sometimes i breathe : respiratory therapy blog

I'm a Respiratory Thearpist

sometimesibreathe@gmail.com (sometimesibreathe) — Thu, 28 May 2009 13:36:00 +0000

The past month has been a little stressful. I've been struggling with the job hunt and inability in trying to avoid the sense of uselessness. My usual day consisted of applying for jobs, playing the harmonica, and getting nagged by parents about being jobless, therefore useless.

After 20+ applications, 3 interviews, and $300 spent on travels, I finally found a job.

I'll be moving to Maryland and starting in July. I can finally call myself a respiratory therapist.
My new life begins in July. For the month of June, I plan on just relaxing.

I'm going to move all the posts before this into a folder called RT school.
The new blog starts......now!

Stop watching CNN

sometimesibreathe@gmail.com (sometimesibreathe) — Sat, 02 May 2009 06:46:00 +0000

CNN lately has been nothing but bad news. Bad news brings depression. Simple solution: stop watching CNN.

If it's not the tanking economy then it's the swine flu. I recently saw someone where a mask near downtown Atlanta. Wearing masks are actually pretty common during allergy season in Georgia. Atlanta is pretty bad for asthmatics...but it's near summer. There was the first case of the swine flu in Georgia on April 30.

This one case of swine flu should not cause mass paranoia. Come on.

Was your hands.
Avoid unnecessary flights.

Be educated, not paranoid.

New grad seeking job

sometimesibreathe@gmail.com (sometimesibreathe) — Tue, 21 Apr 2009 09:43:00 +0000

About once a month I have trouble falling asleep. Maybe my internal clock is screwed up or all that stress I try to ignore. I don't know. Lately, I've finished my clinical rotations and on the lookout for a job.

I'm especially anxious about getting a job. This big hospital that I really like hired four students from our class already. Two of those students have masters degrees. They could be socially retarded amputees and still be hired. Master RT students make the hospital / department look so much better.

I was the last student to rotate through there and I'm entering the market at a bad time. It's not that my interview skills are really poor (I've read countless articles on how to prepare for interviews and practiced accordingly), it's that I'm not getting any interviews.

I think lacking real experience besides these clinical rotations is also a great difficulty I have to overcome.

I've applied to eight hospitals so far and I've received one interview and that only because I was rotating at the hospital. I know eight is not that much, but I get a little discourage when learned that these four students applied to only one place and it's their dream hospital.

I've been told that Georgia pumps out nearly 250 new respiratory therapy graduates every year. 50 of those are baccalaureate degrees or higher. Yahoo HotJobs posting lists 21 in Georgia. 11 of those are either looking for a fake background actors or a nurse.

Majority of big hospitals prefer to hire within / their extern students. It just happens that the last three big hospitals I have rotated through having hiring freezes for respiratory (I'm still hoping the big one will say yes).

My mom has been supportive in the start of the program but her patience is wearing thin. Dad didn't think I would pass the registry and decided that he doesn't want to go to my graduation because "Graudation is no big deal. Find a job."

I actually love my parents and get along with them just fine. They want me to live at home and work around Atlanta so I can save up to buy a house. I'd really prefer not to move out of state but I might not have a choice.

How to deal with night shift

sometimesibreathe@gmail.com (sometimesibreathe) — Mon, 13 Apr 2009 08:32:00 +0000

I've been rotating at this big hospital for the past month. It's keeping me busy, but I only have three nights left. Night shift is tough. There is the extra pay incentive, but most starting RT grads are being pushed into night shift. I really don't mind, but I know some fellow students who do.

Here are some tips I've gathered from fellow therapists about how to deal with having a schedule that's different than the rest of the world:

-A lot of articles say that taking a nap at work is essential for night shift. I think that will just get you into trouble. If you get sleepy, try splashing some cold water on your face.

-Keep your stomach happy. I keep enough fruits and snacks in my happy bag to feed the entire floor. My hospital is fortunate enough to have a grill that is open till 3 in the morning but most of the food is unhealthy...which leads to my next point.

-You know that feeling you get when you eat fried food for lunch and then feel sleepy afterward? It gets amplified on night shift.

-Some of the night shift staff told me that they sleep a whole eight hours before work and they have converted their lifestyle to a night shift model. Others tell me they still sleep at night and just take a few hours nap before work. Find what works for you. I prefer the sleep for eight hours before work model.

