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due to uber-exhaustion from inadequate sleep or rest during the week.
Wide awake this morning at 4am. Worse, when I made the mistake of getting up, the dogs insisted on going out.
Now I can't get moving, but I have much to get done. I think I had wierd dreams too, but mostly lay away worrying about clinicals.
Very, very wierd day yesterday in blood banking. I had to do a ABO/RH gel typing on my own blood. The test, which should have been foolproof, totally failed. The control failed. The forward typing failed. The reverse typing failed. Everything came up positive. Aside from the fact that I know I'm type A, everything cannot come out positive. For example, if forward type A is positive, than reverse type must be negative or something is going on. And the control must be negative or it negates the Rh result. It was a flippin mess and I still don't know why. My other gel tests have all been fine.
Anyway, due to the craziness of the teacher, I fudged the results and threw the test out. Yup, everything came out as expected. Yup. :shrug:
And the craziness of the teacher is a fact. First, as students we are using expired reagents to save the hospital money. Mostly they work, but there is one reagent that is refusing to work, ever. I checked with another student last week, and discovered I am the 3rd student in a row the agent fails with. Between the 3 students, we have done 65 quality checks in a row and it has failed every time. The teacher *refuses* to admit the reagent is contaminated and *refuses* to replace it. However, if we report a failed qc, then all of our tests that day are thrown out and we have to start over. Since we have to complete a couple hundred tests and turn in the results, we cannot afford to do that. So I'm the 3rd student in a row (that I know of) who is fudging results in order to complete the effing rotation. I told the program director that I supposed I could just keep repeating the qc all day, every day until it either works or I run out of reagent...but I don't really want to spend my time that way. She was stunned that the reagent hasn't been replaced. She is too smart to confront the teacher with it while I'm still there, but I suspect there will be new reagent for student #4.
In the meantime, it just kills your motivation. Everything, from that point on, turns into a big "who gives a fuck" fudge job. I hate blood bank. It's the one area where a mistake can literally kill someone. And there we are, practicing with expired,contaminated reagents that are guaranteed to fail every time. :shrug:
Second, the case studies. The teacher is always right, no matter what. And she wants us to do them without consulting our notes or book -- just off the top of our heads. But when I told her that much of the stuff in the case studies we had never covered (and in fact, is not even in our book, never mind our heads) she told me she used to teach and she's read the lecture and it is so. Okey dokey.
Then we sit down to review them, and as soon as we got to the difficult ones, she's like, "well, I don't know what pressures they're talking about there," and "oh, this method was used 20 years ago when I first started and blah, blah, blah," oh, and that stuff is a version of penicillin and blah, blah, blah. So, uh, YEAH, WE NEVER COVERED IT AND I NEVER HEARD OF IT.
Oh, and I was supposed to know that certain coagulation results were "classic" signs of DIC. Except we did NOT cover any specific lab results for DIC in lecture. And the 2 times I have seen it, in this lab and in the other lab where I did chemistry, they did NOT diagnose based on coag results. In one case, I saw the pathologist's report, and know for a fact the diagnosis was based on the RBCs in the blood smear. And in the other case, I saw the hospital's protocol for DIC, which again was based on the RBCs in the blood smear. No mention of coag results in *either* place.
Best of all were questions that I got right that she insisted were wrong. My favorite was "does a single antigen fit this pattern?" and my answer is "no" and she says I'm wrong. So I put her "right" answer (in red -- she requires that we put her input in red :eyes:) directly under the phrase "a single antigen." Her answer, btw, is "yes, antigen E and antigen Dya." In other words 2 distinct antigens are "a single antigen." Her explanation is that there are 2 patterns -- the 2+ pattern at 37 degrees and the 1+ pattern at ahg. And that a single antigen fits each pattern. Except the question didn't ask if a single antigen fit "the 2+ pattern" or if a single antigen fit the "1+ ahg pattern." It asked if "a single antigen fit the (implied single) pattern." Because there is really only one pattern, which is a more complex pattern due to having multiple antibody:antigen reactions. Which was the point of the fucking question to begin with. They were asking if a single antibody was causing all the reactions, or if the patient had multiple antibodies.
But of course, she was right. Unlike the 1st student, though, I don't butt heads with her. I just gracefully admit my incompetence. But at least with that particular question, she noticed my careful positioning of the red correction, and then realized what I was saying. :D She did a doubletake, and then muttered, "well I can see how you might have *thought* that's what they meant. But your answer is wrong." :rofl: What a freakin' fruitloop. I think it runs in bloodbanking...
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