Thursday, August 29, 2013

I have *no* idea why I'm doing something...

At my job I was asked why, on mastectomy specimens, I give a nipple to areola ratio. And I realized... I honestly don't know. I know that certain types of malignancies can involve the nipple and to look for a history of Paget's disease of the breast before grossing a specimen, etc. I know to mention skin changes like peau d'orange and if the nipple is inverted or everted, hard or soft. But, still.. I don't know why I'm measuring the ratio other than it was part of the template I used in school. I read my Lester's manual this morning and didn't see anything in there about the nipple to areola ratio. Maybe it was one of those Duke specific things that was asked by an attending who had particular preferences? Oh well, it was an interesting conversation with the other PA at work trying to figure out the reasoning behind it and for now, until I find a compelling reason why I should be doing it, I'll just give a measurement and description of the nipple itself.

Thursday, August 22, 2013

In which I've instructed my husband not to let the MEs office do an autopsy on me...

So yesterday I had a car accident. It was odd, as I was turning into a parking lot to go look at bicycles for myself the car behind me carried on as though I wasn't there, which resulted in me being half rear-ended. It was upsetting and I'm still waiting back to hear about the fate of my car (to which I am emotionally attached, and has more bells and whistles than any vehicle I've ever had or am likely to ever have). Meanwhile, I went to Urgent Care to get checked out because...well, car accident and I was (and am) quite sore and experiecing funny back twinges I didn't have before, etc. I received some prescriptions and instructions to come back if pain worsens. But...meanwhile, part of me thinks that my abdomen is slowly filling up with blood and I'm going to exsanguinate in my sleep. If that happens, I've told my husband that I don't want an ME office autopsy. They're terribly impersonal.

It isn't logical, but I've had a rough few days (including missing a day of work this soon into starting the job, which was... mortifying) and I'm going to allow myself some time to wallow in worse case scenerios.  I could be developing a hemothorax right now, but I rather hope not.

As far as work goes, can I say what a huge difference a full day's fixation makes in having to gross placentas? They're so much nicer to work with when they've been in formalin for longer than an hour and a half. 

Sunday, August 18, 2013

Oh, hey! Paycheck...

Paychecks are nice. I haven't gotten one in two years, so it is a welcome change to be in a position to be receiving one. Except... I think my first paycheck will be a paper one, which means I should have gotten that from someone last Friday. I forgot to ask about it then so I'll have to follow up on that tomorrow.

In the meantime, work seems to be going pretty well! My boss said that normally when someone has filled in grossing for her while on vacation the pathologists have given her feedback to pass on to them, but so far they haven't had anything they'd like me to do differently. It is very encouraging! Everyone continues to be very nice, and--with permission--I've brought in headphones so I can listen to music while I gross. The gross room is off of the main histology lab so it can get relatively quiet in there, especially since the histotechs leave in the early afternoon.

It hasn't been that bad of an adjustment going from a massive academic hospital to a community hospital. I think it helps that I worked in that sort of setting before I went to school so even at Duke I tried to be economical with my block counts as much as possible while still submitting the necessary sections.

I'm adjusting to the commute fairly well, I think. And my hours mean I have time in the morning to go to the gym and do a bit around the house before heading into work.

Sunday, August 11, 2013

Week one begun and done

First off: Welcome to the Duke Pathologists' Assistant class of 2015! I missed your first day last week, but I'm sure it was a lot of orientation materials and figuring out where you're supposed to go for class tomorrow followed by some awesome eats at Pam's house. Good luck guys, it is an adventure (and if anyone wants to write a guest blog post, let me know!).

Back to me now! I finished general orientation Tuesday morning and got laboratory orientation (always good to know where the safety equipment is). Wednesday started my first full day in pathology. I learned enough Cerner Millennium to work for now and got to start grossing under the observation of the full time PA (aka my boss). Thursday and Friday I was much more on my own.

I should mention that when I started my first job in pathology there was one other grossing tech and I was to learn by watching him (and reading the manual). Which would probably have been much less stressful if he hadn't also chosen that week to stop smoking. Or... had at least told me that he had just decided to stop smoking and was really grumpy and irritable for that reason. I spent the first few weeks of that job convinced he hated me. Which is kind of funny considering how well we ended up getting along.

The contrast between that first week and the first week I just had is marked. Everyone has been so nice! The histotechs have said that they're happy that things are getting grossed in earlier so they have more fixation time (the current PA was promoted and spends her days dealing with management duties, leaving the evenings for grossing) and my boss is more relaxed because the grossing has been delegated. I'm glad to be useful and appreciate that they've gone out of their way to be so welcoming. I need to work on getting everything grossed by 5 (my going-home time) and try hard not to screw anything up!

Monday, August 5, 2013

I'm 2/3rds oriented!

Today was my first day at work. I'm not in the lab yet, just going through the group orientation where I learn about corporate culture and policies. We have another 4 hours of general orientation tomorrow hence the 2/3rds oriented. Of course, that has nothing to do with the lab orientation or training in their computer systems, etc. But I start some of that tomorrow afternoon.

As for where I'm working, I don't think I need to say where. It makes things easier social-media-policy-wise. I do read them, and I try to stick to them. Since I like blogging but would like to never, ever have to go talk to HR about awkward things I will stick with being relatively vague (sorry for the folks that annoys).

Anyway, orientation has been great so far. The main facilitator is one of those people that just has a lot of energy and enthusiasm, which makes something that can be quite dull into a completely different experience. It has been a lot of fun really, and hopefully tomorrow morning will continue on in the same vein. There's been a surprisingly amount of singing and dancing.

Tomorrow afternoon I think I'll learn Cerner Millennium, we'll see if it is anything like CoPath.

Other random tidbits: Today was my husband's birthday, so I'll always remember what day I started work. As a fun coincidence, his first day at his job was our youngest son's birthday (literally... 20 minutes after he started working his boss escorted him to the parking lot and told him to go meet his new son).

Er, and also I found out that apparently I wasn't getting emails anymore when someone leaves a comment. I just figured no one was commenting. So sorry about that... I have a backlog to wade through.