Respiratory Therapist Student Blog

Something that inspired me

So I was treating a patient and he needed a blow by. I had a nurse hold him down because he was a neruo patient who was tied dow. So I was using the blow by and this is basically a SVN (HHN) without an end.
The nurse asked me “when does the patient need this”
I responded  Doctor said every 4 hours.

So she wondered and asked me another question “what are you doing and why don’t you use the mask”

this was where I’m like..wait i never learned about blow by but i know what I’m doing” I told the RN ” well as you can see you have to restrain him, he is not tolerating the NC and that is why it is tied up. If I put a mask on the SVN would probably spill all over the place because he will not sit still.

“so does the drug actually help because I see the aerosol coming out”

Ok so im thinking ok this RN is asking me so many questions but i know the answer

“The drug helps promote secretions and helps him breath better. However honestly the drug is barely going in  his mouth but he still gets a very little amount. ”

Rn said ” o ok.

So what I learned everything in  class saved myself from being ignorant to what I was doing. Maybe this is the beginning of my career.

Winterbreak was fun! Went on vacation. School started and the first week was like…OUCH!!. I have so many stuff to know and im thinking how will i do this? It was like takin 3weeks of a full semester last year put in ONE WEEK of this sem. Anyways. I need to know chest assements, pharmacology, IPPB, ect..etc.

Clinicals was fun today! it was an 8 hours shift. I think if someone asked me.. “what is your worst nightmare in this job field?” I’m not afraid of blood or sticking a needle. I’m not afraid of sputum. My answer is “giving a treatment to someone you know / close to”. I have a story to tell. I went to school around the area of the hospital I am in. I walked into a patients room and by coincidence I did my first Tx of this rotation. I looked at the name and i was like “whoa!! isn’t this ____” I checked and went in the room and it was an old teacher of mine dx c pneumonia. We caught up a little bit and I gave a breathing treatment.

After it was done I walked out of the room and since I knew he was ok from my inspection it did not give me a nightmare. After I walked out of the room I was like “ok so I did a treatment and it went fine”. However when clinicals was over i drove home. I realized that it was my job / duty to carry out treatments and that was it. However I also realized by doing so, I am actually helping a patient get better. I did not think about this, this hard because I never felt how to give a treament to someone you know. It touched me and the teacher is probably thinking “wow one of my own students<10 years ago just helped me to get rid of my secretions and helped me breathe better” Who would have known all the times I turned in my homework, all the times I studied, all the times he taught the subject, all the times he dismissed the class, that I would

ONE DAY GIVE HIM A BREATHING TREATMENT?

Who would have known the quiet shy guy who sat in the corner, getting picked on ( it was before HS) would one day help the teacher breath? Back then that kid was picked on for being so quiet and why he was so smart and people always getting answers from him. Made fun of because he was always studying…however he grew out of it and doesn’t get picked on anymore.

That is amazing. . .

The end result is a well educated person who knows what he is doing and has the ability to save lives..

One of the RTs said..“well hes taking care of his teacher, the way he took care of him and made sure the student knew the material to become successful”

Yea I know i’m on winterbreak and I thought I would have a lot of time to update this but I have been having a fun time with friends, family..and of course work (lol yea right). Well I have been stress free and it is great!. I have to update this more often but I have been too busy getting drunk and partying! For the next few months I will NOT be able to get some alcohol LOL. The next break is spring break and then summer. It has been like almost 3 weeks since I DID NOT open my backpack. Not good but hey I’m going to finish this year without studying. Once Jan1st comes along I’m going to have to open up the books and review everything again. I think I forgot what IS is. LOL So everyone stay safe and don’t drink so much.

The beginning of my winterbreak was kind of well..weird. So I’m not saying this is going to be a “problem” in the future. I’m not saying this might be the worst thing to do. Not saying anything BAD about what I’m about to say. Regarding my post about “girlfriend”. hmm…..honestly I don’t know what can happen when I’m back in school. Other students have g/fs and b/fs and they deal with it pretty well. Other students even have kids. But in my busy lifestyle ahh….how am I going to work with this. I know I can free up time since everyone KNOWS i dont study 24/7….but a deal is a deal…..unless……………..

ANYWAYS THATS MY PERSONAL REASONS AND HAPPY NEW YEAR RTs!!

Before The last Final..

