Yeah i spent the better part of my holiday weekend hitting the books. Yeah, everyone kept saying to stay away but honestly that was the time i had to catch up with my readings, assignments and stuff.
Anyways, lets talk about my assignments from last weeks. I got to do a bunch of sedation cases last week. For the most part, the sedation cases went very well actually. I had one really really sick patient who really bottomed out his blood pressure but we fixed him but he never desated. But our last sedation case was intense, this last patient was really healthy actually. No past medical history except for losing his/her voice and came in for an endoscopy to see what the problem was. Anyways, towards the end of the procedure the patient totally desated to the low 80s. We had the yell at the physician to stop the procedure ( this MD wouldn't stop no matter what we told this person) and we had to ambug this patient a bit to get the sats back up. WOW!!!!that was an intense moment.
Besides that patient, i had a really really sick patient who was getting a diagnostic laparoscopy and in the end this patient did great with anesthesia but unfortunately the disease metastasized and they MD decided not to proceed. It was a pretty sad situation. There's nothing else left to do.
Had a couple of breast cases as well. With these type of cases, you get a lot of PONV. So i tailored my plan to help with PONV. I suggest a propofol drip with the anesthesia (propofol has that antiemetic property) or a precedex drip (to reduce the use to opioids and decrease PONV). We ended doing the precedex drip.
One of my preceptors was especially hard on me this week. I'm really laid back and quiet and this preceptor is trying to beat the quiet out of me. And to be honest, its starting to work. Normally, if a preceptor said something i don't like i just swallow my pride. But this person was getting on my last nerve so i kinda told them off a little, not too bad and actually they took it pretty nicely. I guess that's what i needed to get them off my back.
I don't have my assignment for tomorrow yet. So as soon as i get it, I'll be working on my care plan tonight.
Good afternoon guys and have a safe 4Th of July