Potpourri

So I've made some promises regarding tales of the OR as well as more about the CHP ED. I'm hoping to cover that as well as a few odds n' ends here. Let's start with the OR.

I showed up at 6:45 in the morning, finally learning why it looks like everyone in the whole hospital wears the same scrubs -- they do. Apparently there's an enormous scrub depot on one of the lower levels at Presby, and anyone working in the OR (and probably in some other areas of the hospital) is basically required to take sets of scrubs from that depot each day to keep them as clean as possible, and then to return them at the end of the day. Guess it makes sense. So from there, I got one of those ridiculous-looking cap / hair net things; apparently they're very serious about making you keep those on at all times while in the OR. They take hygeine seriously here, which makes a great deal of sense.

Anyhow, I unfortunately didn't get to see too much in the way of procedures. I saw a couple of intubations, which was pretty cool, and a neat laproscopic procedure. The highlight, though, was definitely the open-heart surgery that I got to see for a couple of minutes. Aside from seeing a living person with a wide open torso, the machinery they used was amazing. There was a very complex pump that essentially replaced the heart, pumping blood throughout the body. This was a rather large machine, with a couple of reservoirs and many tubes, and it was filled with blood. On questioning the nurses, we found out that all of that blood was from the patient; there had been no transfusions (although they had blood standing by should it have become necessary). It was truly amazing; that was definitely the first time I got a good feel for just how much blood there is in the human body.

I also found out that the stereotypes of different personnel seem to exist for a reason. The nurses I had the privilege of observing were very helpful and professional; they invested themselves in what was going on and they were very willing to answer questions and explain things. The anesthesiologist I was shadowing was tremendous -- it'd be hard to find too many clinical educators of his caliber. The surgeons...well, they were a varied group. One older surgeon has a well-deserved reputation for being a genuinely nice guy who's very good at what he does. Many were kind of aloof, although in some cases this was understandable (if you're working with someone's exposed heart, you're probably better off not letting yourself be distracted when the anesthesiologist and three med students walk into the OR). However, some were also what you might consider "stereotypical" surgeons who were abrasive to the support staff, had poor attitudes, and really just weren't team players. On the whole, though, the people that I met and got a chance to work with were phenomenal, and I hope I get a chance to get back there again. I definitely walked out of there far more knowledgable than I had been at 6:45 that morning.

So that was the OR. The CHP ED was an entirely different experience by type (no closely controlled scrub sign-out, for example) but was also absolutely amazing. Talk about a learning experience. Aside from the strictly clinical stuff (I'm thinking that should be a post unto itself), I got a first-rate education in the interpretation of C-spine x-ray and EKGs (specifically SVT vs. sinus rhythm tachycardia). It's amazing how much easier stuff is to remember when it actually applies to real people. The attending I worked with was absolutely outstanding (I seem to be very blessed in that regard) and spent time explaining these things to me in such a way that I couldn't help but understand it.

I do have one gripe about the ED, however...the layout and design is absolutely baffling. This is doubly a problem since it's so unbelivably BIG. I think you could wander for hours and still never know where exactly you were. Furthermore, the rooms are divided into blocks by acuity. Low acuity patients go in blue rooms, then yellow, then orange, and truly sick kids are in red rooms. The docs are assigned to one of these blocks. Each room has a nameplate outside the door -- you know, like "Exam room 7" or something. Each of these plates has a large colored plastic circle at the bottom. Wandering lost in the ED, looking for the red area, I figured that these circles would be a good guide. After all, it would make sense to use these to designate the room block, right? And since all the circles I was seeing were yellow, I thought that must be the yellow area. Sound logic, right? ...Except all of the circles are yellow. Apparently it was a purely aesthetic decision. Kind of like the little kitchen area that runs between two hallways, both equally accessible -- but one end has a door and the other doesnt. There are three openings in the control center for the red block, all leading to similar hallways. One has a door. Two do not. I just don't think the whole thing makes sense. I will say, however, that those are some of the nicest patient rooms (and especially trauma rooms) that I have EVER seen.

Ok, so this post is already much longer than I intended. I'll cut it off here and save the other random stuff (and the CHP clinical stuff) for later. Till then, take care.

Peace and God bless!