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Monday, January 21, 2008

A world where doctors are trained by RTs

I wonder sometimes what the job of RT would be like today if doctors were required to work a day as an RT as part of their doctor training.

If we had RT doctor students, then we'd most definitely need a doctor RT student lounge, and in that lounge we'd have to have a bed and a TV for the doctor students to enjoy between passing out peace pipes.

BEEP.

Knock-knock.

"Wake up, you doctor student," Larry the RT said, "we gotta give another neb to Mr. Edgington."

"Wha...hugh..." The doctor smacked his lips together, rolled over, and snuggled back up under the blankets.

"Come on!" A sound of knuckles rapping on a wooden door. "Get out of that bed; it was ordered stat. Doc. student, come on! we gotta--"

"All right, all right... I'm coming." The doc. student swung his feet from under the covers and sat on the edge of the bed. His eyes were still glued shut. "The nerve of them stupid bla bla ordering more stupid bla bla treatments. When I become a doctor--"

"Yeah, that's what the last generation said. Come on!" He held the door and motioned for the doc. student to follow. Very, very slowly the doc. student managed his way to his feet. He opened his eyes, blinked several times to get used to the light, and followed the RT.

"I just want you to know," the RT said as the duo rushed down the hall, "Is this is one of my favorite patients. He's one of the coolest guys I've ever met."

"Really," the doc. student said.

Upon entering the room the RT observed a patient sitting on the edge of the bed facing away from the door. On a table by the window he saw a comode, and he watched as an elderly nurse replaced the tray of the comode, and rushed past the doc. and RT, into the hall, disappearing around the corner. The smell of bowel was redolent in the room.

The RT walked around the bed and faced the patient.

"You got like this because you went to the comode, hey?"

"Yep," the patient ghasped. "The usual." He was leaning on an end table like short-of-breath COPD patient are famous for, and had his shoulders hunched. While he looked like a COPD patient, the RT knew this patient also had an extensive cardiac history. He was got this way, he knew from experience, not due to bronchospasm, but due to his heart.

"You're a little wet too, I bet," The RT said.

The patient coughed up some of the wet stuff from his lungs and swished it in his mouth. He grabbed a tissue with one hand from a small box and hacked up a good one, but the sloppy wet, white secretions was overwhelming for the cheap tissue paper, and dribbled down his chin and onto his gown. He made no effort to clean his mess.

The doctor student plucked a pair of rubber gloves from a box on the wall, and slid them with some difficulty onto his large hands which, the RT thought, were probably too big to perform small operations. But, then again, what do I know? The doc. plucked several tissues from the box, and cleaned the slobber from the patient's chin.

"Thanks," the patient snuffed between breaths.

"We're going to give you a breathing treatment," the doc. said. The RT observed a bit of sarcasm in the doctor-to-be's voice, but he ignored comment on that as he observed the subject, who was obviously pale, drenched in sweat, and had audible rhales that could be heard across the room. He was laboriously breathing for sure. "Go ahead and listen to him.

"What the heck do I need to listen to him for," the doc. student grumbled. "It's obvious he's wet. What he needs is some Lasix and to pee."

"Um," the RT patted the doctor-to-be on the shoulders. "Doc. student, just do as you're told. If the real doctor orders a treatment, then it's a treatment the patient needs. What's so hard to understand about that. What this patient needs is a breathing treatment. One vial of scrubbing bubbles and the patient will be cured in an hour."

"Oh, come on," the doc grumbled as he put together the neb and squeezed a vial of Scrubbing Bubbles into it. "We've done 20 treatments tonight, and about 5 of them have been indicated. I could be in dreamland right now, instead my feet are killing me."

"Did you look at that vial you just poured in. You certainly don't want to give Xoponex when Scrubbing Bubbles is the ordered medicine."

The doc. student rolled his eyes. "Yes! What do you think." He closed his lips tight and concentrated intently on his task. You're mad aren't you. This oughta teach you to order useless therapies when you grow up.