Hey guys! How’s it going? I have been MIA on this blog for a while because finals is killing me. Yesterday was clinicals and I have to say I experienced what happens in the ER. After 7 weeks of clinicals something finally happens. Not that its good for the patient but stuff happens.

So I went to my clinicals we were just about to do the oxygen rounds for the first time before we leave for the last day. It was fine and I know most RTs don’t like doing oxygen rounds because its time consuming when you have the rounds along with your assignments. To me oxygen rounds was something I looked forward to. 20mins we were just talking and listening to the stories about the “trauma” night where they had the longest Code ever. We were just about to do the rounds when we hear a page overhead. “RT Staff to ER” (something like that) So one of the RTs called the ER to see what was going on. Seems that we get a patient who could NOT breath at all. I’m assuming the patient had little ventilation with a little bit of respiration. We grab a ventilator and a tray ( I still don’t know what was on the tray). The RT made me grab a manual resisitutator (AMBU BAG)

At that moment we rushed to the ER and while I’m holding the AMBU BAG a lot went thought my head. Since I’m only a student, I have NEVER bagged a patient yet. What if I do something wrong?, What if  I forget everything I learned? What if I blank out? And of course the question went to my mind of… “How the hell do I use this?” I had training of the bag but since different manufactors make different ways I never tried using it. This one had Oxygen tubing coming out and I didn’t know where the bore tubing goes. On the walk I studied how it worked and I finally got it. I started to think positive. The patient’s life is NOT exactly in my hands and if worst comes to worst we have 5+ staff (doctors, nurses..etc..etc..) next to me.

We got to the ER and the patient could Not breath. The patient was intubated (I wish I saw this) and one of the RTs were already bagging. They connected the ventilator to the patient and for a few mins I was watching. So many people were just walking in and out. So then the RT said..we can not use the Ventilator. I guess there was blockage or something. ( remember I’m a student and I don’t know how vents work yet) So they took him off the vent but this time they called ME and said.. “come here and bag”. WOW I was bagging a patient who could not breath and I have 1 semester experience. So they put medication and after a few mins they were able to use the ventilator. The patient was “stabilized”

I got to listen to breath sounds 3times. I can’t describe what I heard since I don’t have the vocabulary / terms yet. The first time there was not much things to hear (bagging). Next one was a loud noise like there was restiction. The last one was a weezing which I guess meant he was stabilized.

I was able to see how a patient would “stack” oxygen. (if that is the right term),  From what I over heard, when the patient was taking in the air into the lungs, he was NOT expiring enough.

Whew that was a crazy CODE. We finally got to do our rounds. I added a few on the list because some of them had oxygen that was not on the list of oxygen patients. I didn’t realize how much patients moved around. At least 3x I had a patient who was not in the room. Either D/C or out in the lab.

Sadly this was my last day of clinicals. We stayed for an extra 15mins to say our goodbyes and thank yous to the RTs that assisted us for the last 7 weeks. I was sad when we were walking out. Right before we were going to walk out we heard this

“Alpha Trauma Code Heli”

We stopped and all smiled. The RT said “you guys don’t want to leave right now right?” We all stayed and so excited to see this. A patient was transported by a helicopter. We got to see how the worst comes to the hospital. I saw exactly what I saw earlier that day and this time I looked at who was who. I saw that the physicans were the “boss” of the whole thing. Because they are the ones with the best knowledge. The RNs were doing the best they can to help the physicians. I also saw that someone was always charting. I don’t know what the position is to get that job. Very important to listen because so many things to chart and there is no room for someone saying “what was that? Speak louder”. They also had the lab techs goin in to take CXR (chest x ray). The other lab techs were drawing blood. Then the housekeeping people cleaned up anything that was lying around. The EMTs were filling the information of what happened. And of course I can’t forget to mention the RT. The RT is the one who was managing airway. I know I forgot a lot more but that is all the staff I can recognize.

Pretty interesting day. 7 weeks of doing regular things like , IS (incentive spirometry), O2 rounds, SVN (small volume nebulizer) treatments and it all caught up with 2 traumas.

As for right now, I’m going to hit the books again.

I just studied for my final. Tomorrow is the LAB EXAM and this is really killing me. Drank about a few cups of coffee through out the day and studied for well…8hours? haha. Right now I think I filled my brain with too much information and I can’t even think right. There is nothing else that I want but to finish this lab exam. For anyone in RT we all know how detailed everything has to be and written down as answers. Studying is just too much. However I belive if you study early you would not be doing what I’m doing. I’m studying a little late and craming a few things in.

