So, I’ve worked in the Cath Lab for about five years now. It sounds like a long time, but there are days when it feels like I’ve been there for less than five weeks.
I consider myself pretty intelligent. Well fairly intelligent, anyway. And my Cath Lab training went pretty well, I think. I prepared for the standard 3-to-6 month internship, and by the end of three months I was taking “buddy-call”. Within six months, I could basically handle the requirements of the job whether it was a scheduled case or an acute mi.
The focus of my training at first was “in the room”, learning the procedures, the meds, the equipment, and, of course, what not to say to certain docs. It was fine, and I was pretty comfortable. Until I reached the last hurdle. Oh, and what a hurdle.
Monitoring didn’t look so bad, I thought. Right. There are days that I still think that. But five years later, there are days when I just want to sink under the desk rather than continue monitoring a case I’ve started. And, really, it all comes down to that dreaded word. Hemodynamics.
“Why?”, I ask myself, “Why do I get so freaked out about hemodynamics?” I wish I had the answer. But I don’t. And every single time I’m signed up to monitor a right heart cath, I might as well be on the table myself, having my own palpitations evaluated. It doesn’t help that the newer nurses in the lab just sit right down and start measuring and recording like they were born to it. Damn kids, I tell myself. Computers come so much easier to them!
Not me. I sweat. I fidget. I hyperventilate. I hover over the keyboard, silently reviewing the quick-keys so that I won’t miss a step. I pray to myself that the doctor will follow the “normal” routine, so I can just follow along with the macro. And how often does that happen? Never.
What’s worse is knowing that, with every misstep I make, everytime I have to say “one moment, please” to the doc, I’m one step closer to having to deal with a really pissed off MD, who’s ready to share with me every potential complication of my ineptitude.
Although it’s been a good year or so since I’ve heard the phrase, “get someone in here who knows what they’re doing”, it seems like just yesterday. And the thing is, I really do know what I’m doing. I know the anatomy. I understand the physiology. I understand the wave forms. But…I can’t memorize. I can’t memorize the pressures, and I can’t memorize the wave labels. This is my secret shame!
So, here I am, in the New Year. I’ve resolved that I will study more. I’ve picked up the Kern book a few times already, hoping that the numbers and waves will finally sink into my brain and stay there. But my eyes glaze, my mind wanders…and I close the book. I’ve searched the Internet for sites to review. I read a little…and shut it down.
So if my patient bradys down during the case? No sweat. V-fib arrests on the table? I’m all over it. But ask me to change my scale or sweep speed? I’m all thumbs and stuttering.
I guess there are worse things.