-When you get home from work, don't go straight to bed. You should wind down. Treat your night as if it's your day. If you normally sleep at 9 P.M., then you should try to sleep at 9 A.M.

-Sleep with no light during the day. Our bodies are accustomed to sleeping in the darkness. Block the sun with heavy drapes and wear sleep masks. I first thought sleep masks were stupid. "Why can't people just close their eyes?" I then realized that a quartered sized hole from the window can penetrate my eyelids.

-Coffee. I know it's bad for you, and I'm trying to wean myself off by drinking tea. But seriously, hospitals would be in a lot of trouble if they banned coffee.

Night shift may be difficult for parents or people that are married. It may be even more difficult for parents or the married if they are a new RT graduate. In this economy, we don't really have a choice.

First week externship impressions

sometimesibreathe@gmail.com (sometimesibreathe) — Tue, 17 Mar 2009 05:21:00 +0000

The hospital I'm doing my extern-ship at is a old and established hospital. It definitely has the funding since this is the hospital of choice for celebrities and sports stars. They even have upscale rooms with room service, nicer beds, and a good view.

The first week was pretty positive. They work you hard. Therapists have a lot of control and autonomy...which is what I'm looking for in a first job. I expect to gain as much experience as possible in my first job.

I really like their charting system; everything is digital. Giving out medication requires someone to carry a PDA: scan the drug bar code, then scan the patient's wrist. This system is excellent. It minimizes wrong dosing and drug errors. I just wish this hospital had a scrubs system where they offered free scrubs and a locker room to employees.

The scrubs system should be implemented by every hospital. I can't imagine it being expensive. You don't bring hospital germs back home and you don't bring home germs to the hospital.

My first week gave me a lot of ABG practice, chest compressions, assisting in a Swan-Ganz insertion, and broncospy assistance. I didn't really get a chance of power napping in the closet like some other hospitals.

The nurses were friendly and cute. The two therapists I followed had a plethora of information and felt comfortable with me. And that's what really matters; comfort. If you aren't comfortable with your co-workers, then you don't belong there.

Don't be a preceptor if you don't really enjoy it

sometimesibreathe@gmail.com (sometimesibreathe) — Tue, 10 Mar 2009 16:28:00 +0000

Yesterday was my first clinical day at my externship. I followed a older therapist that truly enjoyed the profession. He had strong opinions about healthcare, life, and respiratory care and voiced his opinion. I enjoyed following him.

I asked him if there was an incentive pay to accepting students for the therapists there.

"Why do I need a incentive?"
He told me that students helps him review forgotten knowledge and that he is obligated to share what he knows.

At my previous hospital, the therapist would receive an extra dollar to have a student follow them. I seriously think some therapist are just doing it for the extra dollar.

Being a preceptor does not only require extensive knowledge and experience, but also a good attitude. Even though I passed my RRT and I'm legally allowed to work as a therapist, I still consider myself a student. I still have plenty to learn, and I don't graduate until May 9th.

I'm not here to work. Don't give me half the patients so we can go to lunch earlier. Don't ask me; "Do you plan on doing something else then RT?"

I admit that at all of my previous rotations, these "rogue therapists" are rare. I've come to realize that I should have asked a superior if I could follow someone else.

Don't be afraid of your therapist. Ask questions. Don't work, learn.

sometimes i breathe : registered respiratory therapist

sometimesibreathe@gmail.com (sometimesibreathe) — Fri, 06 Mar 2009 21:40:00 +0000

I did it. I passed my registry. I spent the last week jamming 2.5 years worth of respiratory information down my throat. I'm excited. The clinical simulations were difficult.

Some tips about the test:

-I took the written and the clinical sims on the same day. Take them at the same day. It's better to deal with one day of stress than two days.

-The written has 115 questions. You have 120 minutes. Don't rush but keep in mind that you have a ~1 min per question. I finished with 3 minutes remaining.

-If you're a fast test taker like me, then recheck your answers. Utilize the red check box that allows you to skip back through them.

-I ate a full breakfast, took the written at 9 in the morning, finished at 11, took a lunch break, and then took the sims. Point: Keep your stomach happy.

-The clinical sims are a mind $#^@. Don't pee your pants when you see "Physician disagrees." I got 12 disagrees the second and third sims. I got really depressed throughout the whole test and thought I was going to fail.

-You have three hours to do 11 sims. Take your time. I took my time and I still had an hour and thirty minutes left. You get ~20 min for each sim.