If only I can add more RAM to my brain I would so I can remember 2 GB of information

( Ram = Random access memory. Used for computers to be able to multitask)

Sleep is what I need. Why can’t you just recover after one hour of sleep and be fine for the next 23hours? I guess life isn’t all what it is. I know I havn’t been blogging much because of time. Finals are REALLY REALLY killing me!! O man.. Anyways I just wanted to let everyone know I’m still blogging but I can’t wait until Finals is over!!!!!!

So I got my medical gas therapy exam back and I got a 91%!! When I took the test I was like “WTF” this is waaayyyy too easy. But after the test everyone said they also had an easy time. So we got our test back and there you go I missed 4 questions. I’m assuming I missed the trick questions that everyone had. I can not tell what the question I missed was, but all I have to say is… a cylinder is STILL safe at 98F. What was I thinking? I guess I was thinking too much and I thought it was in Celsius. Now that I think about if you touched the cylinder with a 98F object aka your hand it will not explode.If you hug a cylinder for 24 hours it still will not explode. ..sigh…sigh..sigh.

In any field of study, I don’t care if you are a psychologist, engineer, rocket scientist, or even a Doctor, you can make the most easiest question to answer the one you get wrong. We all know that you know the answer but you still put the wrong one. That is why in all my years of schooling, even back until elementary school, I always hear the teachers saying “ ALWAYS READ THE QUESTION BEFORE ANSWERING, OR READ IT CAREFULLY“.

Lesson learned AGAIN. So we are moving on to another section and I have to study. This section seems really really hard so I’m focusing on it. The topic is about the lung volumes, calculations of tidal volume..etc..etc. It is a lot of memorizing and a lot of going back and relearning everything

I don’t have much to blog about important educational value because the real purpose of my blog is to show how a student feels while in the RT program. I work about 20hours retail for 3 days a week. I go to class 3times a week + an online class. Then I also have ONE DAY of clinical. So where does my sparetime go? Well I have some spare time but its not a lot. When I blog its usually before I do my studying or after when I’m relaxed. But that is all I can do.

My weekends are very busy because I have work for 8hour shifts and studytime. Basically I wake up early to study then go to work. Then after work study again. Week days I usually spend my time running errans, studying, and of course going to class. Don’t forget to count hours in the classroom because that can take up almost a whole day. Clinicals are about 5 hours shifts and its just like a job. So you can add about 5 hours to my job “time”. So I have about 25hours of job time. Basically I never have time like for a whole day or not doing anything.

Now comes the biggest time investment. “GiRLFRIEND”. Well I’m not the type of guy who never had a girlfriend. I can say I can get a decent girlfriend but no supermodel girlfriend. Recently I noticed that ever since the RT program started I keep getting opportunities to talk to more women and get to know them. They call me, I miss there calls. I want to go out with them, they are busy. When they are free, I am busy. So basically this RT program stripped me of dating.  I’m not complaining because .. right after graduation I can date all I want and I’ll have a higher status. This is coming from a guy who makes less than 15k a year and in a 2 year span making about 50k+.

When ever I manage my time sometimes my job gets in the way of studying. I always think to myself, what is more important. Getting money from this job where I know for sure I WILL NOT go anywhere or study to get this diploma? Of course money right now is also important because daily spending and all. But school always seems to work better because a typical retail job is so easy to get into but pays so much less. I am so lucky I have the opportunity to quit because my parents are there to support me. For others, there is no one else to support them so they have to work. I feel really fortunate so have parents that can support me for the next 2 years. Don’t worry once I graduate I’ll buy my parents something great..

Because of working for 8hours and doing retail I am so tired its hard to study and my back hurts. So I’m going to sleep and waking up around 8 just to study

Well I have a lot to thank for. Here is a good list:

1. Family

2. Friends

3. School

4. Health

5. Stress (good ones lol)

I will be seeing my family and I will be excited since I have not seen them in a while. I met a lot of GREAT friends this year and I had the most fun in the beginning of 2007. I went to so many parties before the RT program. Speaking of RT program I am so THANKFUL I made it in! Nobody knows how much I thank god and everyone else who made it possible for me to get in this wonderful program.

