really loved my time visiting Seattle to attend it. I also enjoyed presenting, albeit it virtually. Besides being a great opportunity to meet with vendors and to attend a LOT of great sessions, it’s a great place to make friends and to catch up with friends. And yet, I’m not going this year. Under the old scheme, I had the advantage of being a User Group leader and as such getting a free pass. This helped me cost-wise, which as an independent consultant was a bonus. That wasn’t available this time around, so that figured into the decision a bit. But perhaps far more decisive was that I really don’t feel like I can take the time off from school.
What makes this doubly tough on me is that there are a lot of friends I really was hoping to catch up with in person and the fact that for the first time, I’d be an actual Friend of Redgate, an honor I’m proud of and with Redgate being the folks in charge, something I wanted to be more a part of than in the past.
I also did not put in to speak this year, because I knew I’d have classes during this time. I had been excited to be picked in 2020 to speak. The impact of Covid forced the conference to go virtual which dampened my excitement some.
So at the end of the day I had decided not to go and pushed the decision to the back of my mind. I figured I had no real regrets.
Then yesterday, a client asked me some questions about Summit and asked me to suggest some sessions that his people might get value out of and to give him some other notes about Summit.
So I had to pull the scab off the wound and to look at all the sessions. I of course saw a lot that applied to my client, but also some I knew I’d be interested in. And of course I saw easily a dozen names of people that I knew. This reminded me how much I’ll miss the social aspect of Summit. So it hit home. I’m going to miss Summit. The regrets are there.
I’ve given a lot of thought over the last 9 months about how my decision to apply for PA School would impact my life. Slowly pulling away from the #SQLFamily is one of them.
This doesn’t mean it’s going to be a complete break just yet. I actually have hopes of applying to speak at Summit next year since by then I should have all my pre-reqs done and have the time to attend. But in the meantime, I have to sometimes pull back from #SQLFamily events to focus on school and I’d be lying if that didn’t hurt a bit. What smooths this some though is exactly how much I’m enjoying my work to move towards PA School. So, on the balance, it’s worth it so far.
Just a quick update for those who have been following my career change. Two weeks ago I started the fall semester of classes. This time around I’m taking a slightly lighter workload than last spring, only two classes instead of the three I took this past spring. They’re also full semester classes, not the 6 week accelerated O-Chem class I took over the summer. This makes the work load a bit easier.
On the other hand, my A&P II Lab is at 8:00 AM on a Monday morning! That’s not the ideal way to start the week, but it could be worse. Fortunately the professor is fairly dynamic and it’s not a snooze fest. I mean where else can I spend a Monday morning digging around in a pig’s heart trying to pick out stuff like chordae tendineae (the literally “heart strings” of a heart) and the bicuspid valve and other valves. Yeah, that’s the way I roll on a Monday morning!
Sadly, the worst part of the schedule is actually Wednesday afternoon between the A&P II lecture that ends just before 4:00 PM and the Bio II lab that begins at 6:00 PM. It’s not worth it in my mind to hop in the car to pop home, grab food and drive back to campus so I’ve been exploring the food options near the campus. The first week found me getting two slices of pepperoni pizza and can of soda for about $6.50. I couldn’t complain in the price. Unfortunately I had forgotten my water bottle and the salt levels were high enough I was pretty thirsty during lab. The second week found me checking out the Chinese food place nearby. I hadn’t eaten there in years. Let’s just say their Sesame Chicken is no match for what I get at Lee Lin’s! We’ll see what this week brings.
You’ll notice I didn’t mention an actual Bio II lecture. Well that’s because there is none. It’s more of an online class. My General Psych class in the spring was hybrid, one in-person lecture and one recorded. This is more self-study, with review the PowerPoints and readings and other links. This does concern me. It’s not that the topic is all that hard, it’s more I have to remember to actually set aside time to go through it and actually take notes like I would in an actual lecture. I found myself realizing last night that the homework and quiz were due at midnight last night, not 6:00 PM Wednesday (like the prelab) is and was hurrying through them. I’ll have to do better for next week.
