on securing a temporary tracheostomy tube:
Criticalist: "You're gonna want to wrap it like this and then reinforce the vetwrap with a piece of tape. Be sure you make an anti-buddy-fucker tab on the end of the tape."
so, reading the treatment sheet is good:
(Technician pokes her head into rounds)
Technician: "Hey Alacrity, can I have the fentanyl and lidocaine so I can start setting up your patient's CRIs while you finish rounds?"
Alacrity: "Oh thank you! That would be awesome. I would like the CRIs diluted in saline please, but I wrote recipes on the treatment sheet. If it's confusing, just leave it for me and I'll set them up in a few minutes."
Tech: "Okay, will do."
A few minutes later, in ICU:
Tech: "Why are you giving this dog so much fentanyl?"
Alacrity: "I'm not-wait, is that straight fentanyl in the syringe?"
Tech: "Yes, that's how we do fentanyl CRIs."
Alacrity: "It's supposed to be diluted in saline! Did you read the recipe that I told you about on the treatment sheet?"
Tech: "No."
Alacrity:
Technician: "Hey Alacrity, can I have the fentanyl and lidocaine so I can start setting up your patient's CRIs while you finish rounds?"
Alacrity: "Oh thank you! That would be awesome. I would like the CRIs diluted in saline please, but I wrote recipes on the treatment sheet. If it's confusing, just leave it for me and I'll set them up in a few minutes."
Tech: "Okay, will do."
A few minutes later, in ICU:
Tech: "Why are you giving this dog so much fentanyl?"
Alacrity: "I'm not-wait, is that straight fentanyl in the syringe?"
Tech: "Yes, that's how we do fentanyl CRIs."
Alacrity: "It's supposed to be diluted in saline! Did you read the recipe that I told you about on the treatment sheet?"
Tech: "No."
Alacrity:
 |
| thanks memegenerator.net |
veterinary households are weird:
Here are some things that are true about my place of residence:
1. All the scissors in the apartment are bandage scissors.
2. There is a stethoscope hanging next to the door.
3. Some of my shoes have bloodstains on them.
4. There is a veritable herd of hemostats.
5. The number for the direct line to the ICU is hanging on the fridge.
6. Some of my pants have bleached cuffs.
7. Occasionally, blood tubes will turn up in random locations (such as the bottom of my tool bag).
8. There is an approximately three inch stack of oncology papers on my desk.
9. A fluid rate calculating wheel is peeking out from between books on the bookshelf.
10. You would not believe the number of highlighters.
1. All the scissors in the apartment are bandage scissors.
2. There is a stethoscope hanging next to the door.
3. Some of my shoes have bloodstains on them.
4. There is a veritable herd of hemostats.
5. The number for the direct line to the ICU is hanging on the fridge.
6. Some of my pants have bleached cuffs.
7. Occasionally, blood tubes will turn up in random locations (such as the bottom of my tool bag).
8. There is an approximately three inch stack of oncology papers on my desk.
9. A fluid rate calculating wheel is peeking out from between books on the bookshelf.
10. You would not believe the number of highlighters.
what the actual fuck:
Oncologist: "I've been wanting an os penis tie clip for some time now. Perhaps this is my chance!"
on changing:
Surgeon: "Yeah, I just change right in my office. I don't cover the window. I figure if someone happens to look in and sees my frighteningly pale ass, they won't look again."
on penises:
Okay, so the other oncology hooligans and I were examining a patient being treated for transmissible venereal tumor (TVT). Whenever we see this dog, we pet him, give him treats, and then sit on him and look at his penis.
Dog penises (as you may know) generally live retracted inside a prepuce. If you want to get a look at the entirety of your patient's genitalia, you need to extrude the penis.
As you might imagine, dogs generally don't like this. Although this dog is very patient with our rude attentions, it's sometimes challenging to get the horse all the way out of the barn.
Our oncologist added some helpful commentary:
Oncologist: "You guys really need to work on your penismanship."
