Good Time for Good News.

tired. brain hurts. but it's been too long since we've talked and i wanted to drop you an update.

so as i mentioned earlier, things are bad financially for our hospital. everyone is in an uproar. they're announcing a bunch of cost cutting measures like eliminating our extra overtime pay and a variety of employee programs and benefits. but we all still have jobs and our salaries aren't being cut. (which can't be said for some of the execs and in-house MD's-yikes!). so we're losing some benefits and some morale, and we have to get used to living low on the piglet instead of high on the hog for a while...but it'll be alright.

and...it's dark and cold out and i wear 3-4 coats at any given time to try to stay warm and am threatening (again) to let all my body hair grow long and shaggy and gain 20 lbs to provide myself a little extra insulation. (my husband finds that joke heelarious, i assure you).

but everything will be fine. the poverty of the nation and the unfriendly weather cannot really phase me today. because today i passed a very important goal. i eventually didn't totally suck at a pretty tricky surgery.

so, here's the thing...i have to be able to be competent assisting in every major type of general surgery before i can take call. and my 'orientation' period is practically up when i will go before my boss and be assessed on my progress and asset as an employee, and it will be determined if i am ready to be solely on my own and able to take night call (finally making me a productive member of the department, an integral part of the team).

so one of the types of surgery that i need to be good at, and that is considered one of the most challenging, is vascular. it's very demanding and particular and each tiny move can be disastrous, since you're playing with people's major vessels and all. it also so happens that the vascular surgeons at MBH are rather...tricky personalities. so it's important that i build the skillz but also that i have the trust of the MD's to provide the needed help in those ruptured aorta moments in the middle of the night when i'm on call.

so, to build said skill(with a "z!") and said trust yesterday i was scheduled to scrub w/ another PA on 2 carotid cases with one of the vascular surgeons. (carotid arteries, when filled w/ plaque can lead to strokes, so when they're over something like 80% occluded, you go in, open the carotid, and take the plaque out, then sew them back up. pretty routine, but also pretty dangerous if not done meticulously, as you can imagine). the goal was for me to 1st assist on the cases and so prove my independence, with the other PA just being there for backup if i needed them.

well...midway through the first case, the surgeon wasn't satisfied w/ my knot tying skills and so yelled and made me give up my position to the other PA. when the case was over, i did not cry or anything, but was pretty down in the dumps and the PA told me to give the doc some space and not to come back for the second case. but i'm bull headed and wanted to prove that i wasn't giving up, so i scrubbed the second one, too. the doc eventually softened to me a little and after the second case he demonstrated what he wants and gave me some good pointers. so in an attempt to show him my interest and desire to improve (i really do love vascular and want to be good, dagnammit), i told him that i would practice my knot tying skills and that the next time he saw me he would be "very impressed."

so, naturally, last night before i went home, when i looked at the assignments for today, what am i scheduled for? same surgery. same doctor. so all last night...in the car, at bible study, while watching TV, in my sleep...i practiced knot tying. and i didn't sleep much last night, tossing and turning (and tying). i kind of knew that if i blew it today, it might not bode well for my job. and certainly not w/ my future w/ this doc. and most definitely not w/ my aspirations to be an awesome vascular surgery PA.

but it went pretty well. i had a PA scrub w/ me on the first case, and the whole room kind of held its collective breath while i showed him my knot tying. but when it didn't completely suck, i just kept going and i finished the whole case as 1st assist. so then we did a little minor fistula surgery....and then we had another carotid. and i did it ALL. BY. MYSELF. and it also went pretty well. not awesome. i have tons of room to improve. not sure if i would consider him "very impressed," but it was alright. and i'm pleased. and i'm just really glad i didn't back down or panic and run into the woods (as i considered briefly in one dark moment yesterday). i showed that i have the desire and am teachable and that eventually i will be a good help.

and now if you'll excuse me, i need to go drink.