Best Week Ever?!!!!

So, Its been a long week and a half since those "wonderful" orientation days.  I'm starting to learn more and grow more comfortable with my surroundings and people at the clinic  I've mainly learned two things: 


1- Stuff happens, Shake it off, Rinse and repeat tomorrow


So, first of all, its Wed August 25th (the month is flying by), in a week since I wrote last- I've learned and experienced things I never really expected to encounter. 


Last Thursday was my birthday.  I wasn't expecting much- figured a few cards and well wishes and that was it.  I remember driving to the clinic in the morning feeling awkward, wondering if I should tell people it was my birthday or not.  See, not all of you know this, but I'm kinda shy/ I don't like making things awkward.  Well, I waked in like any normal day (even though it wasn't really normal yet, cuz it was only like my 5th day) and it started out fine-pretty quiet, and people did wish me "Happy Birthday" (it was on the calendar) and I felt happy.


So, a few hours went by, and I was overhearing one of the nurse practitioners (who is also new and awesome!!) saying that her one gentleman patient had a nasty, rather large, crusty, sore on his elbow.  It was obviously infected with something, so the solution was to do an I and D (or incision and drainage) in order to get all the bacteria filled pus out so it can heal.  So the nurse practitioner- whose done many I&D's before at another clinic she worked at, got the okay from the doctor to do a simple I&D in the clinic.  It was reasoned that This would be better than sending the pt to the ER, and more cost-effective-since we serve uninsured and impoverished patients.


As I was listening to this scenario- I asked the NP if I could sit in and watch the procedure along with the nursing student at the clinic that day, since I had never seen one before.  I also found out at this time that the Patient was deaf and mute (and no one spoke sign language), but the pt could read lips, The NP was explaining the procedure in writing and we were very creative in our hand gestures.  


So, we all walked into the room together where Mr. T (name has been changed) was.  All the equipment was ready and it began.  We sat the patient on a chair with his arm propped up on the examining table.  The NP gave a Novocaine(?) shot directly into the wound at three separate spots.  You could tell the pt was in pain by the expression on his face and the fact that he was squeezing my hand super tight.  We asked him and wrote "Are you okay?" on a sheet of paper, and he nodded yes.  We let the numbing medicine work itself for a few minutes, and the NP got the scalpel out and ready. The scalpel looked like a thin plastic box cutter with a small, metal retractable blade.  The NP made a few deep incisions in the patient's wound, which didn't seem to hurt the patient too bad (he didn't squeeze my hand as tightly as before).   


The next part of the procedure, is the worst part, because, not only do you have to make initial cuts into the wound, but you have to facilitate drainage.  This means the NP had to basically squeeze the patient's arm to help the pus come out.  Since the pain killer only anesthetizes the outermost nerves, this part of the procedure is very painful because deeper nerves are affected.

When the NP was squeezing, every muscle on the patients body contracted, his jaw was clenched, and he was crushing my hand till my fingers were blue. The nurse had to squeeze 3 times in order to get much of the pus out.  She paused and we checked the patient after each "round" and he motioned he was ok and agreed to carry on.  The procedure was finally over and the NP was getting ready to dress the wound.  The patient looked a little pale, and I stooped down to his eye level (he was still sitting in the chair) and motioned a thumbs up and a thumbs down sign (so he could tell us which he was feeling).
The patient just stared straight ahead, I looked at the NP and the student and the NP decided we should get the pt up on the exam table so he could lay down. 


As I went behind the patient to put the table step up, he slumped forward onto the NP.  This guy was just 6 feet of dead weight, and had an uncovered, possibly colonized wound.  I kicked the chair to the side, and we got the patient down to the floor. The nursing student ran to get help, and a vital machine.  The NP couldn't tell if he was breathing at first, and she was shouting his name to try and wake him up. As I looked for an ambu bag, I was like "He's deaf, he can't hear you." 


So, after shaking him and a sternal rub-the patient responded by opening his eyes and moving.  By this time, half the clinic ran into the room and we got his vitals and moved him up to a chair. EMS had also been called, and after getting there (after the patient was laying on an exam table), they assessed him and found him to be fine. We gave him a Diet Coke, and he was basically fine after sitting in our waiting room before going on his way.


I thought my birthday surprises were done for the day, but at lunch my boss whipped out an awesome little birthday cake surrounded by Princess cupcakes (topped with plastic Disney Princess rings). I got Cinderella:)  I loved it and it made me feel welcomed. 


2- Have fun and experience the spectrum of life-even if its awkward


Other than work all day and watch people hit the floor, its fun to get out and play and hit the floor in a different way.


I decided that I want to get the most out of my experience here in Savannah at work and outside of it.


This weekend was definitely headed in that direction-(Here's a quick rundown)


Thursday- went to Vinnie Van Go-Go's for dinner-which is a pizza place  in City Market (a section of downtown Savannah).  And although I've always been told to not eat pizza outside of Chicago or New York- this pizza was pretty darn good, and they had crushed red pepper, which made it all that better.


Friday night-exhausted, so we stayed in


Sat- 
     Day- Went to Tybee Island Beach, got freaked out on the way there with all the talk about the massive increase in jellyfish stings this year (up to over 12,000 stings this summer alone). Thought of Finding Nemo and where they nearly die. Went swimming anyway-it was bathwater warm, and fun.  Relaxed on the sand, read, napped. Nice.
       Night- got dressed up, went to Congress Street downtown.  First bar we went to had 5 dollar 40s, served out of a paper bag... classy.  Went to another bar, then another one in City Market where u walked down to the basement where there was beer pong, a nicer bar, and a dance floor.  Saw a special kid/special 30-something year old dance.  Went back to another bar, made new friends, danced, drank, saw random tourist male peeing outside, time to leave.


Sun-
Relaxed, slept, read, explored downtown with Mike and Linda, found a nice cheap sandwich shop, went to church.  Linda (my older roommate) and I found a local Arts college (Savannah college of art and Design) that was sponsoring a cheap movie ("The Runaways" with Kristen Stewert and Dakota Fanning) in a warehouse just west of downtown.  Met an interesting crowd.   Lesbian couple celebrating their engagement, Saw a dude dressed in all black followed by a super tall and built, pale, blonde lady dressed in all black.  Later deduced that that lady was actually a transvestite. Informed Linda of this the next day in car on way to work. It was an interesting car ride on the way back. Good times:)

All in all, I got to spend time with my roomies, drink, and experienced a different crowd.