Our response:
 |
| thanks teenmomtalk.com |
As you might imagine, dogs generally don't like this. Although this dog is very patient with our rude attentions, it's sometimes challenging to get the horse all the way out of the barn.
Our oncologist added some helpful commentary:
Oncologist: "You guys really need to work on your penismanship."
Our response:
 |
| thanks warosu.org |
no way this could go wrong:
My job is weirdly structured. There's two oncologists, one resident, two technicians, and me in the oncology department. Usually the oncologists are upstairs doing research (but swing by to advise on the cases), and the resident and the more senior technician run the service.
The junior technician and I would love to be involved and consistently try to help, but the resident and senior technician prefer to do everything themselves.
This is wildly frustrating.
This week, both the resident and the senior technician were away on vacation. You can imagine how this went:
The junior technician and I had a really interesting week. It's kind of hard to learn how to do your job if you only get occasional sidenotes on how to do it, which is what happens when the senior people are around...since it takes too much time (? or something?) for them to teach us what they're doing.
So, we both spent the week learning on the fly how to do things like reconstitute and administer chemotherapy. Gaaaaaaaah. You guys, when the big kids get back, I am sitting them down and explaining why this was a terrible idea.
Anyway!
This one afternoon, the technician was diluting out gemcitabine for one dog while I was mixing up another patient's zoledronate. This conversation happened:
Technician: "FUCK! I think I mixed this wrong."
Alacrity: "Wrong how?"
Technician: "I was only supposed to add 300 mg to the bag, but I added all 400."
Alacrity: "Oh. It's cool. We can just figure out the new concentration of the solution, and then recalculate the patient's dose."
(pause)
Alacrity: "Why am I only supposed to get 2 ml of zoledronate back through the filter, but I'm getting 3 each time? Something is wrong."
Technician: "Yeah, this is all fucked up."
Alacrity: "This is like Beavis and Butthead in chemistry lab."
(hysterical, panicked laughter)
The junior technician and I would love to be involved and consistently try to help, but the resident and senior technician prefer to do everything themselves.
This is wildly frustrating.
 |
| thanks abbyismelting.com |
 |
| thanks funsniper.com |
So, we both spent the week learning on the fly how to do things like reconstitute and administer chemotherapy. Gaaaaaaaah. You guys, when the big kids get back, I am sitting them down and explaining why this was a terrible idea.
Anyway!
This one afternoon, the technician was diluting out gemcitabine for one dog while I was mixing up another patient's zoledronate. This conversation happened:
Technician: "FUCK! I think I mixed this wrong."
Alacrity: "Wrong how?"
Technician: "I was only supposed to add 300 mg to the bag, but I added all 400."
Alacrity: "Oh. It's cool. We can just figure out the new concentration of the solution, and then recalculate the patient's dose."
(pause)
Alacrity: "Why am I only supposed to get 2 ml of zoledronate back through the filter, but I'm getting 3 each time? Something is wrong."
Technician: "Yeah, this is all fucked up."
Alacrity: "This is like Beavis and Butthead in chemistry lab."
(hysterical, panicked laughter)
 |
| thanks uproxx.tumblr.com |
bike commuting tips: accoutrements edition
So, it's September.
This means that it's been two months since I sold my car, during which time I've been moving across the country, starting my new internship, and commuting by bike!
Here's a list of handy items to improve your bike commuting experience:
1. Helmet.
I wear a Bern helmet. There's some debate as to whether or not you're statistically safer on a bicycle when you're wearing a helmet, but I'd rather have an extra layer of protection for my brain just in case something unexpected happens.
I've bonked my (helmeted) head on the ground during unscheduled bike/horse dismounts, and I am convinced that a helmet is a wise investment. Make sure it fits correctly, and replace it if you fall on it or drop it from a significant height.
2. Fenders.
Ohhhh you guys fenders are going to make you so happy when it's raining. With fenders, your wheels won't throw muddy water up onto your clothes. Enough said.
3. Rack(s).
I have a rear rack. Some people have a front rack. Some people have a front rack and a rear rack. You can tie and/or hang shit on your rack(s) so you don't have to stuff it awkwardly in a backpack.
