Today I was able to get three check off’s done.  One Major (NT suctioning/ Trach care) and two learning assistant check offs (Administering Eye/Ear drops and Rectal/Vaginal suppositories and transferring a patient with a lift.)

I was not nervous today about the check off.  For the major check off you only had to do one of the two skills.  We literally flipped a large plastic disc with proceedures on it. I got NT suctioning.  Easy  for a respiratory therapist right?  The actual act of NT suctioning and keeping sterile was simple.  Remembering all the critical elements was not.  I struggled with that.  Most of the stuff I would do naturally and all at once.  Crazy. We had to do an amazing 16 area’s for auscultation for the assessment.  We had to make sure to hear the vesicular, Bronchovasicular and bronchial breath sounds. Seriously I never learned how to assess like this in RT school (and you think I would, right?)  Basically we had to assess:

Anterior

1. the apical area of the lungs above the clavicle (right and left)
2. below the clavicle (right and left)
3. 2 mid chest areas  (right and left)
4. under the breasts (right and left)
5. lateral mid axillary (right and left)
6. lower lateral bases (right and left) ( I Don’t know how to really explain it any better)

Posterior

1. Apical area above and below clavical
2. RUL,
3. LUL,
4. RML,
5. LLL,
6. RLL
7. the lateral bases

This is not how I learned but it may improve my assessment skills in my present job.

I did the   Administering Eye/Ear drops and Rectal/Vaginal suppositories on my own.  And no, I didn’t have to put the actual suppository  up the mannequin’s butt. I only had to describe the procedure and the rationale for doing what I was doing.

Doing the lift was kind of fun.  We were literally learning how to use this lift. There were four of us, jen and me (RT’s) and Quincy and Trey (paramedic I was the first patient in the bed.  I was literally rolled over in the bed by Quincy and Jennifer so they could put the “sling” under me. It’s like a mesh sling of sorts. I don’t remember the official name.  So they had to get me from the bed to the wheelchair and back to the bed.  We each got a turn in each position, getting the mesh under the patient (or “client” as our text books refer to the patients,) working the lift and being the wheel chair driver.  It was really fun.

Our lunch and learn was first regarding our interpersonal process  recording (ICR).  This is to prepare us for communicating with our patients or clients especially when we go to Mental health.    We were given scenarios and we had to be interviewed by our partner “in character” and the interviewer had to record (not literally with a tape recorder or anything) questions she asked , her non verbal clues, my responses and my non verbal clues , her feelings about my answers and non verbal clues and whether her questions were therapeutic.  If not how can she rephrase the question to be a therapeutic questions.  I was a 35 year old stock broker (female) who lost a leg in a car accident two weeks before.  My concerns were about who will take care of my children, worries about my marriage, self image, and how would she live as an amputee.   I have yet to write up mine.

I did two quizzes today when I got home for pharmacology and read a couple of chapters in my Phamacology book.  Still need to read the chapter on communication in my mental health book, and read the chapter pages that pertain to cardiac assessment and abdominal assessment.

Next week our check offs will be Cardiac Assessment with Central line dressing (sterile) and Abdominal assessment with Female Foley catheter insertion (sterile proceedure). I volunteered to be the first in our group to do a peer return demonstration in front of the teacher and I kept getting dinged for crossing my sterile field.  Plus it is so hard to maintain a sterile field, and insert a foley catheter while holding a ladies va jay jay open!!  The teacher has imformed us that we will do a lot of these in the Mother Baby unit.   Can’t wait.  Please sense the dry sarcasm.

I have a lot of work ahead of me me before Wednesday an I am working all weekend (Sat-Mon).