#sim lab

[justinesattendingadventures]

"The Doctor"

Today I did an interprofessional team immersion where a bunch of students from the COM, dental, PA, nursing, social work, pharmacy, and occupational therapy schools got together and treated a fake patient.

Everything went well, and since we didn't have a pharmacy student on our team, I became the person in charge of that. This is hilarious if you know me and how much I struggle with pharm, but even though my pharm knowledge is about average for a medical student, it was interesting that it was more than anyone else had acquired so far.

Anyway, I was talking to the patient about her meds, how she's taking them ect. ect. And then as the social work student was talking to the patient, she said something along the lines of "and that's why the doctor is concerned about your medications" and at first I was like there isn't a doctor here?? And the I was like oh... she means me!

Like obviously I'm in medical school and am well on my way to becoming a doctor, but that goal has always been so far away that it barely exists. It was just jarring to hear myself be referred to as "the doctor" but it had a nice little aftertaste of pride. In a little over two years, that'll be true!

[jonesie32]

So I volunteered to be the RN during our SIM lab final, and omfg what did I do to myself?

My “patient” was a 72 y.o. M who was found by his daughter on the floor of his home. Admitting dx of rhabdomyolysis exacerbated by heat exhaustion and electrolyte imbalances. He also has a stage II pressure ulcer on his coccyx. He is dehydrated and has a foley in place with dark amber urine.

He’s confused, oriented only to self, and is very anxious. He c/o 6/10 pain and nausea, but no vomiting.

H&H is a little low, but nothing significant.

Potassium is 6.8

Sodium is 155

All other electrolytes were WNL.

Temperature 104.2

Heart Rate 118

Blood Pressure 80/60

Respirations 22

Oxygen 96% on room air

I walk into the room and my patient is still in his street clothes. Immediately my LPN and I turn down the lights, room temperature and start changing him into a hospital gown.

I auscultate his lungs (clear) and start and grab the aforementioned vitals. That’s when he starts “vomiting” coffee ground emesis (thanks to my lovely classmate armed with a large syringe 😂).

I administer PRN IV phenergan and “call” the doctor who I give my SBAR report to and receive verbal orders for IV meds and fluids including 1/2 NS with bicarbonate to infuse @ 300ml/hr.

Eventually a two hours pass and potassium is down to 5.9 and sodium is down to 142. Blood pressure is starting to go up, and heart rate and temperature are going down.

I can’t remember all the details of what we did, but eventually my patient stabilized and their hypovolemia and electrolyte imbalances started to resolve.

All in all it was a chaotic experience, but I loved it. 🤣

[justinesattendingadventures]

SIM & Surg

This morning I had another SIM lab to practice treating a patient without consequences. It was fun as always and I got to practice explaining complex diagnosis and treatments to the patient in simple language, which I think I did pretty well. It really just made me excited for third year and actually getting to talk to people about their conditions and trying to make sure that they're involved and informed about their own health.

Then we had surgical lectures all afternoon. Surgery is really cool but ugh I don't think I could ever be a surgeon, especially not a plastic surgeon. There's something about making something look so much worse than it already does that I don't like. I know it heals well especially with good surgeons but our lecturer had no years later after photos, just ones taken after dressings were removed so it looked pretty bad. I'm still excited to do my surgical rotation though since I want to refine as many "doctor skills" like suturing as I possibly can while I'm still a student.

[justinesattendingadventures]

Today was another interesting day. I spent the morning in SIM lab acting out patient scenarios which was a lot of fun. We even got to run a full code! This is literally the only environment where that would be fun because there was no patient dying, only a high tech mannequin that we managed to save.

In the afternoon, we had a LGBT symposium where we learned about the health disparities of LGBT youth and had a discussion panel about how to approach patients who are part of the community. Then we focused on the specific needs of transgender patients, the appropriate hormone treatments, and how to perform gender reassignment surgery. One of the 10 physicians in the US who performs these surgeries is an alumnus, and he brought a boatload of pictures to show us. It was a little graphic, especially for someone like me who doesn't enjoy surgery in general, but honestly I'm so glad we had the opportunity to learn from him.

[justinesattendingadventures]

Today I had SIM lab in the morning, which was really cool. We followed a patient (a very high tech mannequin) through an ER visit, a PCP follow up, a second ER visit turned hospital stay, and then grand rounds. It was sooo fun and interesting. We each took turns being the attending so we had to do the history and physical, order labs, interpret them, diagnose the patient, and figure out a treatment.

Then I went to a flu shot clinic where I finally got the okay to give shots to real people! I'm so excited to actually do real procedures even if it's as simple as a flu shot.

[karenlier-blog]

http://www.usd.edu/~/media/files/health-sciences/nursing/simulation-scenarios/acute-kidney-injury-scenario.ashx?la=en

[curlygirlfriends-blog]

So, funny story: I put some flexi rods in my hair so I could be cute for sim lab this week. Then the next morning I overslept. So I hopped out of bed, literally yanked the rods out of my hair and bolted out the door.  On my way to school, at every stoplight, I would separate my curls! I still am impressed that it turned out so well! (I took the picture at the end of the school day)

[introversiontherapy]

There are a lot of things that bring me anxiety. Sim lab at bcit is #1.