-I have this bad habit of clicking, pulse, general appearance, etc for information gathering and then not reading the results. Read it.

-When you click get a physician disagree! Grab your arms and fold them! It'll prevent you from getting 12 disagrees in a row.

-And finally: Don't panic

I also received a e-mail from the big hospital that I applied to; I didn't get it. Whatever, I'm not going to let that drag me down for tonights monumental occasion. Tonight is going to be a fun night.

Simplifying Asthma Treatment by Holly McCarthy

sometimesibreathe@gmail.com (sometimesibreathe) — Wed, 25 Feb 2009 02:46:00 +0000

I located some of my inspiration for the following post in a UK publication, but I gathered their asthma was similar to ours. An article in Saturday's Globe and Mail entitled “Are common drugs a key to asthma relief?” discussed some promising results to found in a study in which asthma sufferers were given anti-fungal medications. Fascinating.

It seems patients with severe asthma noticed significant improvement in their symptoms after taking the anti-fungals. This means new, more toxic drugs may become a thing of the past as we look to more simplified treatments for this common – and often life altering – condition.

The study was also published in the American Journal of Respiratory Medicine (See? Told you asthma was the same there!) and is the first of its kind. Patients were tested for fungi (candida, aspergillus, and penicillium) allergies and, if it was found they had allergies to any of these, they were given itraconazole instead. The patients who got the drugs saw 60% more improvement of their symptoms as those who took placebos. Those results are nothing to wheeze at!

So, while this treatment won't help all asthma sufferers, those with fungi-specific allergies could see substantial relief. This is important due to the fact that so many asthma attacks are triggered by airborne allergens (fungal spores), especially mold. In some parts of the country, it can be almost impossible to avoid if they ever want to enjoy fresh air.

It should be noted that the anti-fungal medications are NOT a replacement for bronchodilators or medications that prevent airway constriction. However, these drugs can block common allergens and aid in decreasing the frequency and intensity of asthma attacks. More needs to be done, however, because there are so many people still suffering with asthma symptoms as current treatments fail them.

It's not a panacea and more research needs to be done but this is very promising for those in the respiratory therapy field who see the havoc asthma can wreak on patients. It can be very sad to watch—especially when children are suffering and nothing seems to work.

Nausea, dizziness and fatigue were some of the symptoms study patients complained about. But, when we are talking about the alternative (not breathing), these seem fairly mild in comparison.

By-line: This post was contributed by Holly McCarthy, who writes on the subject of the best sports management college. She invites your feedback at hollymccarthy12 at gmail dot com

I survived respiratory school.

sometimesibreathe@gmail.com (sometimesibreathe) — Mon, 23 Feb 2009 21:59:00 +0000

Today was the last day of class. It was sad, emotional, and a big relief. I passed my final. We ate, drank, ate some more. We did it people.

Sure I still have two papers to write, a RRT test to take, and 18 days of externship but I feel like a overwhelming sensation of euphoria is spreading over me.

Now this isn't the end. I will still attempt to keep in contact with some of my classmates and potential co-workers. I won't be seeing all the friends I made in RT school as much as before (at least three times a week), because everybody has their own story. I hope everybody finds what they are looking for in this economy. Remember: Don't panic.

The past 2.5 years have been quick. It started out slow and tedious, but this last semester seemed so quick. I'm a little sad because I'll miss my classmates, but I'm also excited.

This is the beginning of my career.

Starting soon: sometimes i breathe: newbie respiratory therapist blog

2nd interview

sometimesibreathe@gmail.com (sometimesibreathe) — Tue, 17 Feb 2009 01:07:00 +0000

My second interview at this anonymous hospital in GA was scary. I was nervous. I dressed the part and I came in with some common interview questions already answered in my head.

Tell me about yourself. I was born in China and I came to the United States when I was five years old. Like most college students, I had no idea what I wanted to do with my life. Biology was my default major because my mom is a biologist. A coworker informed me of respiratory school so I decided to give it a try. It was the best decision of my life. I was elected the respiratory club president because of my desire to unite the juniors and seniors. Our club became official this year and our main purpose is to discourage smoking on campus. I’m ACLS, BLS, NRP certified and I just applied for my CRT license. My customer service experience at Stone Mountain Park and MaxGroup developed my patience with people. In school, I rotated through a variety of different hospitals which has given me a versatile experience in the field.

