Final Rotation

Sunday:

Sunday night, I finished my third shift in a row in the emergency room. The shift starts at 6:45 in the morning with a "huddle." We're on the unit by 7:05 at the latest and and we leave that evening around 7:15 or 7:30, after handing off our patients. It's a long day and we're running for the majority of the day.

At the end of my first shift, my bad posture has caused my leg from hip to knee to go numb. Dave looked it up online, figured out which nerve had been compressed, and we found some stretches and strategies to keep it from happening.

Second shift, more of the same. I go to the bathroom three times in twelve hours, not only to use the toilet, but also to do the stretches that keep my leg from going numb. I engage my abs when I'm standing and it helps.

Though I am focused on my work, one part of my brain is tracking the shape of the day as it relates to time. At three hours, I'm still okay. At four hours...It's not until about seven hours of the twelve and a half hour shift that I start to feel like it's going to be a grind. At ten hours, it's like my brain starts a count-down to seven p.m. when the new people arrive. We don't get lunch until almost 4:00 p.m. and by then I'm ready to eat my shoe. The last hour I feel like I'm dragging a load of cinderblocks behind me everywhere.

When I get home, I'm too tired to eat and too tired to sleep.

I start out the third shift feeling like I had been beaten up and I ended it feeling the same way.

On a medical-surgical unit, over the course of a shift we would take care of four or five patients and would often return the next day to take care of the same four or five patients. In the ICU, we were taking care of one patient at a time (two patients at most), and we would often return the next day to the same one (or two) patients. In the ER, it could be ten or more different patients in a shift, for each shift. So over the course of three shifts, I helped to care for more than thirty patients. And I'm grateful that the hospital where I have been placed for this final term is not a level one trauma center, so we don't get the really gory, scary, heavily damaged patients. (Those patients go to the hospital where I did my MICU rotation.)

The person I'm working with is a very “touchy-feely” type of person, always dispensing compliments and handshakes and high fives and fist bumps and big bear hugs to co-workers, so I found it odd when he told me that he was not the type who likes to touch patients when he examines them. He's been doing this for the better part of a decade, and he has a system. (I probably get in the way of that system. I don't care. I only have to hang on through seven shifts (only four now, two with him and two with another person) to meet my 84 hour requirement, and beyond that, I don't care.)

Monday:

I don't sleep well. I'm up in the night with a cramps in my leg, and, having forgotten to reset my alarm, end up getting up at 4:30 in the morning. I can't get back to sleep so I make some coffee and have breakfast.

I spend the whole day in bed with my exhausted legs elevated, doing homework-- a case study, a three page clinical journal, an online exam--on my computer.

My legs still hurt in the afternoon, so I take an ibuprofen. After I took it, I felt washed out (this usually happens when I take an ibuprofen--and if I take two, it will sometimes knock me out completely, like a tranquilizer). I felt so bad that I took a blood pressure reading and realized that my blood pressure had dropped significantly. This is not a typical side effect of ibuprofen.

Dave went out to pick up medicine for Gray Kitty and for dinner (noodle bowls from the Vietnamese place). I got about halfway through dinner and then went back to bed.