General Fiction posted March 13, 2018 Chapters:  ...50 51 -52- 

This work has reached the exceptional level
There are several surprises in this chapter.

A chapter in the book The Life of Mrs. Armstrong

Surprise, Surprise.

by aryr


Mrs. Armstrong comes out of retirement, and decides teaching has its own unique challenges.
The next morning after the specimens were placed on my desk. I explained what the plan for collection was. As expected the second and third groups responded with disbelief and shock. I had the first group remind me of the issues from last night. Then I told them who would be testing whose. More shock. I did however relieve some of the tension by telling them that everyone would be given a mask.

I let the group explain the procedure and get supplies, when completed the second group spoke with the third group. It was now time to test.

"Everyone in group two will get two paper towels, a mask, gloves and a tongue depressor for their desk and then come up and pick up a specimen bag. The other two groups can hover and watch. I will pass out testing solutions, there are two kinds. You only need one drop of each, so don't drown your specimens. Both are used to detect occult blood, one is used for the card and one for the actual specimen, the bottles specify which. I will also bring around two slides, you will smear a small amount of stool on one slide and then place the other slide on top. We will examine those under the microscope. Please, everyone, write down your findings."

Group two looked doubtful but got everything they needed.

"I have no idea, what each of you will find, but you will have stool of some sort. I suggest you read the bottles first. Oh, when we are finished these specimens just like the blood will go into the biohazard containers. Fortunately, we can flush urine down the toilets.'

I noticed that several techs as well as others in the room had great gag reflexes. But they did manage to succeed in their tests, as did the next two groups. Under the microscope they checked for specimens that showed ova and parasites. There were none, but of course, my dear old doctor friend had provided some in my collection. It was surprising the things this man had collected. Even more surprising was the fact that I was finding it useful.

When we were finished with stool collections we had another day of drawing blood. A continued source of practice. They were doing great. All signs of nervousness and fear had disappeared.

We spent a day discussing the procedure for taking swab specimens, where they could be taken from and why they would test. We also reviewed sputum collection and phlegm. They now knew the difference and how to direct the patient to produce and provide them.

The next day was again a blood draw day. They all recognized the need to be comfortable and to be as perfect as they could be when they ventured out to their supervised clinical experience.

The next day covered a topic that I am sure none of them had thought about, probably never wanted to think about and one that they were now hoping not to have to think about ever again.

Emesis which is not really a threatening word, until you realize that in common everyday language it meant 'vomit', 'throw up', 'barf' and 'up chuck'.

Everyone was astonished to find out that they did learn about testing and handling. I guess this would be a good time to mention I had such co-operating friends. One young lady was in the early stages of pregnancy and suffered severe nausea and vomiting. Because of this she was a great supplier of bile. Bacon and coffee smells produced excellent samples. She had her good and bad days. The bad seemed to be the days she decided to cook bacon for her husband as well as brewing his coffee.

I had a couple of other friends who were both willing and able to provide emesis samples. They had both had gastric by-pass and yet still enjoyed over indulging at least once a month. The result was of course vomiting. I truly believe one has to have the correct mind set to have this type of surgery.

Regardless I was able to get ample supplies of both specimens and they were used for class. I explained that although we did not have the correct equipment available, that sometimes they would have to run tests on such samples. The best test we could do was with the litmus paper. I also told them that in some cases it would involve determining the stomach content.

Doing the gastric strip test caused every one of them to gag and dry heave. In some cases, just picking up the closed specimen bottle produced these effects. I cautioned them all not ever to do so in front of the patient.

I even shared the story of the doctor who used to delight the nurses by eating an egg salad or tuna salad sandwich while he did rounds for his comatose, ventilated patients. One day, I was concerned about one such patient and called him. I do believe he made a stop to the cafeteria before coming to the floor, because sure enough he had his sandwich.

"I can't believe you called me, especially before my scheduled rounds. And I don't believe a word of what you told me on the phone. So, this had better be good."

I directed him to the patient, that was my concern. Explained once again what I had discovered and set up to suction via the trach. As it was earlier, I was suctioning up the same thing.

"Holy shit, those are live maggots in the tube, call down for an immediate flush. We have to get all those little buggers out and fast."

"Yes Sir, I will be accompanying the patient and will call you when we are done so you can check her again."

"Thanks, and I am so sorry I didn't believe you. That will never happen again."

Then he turned and vomited his sandwich into the waste basket beside the patient's bed. It was the last time he ate during rounds and the patient came through the procedure fine and in fact woke up about five months later. She had come in unconscious, needing a ventilator about a month before the maggot issue and remained comatose for about five months after. One day she just opened her eyes and she was back.

Again, everyone gagged and several tore out of the room and down the hall to the rest rooms. It was a day, that everyone of them would remember.

The time was passing by so fast. It seemed as if they had just started their clinical learning, but now they were tying up the loose ends. The last couple of days were used to have them complete different forms that they would use or see.

I called Mrs. Trenton the Thursday evening before they would go to their clinics the next week. Roni has graciously called the labs listed that were willing to accept students and made all the arrangements. She also announced that she would be returning for the clinical checks and that she had been called by the dean. I would be assisting her. We were both so pleased.

On their last Friday, they gathered more to meet and say goodbye. They all knew that they would be able to pick up their certificates the last week of their clinicals. They were delightfully surprised when I advised them that Mrs. Trenton was returning. They were super happy to learn that I would be assisting her. I took the opportunity to remind them that, at any time they could call Mrs. Trenton or myself, with questions or concerns. And that Mrs. Trenton or I would be checking in with them every second or third day.

They were each given their assignment, the location, the required dress code and their name tags. The usual dress code was dress pants and navy blue collared polo shirts. Of course, comfortable shoes, after all they would be on their feet a lot
I had brought in a cake and sodas. The class room was decorated with streamers and balloons.
They equally surprised me with a card signed by them all and a wonderfully silver serving tray. They had a card for Mrs. Trenton and a small gift. We hugged a lot and I promised I would see them in their clinical.

It was enjoyable to watch them grow, as they gained experience. The reports Roni and I received were of outstanding performances. We were both pleased to meet with each of them as they came in for their certificates and we released them to fly on their own.

The End.

Thank you to everyone who faithfully followed. Mrs. Armstrong and her students will miss you. (smile)
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