What's your greatest strength? I was elected RT club president so that demonstrates my ability to lead and cooperate with my peers.

What's your greatest weakness? I feel like my voice is not loud enough sometimes. This may be a problem when I encounter older adults who have trouble hearing. I have been communicating more with hand signals and it seems to work more effectively for me.

Why do you want to work here? I chose this particular hospital as a potential career due to its patient population and reputation.

So why am I nervous? There were four position available. Two are taken by classmates. They have orientation starting in a few weeks. One speaks Spanish and the other is a Master RT.

It's not the end of the world if I don't get this job. I would just be severely upset.

Job outlook: not so great

sometimesibreathe@gmail.com (sometimesibreathe) — Tue, 03 Feb 2009 14:01:00 +0000

When I first entered the program, I assured my parents that finding a job will be effortless. Some of my fellow students entered the program solely due to the job outlook being great for respiratory. Now I'm getting a little worried.

Not only is respiratory therapy saturated in the southeast (We have many RT schools that pump out generous amount of students every year), but the economy seems to be getting worse everyday.

The two hospitals that I would've loved to worked for are on a hiring hold right now. The first one is building a new tower that would double their workload. All the therapists there told me that by the time I would graduate, that they would need at least double the therapists. The week before I left, the manager held a meeting. "We're actually going to open up the new tower slowly floor by floor. You guys aren't getting new therapists." What about the workload? "You'll get use to it."

Great.

The second hospital is a baby factory. I went to a meeting and they told us that they were on a hiring hold: 15 interviews within the past month and no hires. Their theroy is that people aren't having babies due to the economy and also a large part of the hispanic population (a large amount of their customers) have decided to move elsewhere. The manger looked at me and asked, "Are you sure you want to hear this right now?"

You know what? I would rather listen to the truth then be hidden under the shield of ignorance. They are cutting hours for respiratory and nurses. Even the nurses are on a temporary hiring hold. You know the economy is bad when a nurse can't find a job.

So now I'm fussing a little. I believe that healthcare is the best position to be in right now, but don't tell me that healthcare recession proof.

I passed the CRT!

sometimesibreathe@gmail.com (sometimesibreathe) — Sat, 31 Jan 2009 00:26:00 +0000

I was nervous when I got my score: 90. >75 is passing. I did better than I had expected. I celebrated and ate pizza. Next step: RRT.

The pros and cons about working with neonates

sometimesibreathe@gmail.com (sometimesibreathe) — Tue, 13 Jan 2009 21:51:00 +0000

I have been on the Resus (short for resuscitation) team for my clinical rotation, not the neonatal intensive care unit. It’s my first time watching a birth: 12 births on day one and 7 births on day two. I think I’ll start NICU next week. I present the pros and cons about working with neonates:

Pro: It’s easy.
Dry, stimulate, suction, heat, ausculate, give baby to mom or take it down to ICU.

Con: It could be boring.
Basically, you sit in a cubicle until you get a call. This hospital requires RTs to be at all c-sections.

Pro: Babies are cute.
…is the general consensus. Parents get excited. Pictures are taken. People laugh and smile.

Con: Watching a baby come out is not cute.

Pro: Only 5% of babies need a little help with oxygen and 1% need extensive care.
Con: That 1% can genuinely make you miserable.

Pro: Exercise.
Con: You walk a lot between your cubicle and the delivery rooms.

Pro: C-sections are usually quick. ~30 minutes.
Con: C-sections smell bad.
The physician uses a cutting tool that burns the flesh. I could never get use to the smell.

Pro: Some RTs believe that if an infant dies, then it’s ok. The baby never had a life to experience.
Con: Some believe that a dead infant is truly heartbreaking because it lost the chance to experience life.

Honestly, I'm not sure how I feel about the Resus team. I don't picture myself working at it all the time. This hospital rotates their employees through the department and that's a good thing.

New classes and first impressions

sometimesibreathe@gmail.com (sometimesibreathe) — Tue, 06 Jan 2009 14:41:00 +0000

Current trends to extend care:
We write a paper every day. It's actually not that bad. We have group discussions and talk about the current news. Debate over healthcare topics occur every Friday and the professor seems passionate about the class.

Neonatal respiratory care:
The first day was pretty scary. I've had this professor before and I enjoy his way of teaching, but there was so much information. He said that nobody fails neonatal respiratory care and made it seem easy at the beginning of class. I felt overwhelmed by the end of class.

