They Eat Horses, Don't They?

Well, I'm a little tender in the tail today, fellow journeypeople. You see, earlier in the week, whilst on a jaunt about the countryside (otherwise known as "the back 40"), my trusty steed, whose name I have permanently changed to "European Tablefare" spooked at a horse-eating leaf which blew across his path and threw me in the dirt. I landed squarely on my tailbone, which I believe to be fractured, though in typical fashion among those of us in the medical community, I've not wanted to pursue a definitive diagnosis of same. I am tempted to limp along to the emergency room today for an Xray, however, as I spent all day yesterday sitting in one of those fold up metal chairs and I would rather die than sit in one ever again. Oh, the pain!
I was sitting in that chair while attending Hospice volunteer training. I am hoping to carry on my dear mother's "Angel of Death" work, whereby one gives a dying person permission to die enabling them to slip peacefully into the abyss. Hospice is a wonderful organization, by the way, and you should support it with your charity dollars, if you have any.
This week's stressful chack off at the Nazi School of Nursing was Vital signs. I was very prepared, practicing taking blood pressures on everyone I met and not allowing my children to have friends over unless the friends agreed to let me check theirs while they were here. I had the delightful Ms. Fry as my evaluator for this test, a jolly young woman with whom I would probably hang out if circumstances were different. My partner on whom I had to perform the evaluative tests of temperature, pulse, respirations and blood pressure was Ms. Swisher, who is a great student and all around nice person, but, unfortunately, the only one of my fellow students I had not practiced performing the evaluations on. Ms. Fry had the choice of assigning us oral, timpanic, axillary or rectal temperature, and I was grateful that she gave me timpanic. I completed the temperature reading with flying colors, then reached for Ms Swisher's wrist. I could not detect a radial pulse. Ms. Swisher tried to reassure me and told me many other students had had a difficult time finding it. I tried the other arm. I finally managed to find the pulse. For the test, the instructor takes one arm and the student takes the other. Both count the pusle and have to come up with the same number. In my nervousness, I believe I counted 29, 40 instead of 29, 30, as I was exactly 10 off from Ms. Fry at the end of 30 seconds. At any rate, I failed pulse taking the first time. I went on to get perfect scores on respirations and blood pressure, but had to go back the following day and repeat pulse taking with Ms. Corgan as my adjudicator and Ms. Frampton (who has an easily locatable radial pulse) as my subject. This time, I got it right, and so I continue.
It's Saturday morning and I've just seen the most wonderful program on TV Land. I don't have any idea what it was called, as I was just mindlessly flipping channels, having been awakened much too early by the barking family dog, Tater, and having recently attempted to wean myself off caffeine by cutting the real coffee with decaf, but it was an exploration of the gambling habits of the much beloved star of "Eight is Enough", Dick Van Patten. It showed him in a box at the racetrack with Tim Conway and Jack Klugman betting hundreds of dollars on losing horses. Then he was playing tennis doubles with his son, Nels, who I gathered is a tennis pro, Alan Thicke, and Bernie Kopell, of "Love Boat" fame. Alan Thicke was paired with Nels VP and Bernie and Dick played against them. Alan Thicke bet Nels that DVP would want to bet on the game, and sure enough, Dick wanted to make a wager. Everyone talked about how much he cheated and how he always liked to set up the teams so he would win the bet. The next segment was a celebrity poker match with old has been TV stars, including Dick Van Patten and sons Vincent and Nels, Scott Valentine (I can't remember what he was on, but he has aged well!) Robert Mandan, David Groh, Mickey Rooney, Connie Stevens, Charlene Tilton, Jim J. Bullock, Barry Williams, Susan Olsen, Steve Landisburg, Richard Kline, and Dom DeLuise. The whole thing was hilarious and I demand you watch it!

Oh, the humiliation!

Good Lord. Sorry I haven't written anything this week, but I have been very busy trying to pass dressing changes, and it hasn't been pretty. I have donned more sterile gloves this week than Noah Wylie has in eight seasons of ER. My fingers are starting to crack and bleed from all the hand washing. And still the prize eludes me. I have lived my entire life for external gratification and, while I have earned the respect of my peers for sticking with it in the face of such utter humiliation, I still have not heard the roar of my instructors' praise.
I understand the meaning of maintaining sterility and can explain the rationale for every movement. I just can't seem to get through the stupid procedure without making a critical error. The first time I was tested, I forgot to wash my hands after touching the garbage can. I was nervous and distracted because there was extra stuff on the supply table that I was not sure if I was supposed to use so I took it and made extra work for myself in an effort to appear an overachiever. However, it threw off my carefully choreographed rhythm and I forgot the essential hand washing. On my next try, (for a different instructor) I did everything perfectly, except my gauze caught on the dummy's stitches (they're made of fishing line) as I was swiping the wound. I started my swipe over, knowing that I would never do that in real life, that the gauze would not get caught on the stitches in real life and stating to the instructor, "I would never do this in real life." It didn't matter. She let me finish the procedure, then said,"I'm sorry Ms. Dependent, I have to fail you." So today, I tried again, for a third instructor. I made it past the first three hand washings, gathering my supplies, draping the client for warmth and privacy, and had even used the term "serosanguinous exudate" properly. As I was donning my sterile gloves, the final step before actually cleaning the wound, the paper they are packaged in flipped back and MAYBE contaminated my left glove. I didn't even realize it, but the instructor was watching me like a hawk. "Are you happy with your gloving technique?" she asked. I panicked, knowing there was something wrong, but having no idea what it was. "Um, well, it was kind of hard to get the right one on, but I thought I did OK," I said. "I think the paper flipped back and contaminated your left glove," she said. I am a big picture person, and the detail had evidently eluded me in my haste to get to the wound cleaning part. It was unbelievable, I have been getting compliments on my gloving since the first week of school. I must have looked completely panic stricken, because she said, "Let's just call this a practice session and you can practice really hard over the weekend and do it again for me on Monday."
I am grateful for yet another chance, but keep in mind, I have been practicing for a couple of weeks now. My peers, who think I am smart, all run to me as I enter the lab. "Oh, Code, please watch me do a dressing change and tell me what I am doing wrong." I have critiqued many, and helped them to overcome their difficulties. When others watch me, they say, "Oh, you do that so well. I love the way you set up your sterile field." I performed the procedure no less than THREE TIMES in the lab this afternoon with NO ERRORS. I just can't seem to repeat the phenomenon when a person of authority is watching.
Ah, well. Monday is another day. I had better get it right, though. There is only one instructor left and the lab is running out of gloves and gauze pads.