It's Pat!!

I've known a few Pat(s) in my life. My father in law & brother in law, my next door neighbor's mom (when I was growing up), and my favorite professor who was my medical terminology instructor at CRC are all "Pats". The television series, Saturday Night Live poked fun at the unisex nature of Pat & the confusion over whether Patricia is really a Patrick and vis versa. Today in lab, we had sim-Pat. Our procedure was to intubate him with a nasogastric tube for suctions, feedings/medication administrations etc.

The roadies had watched the video over the weekend and were anxious to see how we'd do in the simulation of it. Essentially you have a patient in bed (sitting up) in what is called a high Fowler's position. Pat was conscious (as much as a dummy can be) and part of it was working through the approach to prepping for the procedure, explaining it to the patient and gaining their trust and cooperation, "Ok, Pat, I'm student nurse. I'm going to stick this long piece of hose up your nose & down your throat...which will pass along your oropharynx and into your esophagus where it will enter into either your stomach or your lungs. I am going to shoot for the stomach - but I want you to hold up your index finger, if something doesn't seem too right, you just let me know..but...first thing's first, I am going to make this tube nice and slippery, ask you to tilt your head back and when it hits the back of your throat and you feel the gag reflex, I'm going to have you tilt your head forward chin down, while sipping this water, which will help the tube slide down the back of your throat and into your stomach."

Piece of cake. Right.

Once the tube is in the stomach, the nurse then verifies that the tube is in the right place. The process involves pushing an air bolus through a syringe into the tubing while auscultating (using the stethoscope) the stomach to see if you hear a swoosh. After that, the nurse aspirates gastric juice to assess it visually and either re-injects it and/or tests the gastric fluid's pH. If that doesn't satisfy the nurse's assurance of the tubing arriving at ground zero, then radiology will bring up a port and confirm placement with an x-ray. Whew. I'm feeling a little sweaty.

After securing the line, everything is charted. Rechecking placement occurs often & according to suction, feeding and/or medication schedules.

The class was so focused on Sim Pat's throat, we didn't know he was a she until we went to ausculate 'his stomach...that's when the big reveal occurred. Whoops. Hello Patricia.