Rich Man

Dear Mr. Ira,
It is the request of one Akito Suvarta that you be present at the address on the enclosed blue index card on the 15th of April, 2005 Anno Domini. You are to clear your schedule for at least the week before and the week after. You are to bring one (1) sleeping bag, one (1) change of clothes, any hygienic items you wish to bring, two (2) weeks worth of MREs (to be obtained at the address given on the enclosed white index card), and, if you wish, one (1) flashlight, and one (1) book of your choice. You are not to bring any electronic equipment, any cellular phones or radios, or any means of audio or visual recording (no cameras, no tape recorders). You may not bring any other person(s) with you. You are to transport yourself alone. Upon your arrival, you will receive further instruction. If you are present at the specified location on the specified date, the sum of $300,000,000 USD will be transferred into an account for use by you or any person(s) of your choosing. If you are not present at the time and place specified, no money will be given, and there will be no further correspondence. You may tell your spouse of this offer, but no one else. We look forward to your visit.

-Iron Crutch corp.

Ardal Ira folded the letter and set it in the middle of the kitchen table. His wife reached for it, but she seemed loathe to touch it. She put her hand back in her lap. There was a long silence. Ardal broke it. 

“So?” It came out as almost a whisper. 

“I’ve never heard of the Iron Crutch corp.” 

“Neither have I. They must be well-off.” 

There was another long silence. Ardal took the letter and folded it into his pants pocket. His wife broke the silence this time. 

“Are you going to go?” 

“I don’t know. I suppose I have a month to decide.” 

“Is there a number you can call to…I dunno, get some information on this?” 

“Doubt it.” 

“Well, I mean…it’s three hundred million dollars. It’s not like we couldn’t use the money.” 

“It’s not like we need that kind of money.” He paused. “Do you think I should go?” 

“I don’t know…maybe. I’m not gonna say I wouldn’t like to have three hundred million dollars.” 

“We don’t need that much money.” 

“Then we can give some away if you want.” 

Ardal rifled through his pocket and pulled out the blue index card. He leaned back against the wall, staring at the address on the card. 

“So…what are you gonna do?” his wife asked. 

Ardal sighed and put the card back in his pocket. 

“I don’t know.” 

Ultrasound Nursing Article

Here’s an article I wrote a long time ago that combined helpful information with some art (I think!).


 

After (finally) deciding on a career path – and after reviewing the types of salaries you can expect , you decide you would like to be an ultrasound technician and work in a hospital setting.  However, while interviewing prospective employers, you notice each hospital informs you what Trauma Level they are. Before dismissing this information, take note and in fact, learn more!  Trauma Levels indicate many things about each hospital and could, therefore, help determine what your job might be like working there.

Each hospital has a trauma level determination, and can range from level one to level four. To qualify at a certain level, the hospital must meet the standards set by the American College of Surgeons. Some of the factors include available specialty services and patient volume (how many patients the hospital treats annually).

Level One hospital – has the care and equipment to handle critically injured patients. These hospitals are leaders in the field of trauma and injury. They maintain research programs and surgical residency programs. An example of a Level One hospital would be a large university hospital, such as Ohio State University, in Ohio.

Level Two hospital – works closely with a Level One hospital. As well as providing outstanding care, these hospitals provide supportive and supplemental care for the Level One hospital. These hospitals have specialty services as well, but only essential ones, and are not required have research programs.

Level Three hospital – can handle most trauma patients, including ICU patients. These hospitals have transfer agreements with a higher Trauma level hospital (either Level 1 or 2) to transfer care if there is need. For instance, in a multiple car accident or a fire where many victims will need to be treated, transfer to a Level 1 or 2 is typically done.

Level Four hospital – can stabilize and treat a patient. These hospitals are typically in remote areas and no alternatives are available.

You have chosen to work in a Level Three hospital. You will enjoy working in the close-knit community within the hospital. Many employees know each other, and work together to provide the best possible care to the patient. You may notice wonderful employee- started programs in a Level Three hospital such as weight-watchers, share-a-ride, as well smoking cessation groups.

