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Wednesday . July 09 . 2003 . 9:45pm wednesday, bloody wednesday I had not such a great day at work. The in-service exam was basically a joke, since I didn't know any of the answers, but I just tried to get through it as fast as possible. Taking multiple choice tests very, very, very fast is actually not such a bad strategy, because they're torture to linger through, and I find that going with my gut is not a bad way to pick answers. And then you have more free time afterwards! I finished Step 2 of the Boards two and a half hours early, and that was after taking a ninety minute lunch break. (And yes, I did well.) Go go Speed Tester! I won't do well on this in-service exam, of course, but I didn't prolong the experience either. I returned to the floor to find everyone in a tizzy over a mistake that I'd made before leaving the floor. A patient of mine, who happens to be on the small side, needed a transfusion, and so I ordered blood for him from the blood bank. However, thinking that a unit of blood (one of those bags you fill up when you donate at those blood drives) is the smallest volume you can order at a time, that's what I ordered for him. A single unit is the smallest blood order I've ever seen, but then again, I'd only seen transfusion in adults. So it actually turns out that you can order fractions of units, if the patient is smaller than one unit's worth. Who knew? They just connect the unit bag up to a smaller bag and squoosh the blood on through. Huh. Live and learn. Story of my life. I wasn't all that perturbed by this, since it's quite obviously one of five million mistakes I make a day, and I'd never intended for this patient to get all the blood, but everyone else was flipping out. Nurses were flipping, WHAT IF WE HAD RUN THE ENTIRE BAG IN BY MISTAKE? WE COULD GET SUED! Fellows were flipping, WHY DIDN'T THE BLOOD BANK CALL TO TELL US WE HAD ORDERED TOO MUCH? Which created this whole pandemonium of WHAT THE HELL IS WRONG WITH THIS PLACE, HOW COULD THIS HAPPEN, LOOK AT ALL THIS BLOOD WE WASTED! (It was about 2/3rds of a unit.) That the only people that weren't flipping out were my senior resident and I. He: "Well, next time you'll know that you can place an order for 10 to 15ccs per kilo." Me: "Yup, will do." I mean, it's not like the end of the world, I didn't order a gallon of blood and leave it out in the sun to rot or anything. We didn't try to infuse the patient with 20 times his body volume in packed red blood cells. The patient got his transfusion, which is what he needed, and that's that. Not to say that I didn't make a mistake, because I did, I did I did I DID, but look on the bright side, I'll never, ever make that error again. And hey, I'll even give blood the next time the Red Cross has a blood drive, which should more than make up for the portion of a unit I wasted. That should soothe every corner of my conscience. In some imaginary corner of my mind, a small child is bleeding out, and all that she requires to live is the 200ccs of Type O positive that we just trashed. It did put me in a little of a tense mood for the rest of the day, though. I was trying to be extra considerate to smooth things over, "Please" and "Thank you" and "Excuse me"-ing my way through the day, but also much less able to tolerate the rudeness of others. When another doctor snapped at me for opening up a file cabinet in front of her, brushing her legs (I had said "Excuse me," but she didn't hear me since she was yammering on the phone) I almost lost it. Don't you hate it when all you're doing is going out of your way to be nice and polite, and people somehow twist things around and make it out like you're the one who's being rude? Gah! Tomorrow will be a better day, I'm sure. xo Michelle |
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