Patient care management:
This is a prep class for the RRT. We pretty much go through a clinical simulation everyday.

Clinical V
Neonatal rotation. It's two 12-hour shifts a week for a month. I get to watch a live birth. Cool?

It looks like this semester is not going to be that stressfull. Fingers crossed.

My job interview

sometimesibreathe@gmail.com (sometimesibreathe) — Wed, 31 Dec 2008 12:22:00 +0000

My job interview was pretty poor. I was going up against two fellow students. One is a master student. He is a smart kid with a BS in biology. He rotated through this hospital and he also is doing his NICU rotation there starting in a few weeks. The other student had her ICU rotation there last semester. She play cards with the RTs at this hospital outside of clinical.

I met the manager a few months back in a volleyball tournament. The female student was the one that introduced me to the manager. So...I'm just some guy the manager met at a bar one random night.

I interviewed with a recruiter who told me that there were maybe two positions open. Even though I felt the interview went nicely, I still feel like the underdog since I didn't rotate through the hospital. I asked questions. I was genuinely interested and I believed I had something to offer. Yet I still feel like I won't get the job.

It's not just what you know, but who you know that really matters sometimes.

I'm 4/5 through the program!

sometimesibreathe@gmail.com (sometimesibreathe) — Sat, 13 Dec 2008 16:52:00 +0000

I'm done with finals. The next few weeks will be comprised of much needed relaxation. Then again, I should be studying for the CRT (certified respiratory therapist). I took the NBRC validation study yesterday and I failed. I took the practice CRT test from our school and passed.

The NBRC recreates the CRT test every five years or so. The validation study is a test that is free for students that will determine which questions they will use in the future. I got a 69% out of 100. I needed at least a 75.

It was a difficult test. I missed all of the infection control questions. This one really bothered me:
What is the greatest factor for infection control with non-disposable equipment? Heat, Pressure, exposure time, or strength of solution?

I also didn't know this one: Which of the following does the patient sign for pallative care? I don't know! What does that have to do with respiratory?

I'm not going to take the test until I'm confident that I'm going to pass. I'm not paying $200 dollars to fail.

Please don't be clostridium difficil

sometimesibreathe@gmail.com (sometimesibreathe) — Fri, 05 Dec 2008 03:01:00 +0000

I've been sick for the past two days. Today was my last day at clinical. I passed out from 2-3 PM in the respiratory department (great last impression). My symptoms started to appear yesterday, after lunch.

The most common symptoms of mild to moderate C. difficile disease are: Watery diarrhea three or more times a day for two or more days, mild abdominal cramping and tenderness.

I was exposed to c.diff last week. Don't you hate it when the nurse says, "Oh yea. The lab results are back. Your patient in room 4 has c.diff." ...after you spend all morning providing treatments to that patient?

Hopefully, it's food poisoning. Food poisoning has some similar symptoms and it's much easier to treat. Unfortunately, I have a test tomorrow. Finals week is next week, and I'm exhausted, dehydrated, and my tummy hurts.

Dinner converstaions

sometimesibreathe@gmail.com (sometimesibreathe) — Fri, 28 Nov 2008 17:12:00 +0000

Since my family doesn't celebrate anything, I spend my holidays with other people's families. I'll celebrate my father's birthday by giving him a high five.

Thanksgiving was great this year. I spent time with my classmate's family. I stuffed myself with everything except the turkey (I'm a big fan on fat). Around the table, we talked about the weather, travel, food, and life at a hospital. Working at a hospital provided me some interesting stories.

I don't see how a office job is appealing to anybody. I worked at a office in my previous life. The most interesting water cooler stories were about the weather and personal relationships. Describing the job as "monotonous" is a understatement. Being at the hospital, you see all types of people.

I talked about suicide, healthcare costs, shoving a tube down a patient's throat, and my first experience touching someone's brain. I'm still waiting for the day when someone overdoses on Viagra.

Happy Thanksgiving everyone.

The Great American Smokeout

sometimesibreathe@gmail.com (sometimesibreathe) — Mon, 24 Nov 2008 19:35:00 +0000

...was November 20th. I skipped a day of clinical to go to school. I spent a good two hours trying to convince students to stop smoking for that one day. It was a lot more difficult than I had expected. Some students were receptive, some were not. I offered chocolate and a pen for one cigarette.

