The Worst Part of My Job

While there are many aspects of my job I do not like, I think there is only one that I absolutely despise…trach care/suction….<br />Now while I know how to do it and have no problems accomplishing the skill, I just do not like doing it at all.  The other night I was providing care for one of my patients who just so happened to be trached.  The orders were for trach care every 12 hrs and suction every 4 hrs.  Normally respiratory therapy will do the suctioning, but this particular night there was only 2 RTs for the whole hospital, so of course their trips up to the floor were few and far in between. 
At around 0430, I decided, I probably could not put off this dreaded task any longer…but wait…YES!!! I still had a sandwich and it was imperative I eat it right then ;)  Believe me when I say this made my night even better…putting off the trach care for another 30 minutes…
Finally at 0500, I could put it off no longer.  I went into the patient’s room and began to prepare for the trach suctioning.  I set up my sterile field, prepared my necessary instruments, and checked my catheter, now to begin the suctioning. 
As I advanced the suction catheter down the cannula, I felt for the resistance and then quickly pulled the catheter out, yielding a ton of mucus from the trach/lungs.  I did this two more times and noticed a difference in the patient’s ease of breathing. 
I pulled out the inner cannula and cleaned around the trach.  As I began to insert the new cannula I was having difficulties putting it back into place.  I couldn’t get the final twist to lock it into place…finally I was able to snap it into place.  With the snap, the patient began to cough and gag.  As I went to put the trach collar back into place, to ease the breathing, this huge mucus plug comes flying out of his trach and lands on his bed.  It was beyond disgusting!!!  This led to more suctioning to clear the airway and more cleaning around the trach site.  My happiest moment that morning was when I could strip off the gown and gloves and leave the room with a clean trach and airway!!!  How I despise trach care/suction!!!