stress and de-stress

On top of a crazy week at work I had two tests on Thursday and a paper due on Friday, none of which I felt very prepared for.  After Tuesday's crazy day I did not have the capacity to start writing a paper or indulge in intense studying so I made the executive decision to make it an early night and cram it all in after clinical on Wednesday.  After clinical and a quick nap I hit up the arrhythmia strips which was one of my tests.

There were 19 different heart rhythms that we needed to be able to identify on an EKG strip plus causes and treatments for them.  This was one of the only tests that I studied for weekly.  One week I focused on sinus rhythms, one week junctional rhythms, one week ventricular rhythms and so on.  I was getting frustrated because I knew the rules for all the rhythms but the strips are not always that straight forward and obvious.  Which I guess is the point of higher level thinking and applying your knowledge rather than just spitting it back out.  Is that a p-wave or is it undiscernible or is it just artifact?  Should I start measuring the PRI and QRS interval here or here?  It is frustrating.  By the time I figure our the arrhythmia the patient would probably be dead!  Our book literally has hundreds of strips to practice on and my confidence was decreasing as the night went on. I studied arrhythmias for a good 6 or 7 hours that night.  We needed to get a B or better on the test or we had to retake it and I was not going to add another test to take on my list of things to do.  With my primary focus on arrhythmias I chalked up my public health test as a common sense test and most of the content seemed like a review of my health promotion class so that wasn't high on my priority list.  And I wasn't going to increase my stress by thinking about the quality improvement paper that was due the next day.  That would have to wait until after the tests.

I finished the public health exam and of course everyone was complaining about how ridiculous the questions were.  I personally walk away from those crowds and don't like to talk about the test after the test.  It only makes you more nervous when people are like what did you put for this one, oh I put this... yada, yada, yada.  I chose to go to the computer lab and print off stuff for my trip to Charlotte (that will be the next post) and ignore all the buzz after the test.  There was a quick study session reviewing strips after lunch and then we had a lecture on OB emergencies before the arrhythmia test.  Did you know that even with a very low incident rate, 10% of maternal deaths are due to as little as 1cc of amniotic fluid getting into the pulmonary vasculature?!  They think the fetal cells and hair cause an anaphylactic reaction and the airway closes.  They are now changing the name from amniotic fluid embolism to anaphylactoid syndrome of pregnancy.

Anyways it was hard to completely focus in lecture, because all I was thinking about were EKG strips.  Then it was test time.  Lynn, our instructor, was like guys this isn't suppose to be that stressful and I replied, "Lynn have you met our cohort before?" to which she just laughed.  She was kind enough to grade our tests right then and there so we knew if we passed or had to retake it.  That was the most nerve-racking part.  Just sitting in line waiting your fate.  When she graded mine I was able to identify all the strips correctly, I just got one silly multiple choice question wrong which I should have known in the first place (pts in v fib don't have a weak pulse, they have no pulse!).  I will take the A though.  Since we had two tests that day, Lynn was kind enough to push back our due date for the paper from friday to sunday so that meant I could go home and enjoy a bottle of wine with the company of my roommate. And that is exactly what I did!