"I could be sleeping." The doctor placed a mask over the patient's face that was connected to some O2 tubing, which the doc. pluged into a flowmeter on the wall, and turned up the flow on the flowmeter. The nebulizer spun to life, hissing. The magic mist instantly filled the mask and billowed through the holes in the mask into the room. Heressed his fingers around the patients wrist and stared at his watch.

The Rt laughed to himself as he stepped around the bed and stood by the door. "Doc. student," he said, smiling, "There will be plenty of time for sleeping on the job when you become a real doctor. You should just be happy our bosses let you practice for that part of your job with that bed in the student doctor lounge. If it were up to me you'd have to stay suffer with staying awake like us RTs and RNs have to."

A fresh, sweet smelling breeze suddenly wafted over the RT as a pretty young dark haired nurse came into the room. The doctor let go of the patients wrist, stepped back and the RN gently positioned the syringe into the port on the patient's IV line. "I have something that will make you pee."

"Good," the patient said.

The RT sat in a chair by the door so he was facing the back of the patient, but could observe his student closely. He crossed his legs, and set his clipboard on his lap. He watched closely as the patient inhaled the magic mist. He knew the treatment wasn't the solution to the patient's ailments, but he enjoyed bossing the student around, because he also knew in a few years it would be the other way around.

"You know what," the RT said on a whim and looking over at the doc. student. "When you are a real doc., you'll get paid $200,000 more a year than me, and you'll get the privelage of us catering to your every whim. And , when your work is done, you'll be allowed to sleep all you want, while we lowly RTs will have to stay awake no matter how slow or tired we are."

The doctor looked at the RT with deep, dark glaring eyes. His eyebrows curved inward so they were snug over the base of his long, narrow nose. Then he relaxed his face, plucked the nebulizer cup from the mask, tapped it a few times, and pressed it back into place. More mist sputtered another moment, then the mist was gone.

All the RT could hear now was the familiar hiss of oxygen, and of course the patient's harsh, gurgling breathing. "It's done."

"I know," the doc said. He removed the mask from the patient, stuffed it into its bag, and set tossed it onto the windowsill. He listened to the patient with his stethescope.

"Do I sound better," the patient said, with a choppy breath between every second word. "Because I sure don't feel better."

"We're working on that," the nurse said, and left the room.

"You guys... are... pretty funny," the patient said, smiling despite his predicament. "You are... a pretty... good duo. Lasix works far better for me that that treatment."

"We'll come back and check on you in about ten minutes," the RT said.

"Ten minutes," the doctor on the way back to the RT cave. "So, after we get him fixed, how long before the next scheduled procedure."

"Three hours," the RT said. "Time to get some charting done."

"Well, I'm going to take a nap first."

BEEP

The doctor jumped at the sound. The RT observed the swear word that crossed the doctor's lips.

"Well, let's see what that is." The RT nonchalantly reached into his pocket and pulled out his pager. "Ah," he said, "Another ABG in ER. Well, how about that."

"ANOTHER ABG" "I hope it's not the same as the last ABG, where the patient was NOT labored, and had a sat of 98 percent on room air."

"Look doc. student, it doesn't matter. Our job is to do what we're told."

"Well, that's gonna end when I'm a real doc here."

The RT rolled his eyes. "Yep, I've heard that one before."

Fast forward two hours.

The doctor student grabbed a donut from a stash of treats provided complimentary by the hospital cafeteria for doctor students only to ingest and not for RTs to enjoy (however they've been known to sneak one from time to time), slammed the door to the RT Cave doctor student lounge, and flopped onto the bed. He groped blindly to one side of the bed for the remote control. When he failed to find it, he stuffed the donut into his mouth.

Through the door he heard a muffled beeeeep, followed by a knock on the door. "Come on, doc, time to go do another ABG."

"Argh."

1 comment:

Djanvk said...

Good story partner. That is something that definitely needs to be added to medical school.