Some people prefer the backpack, though. You do you.
4. Gloves.
You know what's cool about gloves? They keep your hands warm when it's chilly (unless you get the fingerless ones). They look awesome. And...if you ever fall onto pavement or gravel, you'll tear up your gloves instead of your palms.
5. Rain pants.
Arriving at your destination mostly dry > arriving at your destination with rainwater running into your underwear.
6. Rain jacket/poncho.
See above, re: rainwater running into your underwear.
7. Waterproof/water resistant shoes.
It's pretty amazing how thoroughly wet you can get when you're riding your bike in the rain. Don't neglect your footwear, or you'll be squelching for the better part of your day.
8. Bike locks.
Locking your bike is a whole separate subject for another day, but for starters, I use two locks of different types (U-lock and chain lock) to lock my bike. Both keys go on my key chain, and both locks nestle in one pannier when I'm riding.
9. Pannier(s).
A pannier is a pretty sweet receptacle for whatever you might need to carry with you throughout the day. I have a pair of waterproof Ortlieb panniers that attach to my rear rack, and so far they've done a solid job of carrying:
- Groceries
- Stacks of journal articles
- Extra scrubs
- Lunch
- Extra jacket
I like that my panniers are easy to detach and carry around, and they can carry absurdly large volumes of stuff before the balance of my bike starts to feel weird.
10. Bike lights.
Bike lights help 1) you see in the dark and 2) other people see you in the dark. Both of these should happen as often as possible. Safety!
This means that it's been two months since I sold my car, during which time I've been moving across the country, starting my new internship, and commuting by bike!
 |
| thanks bulletproofcourier.blogspot.com |
1. Helmet.
I wear a Bern helmet. There's some debate as to whether or not you're statistically safer on a bicycle when you're wearing a helmet, but I'd rather have an extra layer of protection for my brain just in case something unexpected happens.
I've bonked my (helmeted) head on the ground during unscheduled bike/horse dismounts, and I am convinced that a helmet is a wise investment. Make sure it fits correctly, and replace it if you fall on it or drop it from a significant height.
2. Fenders.
Ohhhh you guys fenders are going to make you so happy when it's raining. With fenders, your wheels won't throw muddy water up onto your clothes. Enough said.
3. Rack(s).
I have a rear rack. Some people have a front rack. Some people have a front rack and a rear rack. You can tie and/or hang shit on your rack(s) so you don't have to stuff it awkwardly in a backpack.
Some people prefer the backpack, though. You do you.
4. Gloves.
You know what's cool about gloves? They keep your hands warm when it's chilly (unless you get the fingerless ones). They look awesome. And...if you ever fall onto pavement or gravel, you'll tear up your gloves instead of your palms.
5. Rain pants.
Arriving at your destination mostly dry > arriving at your destination with rainwater running into your underwear.
6. Rain jacket/poncho.
See above, re: rainwater running into your underwear.
7. Waterproof/water resistant shoes.
It's pretty amazing how thoroughly wet you can get when you're riding your bike in the rain. Don't neglect your footwear, or you'll be squelching for the better part of your day.
8. Bike locks.
Locking your bike is a whole separate subject for another day, but for starters, I use two locks of different types (U-lock and chain lock) to lock my bike. Both keys go on my key chain, and both locks nestle in one pannier when I'm riding.
9. Pannier(s).
A pannier is a pretty sweet receptacle for whatever you might need to carry with you throughout the day. I have a pair of waterproof Ortlieb panniers that attach to my rear rack, and so far they've done a solid job of carrying:
- Groceries
- Stacks of journal articles
- Extra scrubs
- Lunch
- Extra jacket
I like that my panniers are easy to detach and carry around, and they can carry absurdly large volumes of stuff before the balance of my bike starts to feel weird.
10. Bike lights.
Bike lights help 1) you see in the dark and 2) other people see you in the dark. Both of these should happen as often as possible. Safety!
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