Oct. 9th, 2016

hillarygayle: (Nurse Hillary)
I finally got a paycheck! We stumbled right before the finish line, as we didn't realize one of my credit cards was set to auto pay. It was the one I'd used to get my DEA number, so it was a very LARGE sum of money taken from our checking account all at once and put us in danger of having a series of cascading overdraft fees. Fortunately we were able to get it refunded very quickly, and they refunded the one overdraft fee that did happen. Whew!

My paycheck for September landed the day after that. Man, it could've saved us a lot of trouble a few days earlier, but whatever. We are once again financially solvent! We celebrated yesterday by eating sushi at Sumo and going out for some not-really-necessities shopping. :) I feel like we've had the hatches all battened down financially for the last few months, and it's caused us to be pretty hermit-like to avoid unnecessary expenditures. The spending moratorium was lifted yesterday, and I got myself a new foundation, a new Urban Decay lipstick (one of the classic colors from the 90s!) in Smog, and a new Ava & Viv t-shirt for work. Bought Ganon a plush Eevee. He was thrilled.

Work is still going well. I'm trying to get my perfectionist tendencies under control so I don't beat myself up every time I fail to know something. I get really anxious when I find something I don't know and have to ask, which is bad for my mental health and not logical at all. So in addition to my Socratic questioning method, I've also purchased Barkley's Guidelines for Acute Care Nurse Practitioners and Tintinalli's Emergency Medicine, which are on my iPad. Between those, Sanford's Guide to Antibiotic Therapy, and my forthcoming Up To Date login, I should have enough resources to back myself up on anything I need.

Had a few other "firsts," such as the first person to whom I had to say "There is nothing about this situation that's an emergency, and this was not an acceptable use of the emergency room." Had the first person I asked for the appropriate pronouns (their gender presentation was off from their stated gender, so rather than be damaging, I asked) and was treated to the most genuine, soul-deep "thank you" from the relatively young patient and their father, who have had nothing but bad experiences with medical situations up to this point. Had my first person curse at me, turning their back to me and muttering "fucking liar" under their breath when I explained for the 4th time that radiology was not reading our plain films in a timely fashion and that was causing their excessive wait.

It remains a very intense job, as it always will in the emergency department, but I love it so far. It could be a honeymoon period, but somehow I doubt it. Somehow I feel like emergency medicine, with all it's mundanities, repetition, and moments of fire, screaming, and excrement hitting air circulation devices, is my spot.
hillarygayle: (Hillary Deepwood House)
There is definitely something I need to take up with my advisor in the program at UTHSC, though.

During my time in the program, we were given VERY little information about vaginal, uterine, & cervical problems. We were acute care, and there was a women's health program, and never the twain shall meet! In fact, I once asked if I could do a written report on the ICU management of a post-delivery patient who was on the vent, and my advisor specifically told me that was women's health and we didn't do it. Okay, sure, it started with the delivery of a baby, but are you telling me the OB-GYN is going to manage that patient in the ICU? Naw, it ain't gonna happen. But the only training we got was for swabbing for sexually transmitted infections.

So here I am working in emergency, with my adult and geriatric patients, and guess what? It turns out about half the people I see in the ED have uteruses, vaginas, and cervixes! And sometimes those people are having problems with those things, and they are not sexually transmitted infections! WEIRD, THAT.

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Oct. 9th, 2016 03:03 pm
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