People all gave me the same excuses: "You picked the worst day ever. I just had a test and I'm stressed out."

I also encouraged students to go to a conference on smoking and attempting to raise the excise tax in Georgia. It was free and there were door prizes. The current excise tax on every carton of cigarette in GA is 37 cents. That's pretty low compared to the other states.

One of the goals of ourRespiratory Therapy club is to eventually ban smoking on campus (Pbfft. Yea right). It will take a lot of work and not everybody is committed. I was pleasantly surprised that people actually showed up to the conference. Maybe there is hope.

I should move to another city

sometimesibreathe@gmail.com (sometimesibreathe) — Sun, 16 Nov 2008 15:04:00 +0000

I have been in Philadelphia in the past two days for a student conference at a hospital. This hospital was beautiful and so was the city.

They said over 800 students applied for this conference: ~250 were accepted, nearly 180 were nursing students, ~28 respiratory students, and the rest were pharmacy students. They covered my flight, hotel stay, and food...so why not go? I was the only student from my program went to this conference. All I had to do was right a short essay and submit a letter of recommendation.

After talking to other RT students from North Dakota, Washington, Michigan, and Texas, I've noticed that all the RTs here we in baccalaureate degree programs. This hospital wanted the best of the best.

I like how Philadelphia is more dense in population then Atlanta but not as dense as New York. In Atlanta, you can't get anywhere without a car and in New York, you can't get anywhere with a car. The cost of living in Philly seems to be in the middle range also. My friend tells me that parking is a pain due to the "parking police" there and gang violence is high in the northern district.

I considered moving to Philadelphia because I'm single, have no kids, and I'm the only child. Basically, I'm not "tied down." I also have a close friend that lives in Philly, and this hospital is very impressive.

Unfortunately, they don't offer a sign-on bonus since they don't have trouble attracting people. The pharmacy department had one position open and relatively 40 students. Of course not everybody applied for a interview. Some wanted to see the hospital before clinical rotations, internship, or even volunteer work. I have no idea how many positions were open for respiratory.

I definitely made a impression to the staff. I just don't know if it was bad or good. My first flight was canceled, and and second flight was delay so I was five minutes late to the interview. The manager was very nice and made me feel welcome even though I was late.

I was also one of two men out of ~28 RT students. I spent the rest of my time at the conference, watching power point slides and thinking of intelligent questions to ask the staff.

After dinner, they checked us into a wonderful hotel. I decided to not call it a night and walk around town. I met some fellow RT students and we took the train to a couple places. Later in the night, my friend got off work and we talked about the good times. I got about four hours of sleep before the next morning conference. Thank you coffee.

We talked more about the hospital, the city of Philadelphia, and ate a delicious breakfast. We then took a trolley tour around the city. I ran up the Rocky steps and sang "Eye of the Tiger." Then I passed out on the airport and on the flight home.

I had a good time and I will seriously considered moving to this city if I get a job offer.

My curfew is 10 p.m.

sometimesibreathe@gmail.com (sometimesibreathe) — Mon, 10 Nov 2008 22:58:00 +0000

People laugh at me when I tell them I try to get to bed by 10 p.m. I read that its a good habit to sleep and wake up at the same usual times. I commute to school and wake up at 7 a.m. to be on time for a 9 a.m. class.

On Tuesdays and Thursdays, I must wake up at 5 a.m. because clinical rotations start at 6:30 in the morning. I want to get to the point where I don't even need a pill to fall asleep or alarm clock to wake me. My dad has that ability that I envy.

My body does not seem to function correctly without at least 8 hours of sleep. Sometimes I'll even get more hours of sleep and the coffee is still required.

I'm also trying to wean myself off coffee by using tea. It's not as effective. It's difficult to resist the dark, silky-smooth, and fresh roast sometimes because coffee is found everywhere at the hospital. We have three running in the ICU, one in the RT department, and one in the bathroom. I'm joking about the last one.

I'm pretty convinced that I would be better for night shift. Some of my classmates sleep less than 6 hours a day due to kids or work. They play catch up on the weekends.

Sometimes I drive home half asleep from clinical at 3 p.m. and it's pretty embarrassing. I've come to two close calls. One scared me to a point where I had to pull off to a nearby Zaxby's and eat some chicken. Seriously, how do you people survive without caffeine?

