Hey all, I am a relief tech. I have been going to the same clinics for a while. I’ve established good rapport with the doctors and techs. I’m pretty honest with what I don’t know and what I’m not comfortable with.
Recently, we had a table case. I was a doctor tech and basically had a frenchie in respiratory distress. Had to be intubated. This was a pretty complex situation because of owners, financial constraints, etc as we all know in this field. They tried to leave AMA, dog went blue as soon as it came out of oxygen kennel. Had to rush it back inside. Vet said we need to intubate and figure this out.
So here’s where my part came in. I was monitoring this intubated patient. I’ve monitored for anesthesia before, sure. It’s been a while since most of my shifts involve triage and floating. I had never monitored an intubated patient under these circumstances before. So this was a situation where I was familiar with anesthesia monitoring, but I didn’t know what table case monitoring was supposed to be. And I didn’t know that I didn’t know.
Something I think about a lot in this field, when we have licensed and unlicensed people. An LVT can be really inexperienced next to a grand fathered in VA that’s been doing this for 20 years. A big thing to note is recognizing that you know you don’t know versus fake it til you make it (dangerous) versus not knowing what you don’t know (really dangerous too).
And I’ve been pretty comfortable with recognizing “oh no I can’t place a central line because I’ve never and I definitely do not understand the process” or “no, I don’t relief for surgery because I have a very knowledge of what they do”.
Here, I just didn’t realize that there was so much more I could have been doing.
The doctor was busy. Only able to check in with me and pt a few times while she addressed other pt and talked to the frenchies owners.
Oncoming night tech arrives, probably one of the smartest technicians I have ever met.
He watched over what I was doing, how the patient was doing, and he waited before proceeding to intervene. The patient was not very stable. Breathing fast. ISO was being used. The doc didn’t want to do a prop CRI. This hospital didn’t have a ventilator and typically won’t see cases like this. But the options were basically zero so here we are.
Within about 20 minutes, the tech gets the patient’s CO2 levels down, gets RR down, stabilizes temperature, and all around knocks my socks off. I asked a lot of questions. And I learned so much. He got approval to start the dog on the prop CRI which helped. He explained the ideal things to do for a table case.
But eventually the frenchies CO2 went right back up and no interventions were working. He postulated that the dog probably had a lot of CO2 stored somewhere (like in the tissues).
Owners elected to euthanize. They didn’t have the funds to push this past what we had already done.
That case was a big lesson for me. And I got a big taste of learning how much more I still didn’t know. I don’t play pretend. I’m honest. I say when I’m not comfortable. But that was so humbling because I had been with that patient for 2 hours and had no idea.
I just wanted to share this experience. I am a happy learner. I am enthusiastic about this field and expanding my knowledge. This definitely felt like a harsh lesson. And I am trying my best to put away the what ifs.
If anyone can share insight for a situation like this, and a lesson such as this one, I am all ears.