Meanwhile I still wait to hear about the tech position I’m supposedly in the running for.
So that’s where things are. This week. We’ll see in a few more weeks!
That said, I do think I’m fully prepped for the first A&P Lab practical quiz next week, though I should bone up on the coronary blood vessels! (side note, the arteries have cool names like the Anterior Interventricular Artery, while the veins, like the one parallel to the AIV is simply the Great Cardiac Vein. It’s almost like someone got bored naming the veins.
Figured it was time to update folks on where I stand on my transition towards applying to Physicians Assistant school. I’ve mentioned that I have a number of prerequisites I have meet in order to be able to apply. For example, since I had never taken Organic Chemistry in college, I had to get that out of the way. I have a number of other classes too and in fact just started my next round for this semester, namely Anatomy & Physiology II and Bio II. Both are with professors I had previously (though my Bio II professor for lab and lecture I had only for lab previously). In any case, classes started yesterday and I’m looking forward to them.
But, the biggest prereq that had been weighing on my mind had been my patient contact hours. I need at least 1000 of them. I had put this off until recently because I had a lot of other things on my plate and wanted to give them my focus. Several people had told me “Oh, you’ll have no problems getting them. Albany Medical Center is hiring like crazy.” I was hopeful, but a bit cautious. I had actually applied for a job months ago and gotten rejected almost immediately. My suspicion was that my resume was purely IT tech and didn’t even make the first cut. This time around I moved stuff around and emphasized my work with the National Cave Rescue Commission as an instructor and my being a part of the Medical Interest Group. But again crickets. I was starting to get nervous. I finally decided to ask a friend for a favor as they had some inside contacts. Strangely, while I rarely mind doing this for friends of mine if I can, I feel uncomfortable asking others for such help. In any case, while chatting with them on line, my phone rang and it was Albany Medical Center (small aside, sadly the reason I have their number in my phone is because of when my father was dying there, I needed to mark it as a number that would get through my “do not disturb” hours.)
At first I thought my friend was being supremely efficient. But no, it was simply a coincidence. This was a call from someone in the Labor and Delivery department asking me to come in. Now, fortunately, being a consultant I have flexibility to set my hours, so I was able to schedule to come in the next day (last Thursday).
First, I have to say, part of the job definitely seemed fascinating. But, as the interviewer quickly realized and admitted, it probably did not fit my needs for the number of patient contact hours. Then, something happened that is one of those “never do in an interview” moments, but one of us pulled out our cell phones. Fortunately it was her. She was texting her counterpart in the Emergency Department seeing if they were available then and there to meet with me. Sadly they weren’t. But she promised to follow up.
Sure enough, on Friday I received a call asking me to come in. Unfortunately I was in a meeting with a client so it was very brief and came down to “Can you come in Monday at 10:30 and if so, go to the Peds ED Triage and ask for so and so. And would you be able to shadow that day?” Really no more details than that. But I’m good at following orders and sure enough yesterday I was there at 10:30 asking for the indicated person. I was escorted upstairs to meet with them who transferred me over to their boss. She and I talked for no more than 5 minutes when she asked me if I had time to shadow a patient tech or two. I of course said yes. How better to get a feel for what my work would be. I ended up spending about 3x longer than expected and followed 3 patient techs.
I can’t go into details other than to say it was both overwhelming and thrilling. Being in the ED there’s the opportunity to do a lot, even at the level of a patient tech. Sure, a lot of it is simply scut work: restocking supply cabinets, doing nasal swabs, handing charts to doctors. But I’m ok with that. Honestly, I think that sort of work is critical and often overlooked and despite my goal to be a PA, certainly not beneath me.
But there’s potential for a lot more. There’s simple stuff like taking EKGs. But there’s also the opportunity to being involved in assisting when trauma patients come in, doing CPR and observing a lot. For what I want to do, I think this is the perfect fit!
Green Mountain Software 