The Kicker has left the building

sometimesibreathe@gmail.com (sometimesibreathe) — Fri, 07 Nov 2008 19:32:00 +0000

I give nicknames to memorable patients. The Kicker has been in the ICU for a few weeks. He came in with altered mental status: drug induced. He is a caucasian, obese, diaphoretic man. The alcoholism and opiates finally caught up to him. Unfortunately, the Narcan didn't touch him. Narcan is supposed to reverse opiates.

He built up such a strong tolerance to drugs. I think the nurse gave him enough Versed to knock out a horse. The max amount of sedation allowed just made him angry.

I don't know his back story before the ICU, but the nurse managed to call his daughter. She said not to call again and instantly hung up. She was not happy and did not care apparently. So now we deal with him.

The nurses were not happy since he had "awesome" diarrhea. We use "awesome" in place of copious and explosive (hospital humor). The respiratory therapists were not happy because he loved messing with the endotracheal tube with his tongue. He also has a undesierable stench surrounding him.

His arms were tied the first few days. A nurse was listening to his stomach and then BAM! The Kicker's legs raised and the nurse flew back. The nurse was convince that he knew what he was doing even though he stares off into space all day long. His legs were tied.

We waited and waited. LTACH finally came. LTACH stands for Long Term Acute Care. The ICU and RT staff are throwing a party.

My ABG streak sucks

sometimesibreathe@gmail.com (sometimesibreathe) — Thu, 06 Nov 2008 21:52:00 +0000

I’ve been missing my past few ABG’s lately and I’m not sure why. It’s a frustrating feeling, especially when the patient is sedated and not even moving. I had a good hit-to-miss ratio when I first started poking my patients in the beginning of the semester.

Getting an ABG does not seem like a difficult procedure but everybody misses from time to time. As you practice more and more, hopefully you’ll miss less. I remember being angry at a nurse for missing my brachial artery a long time ago.

I heard getting a radial artery is more painful. We prefer that site because it has collateral blood flow through the ulnar artery. I wish someone would get an ABG from me. I want to be on the other end for once.

Pain subjective from person to person. Some people take ABGs really well, some patients freak out. I wonder how I would take it.

How to fail at death

sometimesibreathe@gmail.com (sometimesibreathe) — Fri, 31 Oct 2008 01:16:00 +0000

Over the course of approximately three months, I've encountered three attempted suicides. These three happen to not just fail at life, but also at attempting suicide.

What patient One did:
Patient One put a double barrel shotgun under his chin. Little did he know that the deadspace in the shotgun creates a bolus of air that would push his chin away as he pulled the trigger. He stayed on the ventilator for three months while the hospital drained its resources on a guy missing half his face. He eventually died.

What patient One should have done:
A sawed-off shotgun aimed at the medulla oblongata or dived off a really tall building.

What patient Two did:
Hung himself. Neighbor walked into his house and saw him. The patient stays on ventilator for two days. He wakes up with a sore throat and angry at the healthcare workers. The family comes in to kiss his checks.

What patient Two should have done:
Locked the door or dived off a really tall building.

What patient Three did:
Sat on the porch and shot himself in the brain. The girlfriend decided to just stop by and saw his mess. The patient arrives at the ER. He missed the medulla oblongata. He continues to live for a three hours while I bagged him today. The girlfriend comes in to say goodbye.

What patient Three should have done:
Went inside or dived off a really tall building.

If I ever truly contemplated on committing suicide, I would make sure I got it right the first time. I mean 100% death: No going to the hospital BS.

I would dive off a really tall building, or eat 12 cans of...pork brains?

Hemodynamics test

sometimesibreathe@gmail.com (sometimesibreathe) — Thu, 30 Oct 2008 02:14:00 +0000

I received A's on my past three tests. I'm pretty proud of that; my physical health is not. I've had a general feeling of malaise ever since I stayed up extra late for that research test on Monday. I had a Hemodynamics test today and then took a extended nap. No problem.

A lot of classmates seem to really dislike Hemo. They toss the notion that "Why do we have to learn this? Don't the nurses take care of it?" I hate that: the desire to become blissfully ignorant. Now I'm not saying this class is the most interesting class ever because it's not (for me anyway). But it is our profession as a RT to be knowledgeable in not just cardiac/respiratory system, but also the whole picture.

They can hire any homeless guy to toss albuterol treatments; Place drug in a nebulizer and then crank up the flowmeter. I like to think I'm smarter than most homeless people.