Externship: Week 7

Wednesday, December 24, 2008

Week 7 of my externship flew by!

Tomorrow is the last day of my externship and today the Office Manager pulled me into her office and offered me a permanent position! She was highly complimentary of my professionalism and abilities as a Medical Assistant. She also shared with me the feedback she received from the physicians and patients and it appears I made quite an impression on everyone in the office. Boy did hearing all that feel GOOD!

A few weeks ago I had a slight problem with one of the other MAs. I was in the hallway with a patient when the other MA behaved in a very unprofessional manner toward me -- and in front of the patient. Her comments were out-of-line in general, but she definitely should not have shared them with me in front of a patient.

I stewed for a little while about the incident with the other MA and finally decided to handle it properly -- the professional way.When I noticed the other MA had finished with her patient and was alone in one of the exam rooms, I asked her if she had a minute to talk and she said yes. I stepped into the exam room, closed the door behind me and in a business-like tone of voice I let her know that she was not only completely out of line, she should never have approached me to discuss anything like that in front of a patient.

That MA met with the Office Manager to let her know of the exchange between us and not only was the office manager completely impressed with the way I handled it, she totally agreed with what I said. Much to the dismay of that MA.

During Week 7 I assisted a different MA with an ear irrigation on a patient with impacted wax. I was not yet ready to perform this procedure on my own -- and this would only have been the second time I have observed -- so I offered to assist instead. It's not that I am not confident that I can perform this procedure, I am just a tiny bit hesitant because it takes very little to puncture an eardrum.

Our patient was a very sweet and funny, average height, but very thin, elderly woman. The MA and I took turns looking into the patient's ear with the scope trying to determine the severity of the situation. Absolutely none of those peeks prepared us for what we finally extracted from her ear.

For starters, the patient had very tiny ear canals -- similar to those of a young child -- which means it took quite a bit more water than usual.The apparatus we use to squirt water into the patient's ear reminds me of a metal cookie press with a (icing) decorating tip on the end. We also use an emesis basin (a small, odd-shaped bowl you find in hospitals) to catch the water as it drains from the ear.We draw warm water into the tube, gently insert the tip and, pointing the tip toward the top of the ear canal, begin squirting water into the ear. (Pointing the tip straight into the ear canal can severely damage -- or puncture -- the eardrum.)

We were able to dislodge small particles of wax and I think we were just finishing our third tube of water when the other MA stopped to draw the fourth. As the patient raised her hand to her ear, the other MA noticed a large object sitting right at the opening of the patient's ear canal and prevented her from touching it.The MA picked up a currette (tool) from the counter to scoop the object out of the patient's ear. Instead of successfully scooping it from the patient's ear it flopped out onto the floor near the MAs feet. By this time the three of us are giggling like crazy, the patient is thrilled she can hear again and the MA scoops the object off the floor and onto a paper towel.

Although my husband may disagree with me, I really do have a pretty strong stomach. (Baby, does last Christmas mean anything to you?) The combination of a hot, stuffy, small exam room, the marble-size, multicolored object on the paper towel, and the smell emanating from it, I quietly excused myself from the room.

The very important thing to remember is this: I did NOT vomit! I was gagging at the base of my throat, but I did NOT vomit!

After taking a few deep breaths and running cold water across my wrists, I returned to the exam room and assisted the other MA with finishing up.