My health is fine and since I’m still young I am in good shape. However I am overweight haha. But I can fix that pretty fast since I done it before.  (lose weight). All the daily stress I endure, made me a better person. I am able to communicate well with people and set up good meeting times.

Now this is where everyone else can be thankful. Everyday we walk, talk, eat, BREATHE, ETC..ETC.. I’m sure everyone is aware that the patients in the hospital are sick. Specially the ones that are on our ventilators and on the oxygen. We as humans are lucky that we don’t have any illness. The health people should be very thankful they have their lives.

Specially us RTs we are able to talk very well to patients. A patient who cannot talk would wish he or she can talk. We are able to walk for 8-12 hours. A patient who has an amputated knee or a bad leg would wish he or she can walk. We are able to BREATHE. The most important thing to any living thing out there. We as RTs makes sure everyone can breathe.  I am pretty sure an RT out their has saved a life before and that is something the patient and you can be thankful. Just remember that everything you do somebody wishes they can do. Even while reading this blog, somebody out there is blind. We should be thankful for our everyday health.

Turkey…Turkey…What?. Well before any RT goes to work for thanksgiving and you are working a 12 hour shift.. remember not to eat the turkey. I learned this today. Turkeys have high levels of TRYPTOPHAN. Most of you probably will have to review chemistry and A&P. Just to save you time I’ll tell you what it does. Basically it makes you sleepy LOL!!..

According to Wiki

Tryptophan as a component of dietary protein is particularly plentiful in chocolate, oats, bananas, mangoes, dried dates, milk, yogurt, cottage cheese, red meat, eggs, fish, poultry, sesame, chickpeas, sunflower seeds, pumpkin seeds, spirulina, and peanuts. [11] It is also found in turkey at a level typical of poultry in general.[12]

Turkey meat and drowsiness

One widely-held urban myth is that heavy consumption of turkey meat (as for example in a Thanksgiving feast) results in drowsiness, which has been attributed to high levels of tryptophan contained in turkey.[43][44][45] While turkey does contain high levels of tryptophan, the amount is comparable to that contained in most other meats.[12] Furthermore, postprandial Thanksgiving sedation may have more to do with what is consumed along with the turkey, in particular carbohydrates, rather than the turkey itself.

It has been demonstrated in both animal models[46] and in humans[47][48][49] that ingestion of a meal rich in carbohydrates triggers release of insulin. Insulin in turn stimulates the uptake of large neutral branched-chain amino acids (LNAA) but not tryptophan (trp) into muscle, increasing the ratio of trp to LNAA in the blood stream. The resulting increased ratio of tryptophan to large neutral amino acids in the blood reduces competition with other amino acids for the large neutral amino acid transporter protein for uptake of tryptophan across the blood-brain barrier into the central nervous system (CNS).[50][51] Once inside the CNS, tryptophan is converted into serotonin in the raphe nuclei by the normal enzymatic pathway.[46][48] The resultant serotonin is further metabolised into melatonin by the pineal gland.[9] Hence, these data suggest that “feast-induced drowsiness,” and in particular, the common American post-Thanksgiving dinner drowsiness, may be the result of a heavy meal rich in carbohydrates which, via an indirect mechanism, increases the production of sleep-promoting serotonin and melatonin in the brain.

Now that I think about it..the time is about 1208 and I just ate turkey…i feel sleepy..so this is all I am going to blog.!

ONCE AGAIN HAPPY THANKSGIVING

At first there was nothing going on. I was assigned to the ER just to watch the whole department. They said right BEFORE holidays there is not much patients coming in. It was true because nothing was going on. I saw a few patients but it was just a very slow day. Half of my clinical was just walking around not doing anything because there was really nothing to do. Even the other RTs were just kicking back and doing simple rounds.

I was in the lounge and I was assigned to another RT because she was going to check on patients and give medications. This is where I had the most fun. I saw how suctioning works and how to do it. The patients seemed not so happy about it. listened to their breath sounds before and after and it was improved by a lot. I really don’t know anything about breath sounds but all I know was that I heard something that wasn’t suppose to be heard.

Then the RT taught me how to use a syringe. I did it once in one of the classes but that was it. So instead I got more experience doing it. I had so much fun on this clinical that I was willing to even stay for another hour. But since I wasn’t able to since I’m a student I stayed an extra half hour.

So I had a good clinical day!