Because the hospital is smaller, you will soon become familiar with ‘regular’ patients, those who are elderly residents in the community. While a Level 3 hospital is smaller, in terms of how many patients are seen per year, these hospitals can typically see a wide variety of medical conditions, illnesses and diseases. This is due, in part, to the rather large service area some of the smaller hospitals cover. In more of a rural setting, because of the farming influence, some Level 3 hospitals see quite a bit of trauma.

Your day will begin clocking in for your seven to three shift. At your hospital, there are two Ultrasound Techs that work the day and evening shifts, from three until nine. There is one night shift Ultrasound Tech.

You start your day dressed smartly in your hospital scrubs. Using your hospital identification tag, you clock in. Your hospital id tag must be visibly worn at all times, and you are proud yours says Ultrasound Tech.

After speaking with the night shift, you review the days’ schedule. You see that the first patient you will see is located on the Medical / Surgical wing of the hospital. You read the patients’ chart. The patient is having pains in her lower abdomen. Her Physician has ordered an abdominal ultrasound.

You walk to the Medical /Surgical wing, notify her nurse and enter the patient’s room. Each facility has procedures to properly verify a patient, usually by verbal confirmation as well as bracelet (hospital i.d.) You identify yourself with a smile and explain why you are taking her for an ultrasound. The patient is bed-ridden, so you unlock her bed. After assuring all bed rails are up you wheel her down the hall. It is kind to ask the patient before this journey if she would like an extra blanket, and to prudently check that her body is covered well.

Once back to the ultrasound area, you take the patient’s history. Before the abdominal ultrasound can begin, the patient must be placed in a prone (lying down) position so the best images can be obtained. Typically, you will now sit on a stool next to the patient, adjusting the screen if needed for proper view.

After explaining the gel may be a bit cool, you place the clear, water-based gel to the abdominal area as indicated on the patient’s history of complaint. Using a hand-held transducer, you will slowly move the transducer around the abdomen. You may, from time to time, instruct the patient to hold very still or to hold their breath for a moment. After obtaining the best possible images, you inform the patient she is all done with the test.

Once the procedure is done, the patient’s abdominal area is wiped clean of the gel. The patient is properly covered, bed rails are locked upright, and she is transported back to the Medical / Surgical wing to her room. Any part of the ultrasound area that came into contact with a patient must be properly cleaned before each new patient.

During the day, you enjoy seeing patients from the hospital, transporting them to and fro, performing ultrasound tests as well as those that are scheduled (outpatient). In a typical eight-hour shirt, you may perform ultrasound tests on eight patients. Along with patients, you will be responsible for completing paperwork as necessary. Along with patient charts, there are logs, records, supplies that need tracked and ordered, as well as regular machine servicing and cleaning. Each facility has its own procedures and practices to track the daily activity in your department. Patients may call in to schedule appointments, or to ask questions about their upcoming tests.

Suddenly, the Emergency Department notifies you by telephone there is a patient that will need an urgent ultrasound of the abdomen. This patient has suspected kidney stones and is in a lot of pain. He is currently sedated and comfortable enough to have the test performed.

You walk quickly to the Emergency Department to collect the patient. After bringing them back to your department, you begin to efficiently perform an ultrasound. You begin to notice the patient is quickly becoming more and more agitated. His brow begins to sweat and his face contorts in pain.

As an Ultrasound Tech, you are trained to recognize the patient’s pain level has returned. He must be made comfortable in order to complete the ultrasound process. After summoning his nurse by telephone, the patient is made comfortable and the testing is completed.

Once you have completed your shift, you give ‘report’ to the next shift. This can be done in writing, or verbally, depending on the hospital. A report is simply an outline of your shift to the next, highlighting any necessary changes or tasks that may need to be performed.

A bit tired after a full shift, but pleased at the satisfying day you have had, you clock out and go home.