Whilst sitting in the ICU writing a progress note some random man comes up to me:
Man, "Hi! I am going for a smoke."
Me, "Ok."
Man, "Do you think that it is odd that I am going out for a smoke?"
Me, "Well, I don't know if you smoke."
Man, "Do you think this is funny?"
Me, "No." (me clearly not laughing)
Man, "Oh, you don't get it!"
Me, "I guess not?" (very confused at this point)
Man, "I am so-and-so-in-room-###'s twin brother and thought I'd trick you."
Evidently I did not think that it was as funny as he did since I had never seen the patient in room ### before.
Tuesday, September 27, 2011
Monday, September 26, 2011
Patients' Charts Should Come w/ User Manuals!
Today was my first day of Internal Medicine (IM) and it was overwhelming to say the least. I seriously was given a list of patients to see and told "go!" No resident or physician to tell me what to do; only my two fellow classmates to instruct me on what they thought they knew.
I literally saw my first patient ever today. I was so scared! I have had practice with fake (actors) patients but never a real-live sick one. It was definitely a first for me. I attempted to read up on the chart, then proceeded into the room to speak with the patient and her husband. They were very nice and helpful (besides the lady being agitated a having to sit up).
I really don't think they had any idea how nervous I was! But, I got a quick history and did a small physical and attempted to write my progress note. I hadn't done a SOAP note since April and had to dig deep to remember what the components were. Furthermore, the notes that I had been taught were around 5-7 pages long and there was no way that this was going to fly. I got the note down to one page, but whether I included the pertinent information is questionable. I certainly hope that I get some feedback on my notes (especially for my assessment and plan) so that I know what is actually expected of me.
To add onto the stress the attending asked if I could dictate a Discharge Note for her. Ha! I fumbled my way through the chart and started to attempt to dictate when I realized that I was pressing the play button when I wanted to pause and the pause button when I wanted to play. Ugh. Then, I got really confused since I couldn't see the physician signed copy of the meds that the patient was to go home with, so I ended up stopping the dictation completely. I had asked somebody around me if there was a sheet that I had neglected to see and he didn't see the correct form either and my attending was no where to be seen. Luckily the patient isn't going to be discharged until tomorrow and I was told that I could do the dictation tomorrow if I wished. And I definitely wish to do it tomorrow! After I discuss the med sheet with the doctor.
I feel like I am feeling around in the dark really having no idea how this world in the hospital works. Eek! :O
I literally saw my first patient ever today. I was so scared! I have had practice with fake (actors) patients but never a real-live sick one. It was definitely a first for me. I attempted to read up on the chart, then proceeded into the room to speak with the patient and her husband. They were very nice and helpful (besides the lady being agitated a having to sit up).
I really don't think they had any idea how nervous I was! But, I got a quick history and did a small physical and attempted to write my progress note. I hadn't done a SOAP note since April and had to dig deep to remember what the components were. Furthermore, the notes that I had been taught were around 5-7 pages long and there was no way that this was going to fly. I got the note down to one page, but whether I included the pertinent information is questionable. I certainly hope that I get some feedback on my notes (especially for my assessment and plan) so that I know what is actually expected of me.
To add onto the stress the attending asked if I could dictate a Discharge Note for her. Ha! I fumbled my way through the chart and started to attempt to dictate when I realized that I was pressing the play button when I wanted to pause and the pause button when I wanted to play. Ugh. Then, I got really confused since I couldn't see the physician signed copy of the meds that the patient was to go home with, so I ended up stopping the dictation completely. I had asked somebody around me if there was a sheet that I had neglected to see and he didn't see the correct form either and my attending was no where to be seen. Luckily the patient isn't going to be discharged until tomorrow and I was told that I could do the dictation tomorrow if I wished. And I definitely wish to do it tomorrow! After I discuss the med sheet with the doctor.
I feel like I am feeling around in the dark really having no idea how this world in the hospital works. Eek! :O
Saturday, September 24, 2011
Radiology - Check!
Well, I have officially finished my first rotation - Radiology. Woot, woot!
And, I have definitely ruled out being a radiologist. Seriously, I basically sat in a dark room almost all of the two weeks staring at a computer screen reading radiographs, CT scans, and ultrasounds. There is not a lot of patient contact at all. It is more like there is NO patient contact in diagnostic radiology. Boring!
I feel like I did learn a bit about learning how to read chest xrays, CT scans, ultrasounds, etc. I really had no exposure to radiology prior to this experience and I am glad that I had it, but I just don't want to do this for a living.
The best part about the rotation was that I got to see several interventional radiology procedures (biopsies, lumbar punctures, etc). I really liked this part of it, but the interventional radiologist was quite the moody guy. Most of the time I stood against the wall in the room observing, but the last day I was with him he let me hold the lidocaine container while he sucked up the medicine in a needle, as well as put a piece of equipment onto the sterile field. He really did take his time to teach me and the other medical student on the last day and I really appreciated him going through things step by step.
Well, one rotation in the books. Now, onto Internal Medicine!
And, I have definitely ruled out being a radiologist. Seriously, I basically sat in a dark room almost all of the two weeks staring at a computer screen reading radiographs, CT scans, and ultrasounds. There is not a lot of patient contact at all. It is more like there is NO patient contact in diagnostic radiology. Boring!
I feel like I did learn a bit about learning how to read chest xrays, CT scans, ultrasounds, etc. I really had no exposure to radiology prior to this experience and I am glad that I had it, but I just don't want to do this for a living.
The best part about the rotation was that I got to see several interventional radiology procedures (biopsies, lumbar punctures, etc). I really liked this part of it, but the interventional radiologist was quite the moody guy. Most of the time I stood against the wall in the room observing, but the last day I was with him he let me hold the lidocaine container while he sucked up the medicine in a needle, as well as put a piece of equipment onto the sterile field. He really did take his time to teach me and the other medical student on the last day and I really appreciated him going through things step by step.
Well, one rotation in the books. Now, onto Internal Medicine!
Tuesday, September 13, 2011
Holy Cow
Whoa is how I feel at the moment. Currently I am on radiology and feel like I am a such a little fish in a big pond it is sad. Really, I am overwhelmed and amazed at how much people know and how much I don't know. I have some serious hard learning ahead of me...that is for sure.
Today I saw radiographs, CTs, upper GI swallow, CT guided biopsies (2) and learned much, much more. Plus, I read my first entire chest xray correctly today...without any help at all. Although it was all normal, I still had to look at all of the components of the chest xray and convince myself that everything was actually just fine. Small win for the little third year medical student.
I definitely have to be more assertive. I know that I am quiet and soft-spoken, but I really don't want people to think that I don't care, because I really, really do, it is just that things are so new and intimidating that I will have to try extra hard to ask appropriate questions, speak up when I don't understand, etc., etc.
Basically my schedule has been: sleep, drive, lecture, sit in a dark hole all morning, lecture/lunch, sit in a dark hole all afternoon, drive, eat, read, sleep, repeat. I put in 10 hours yesterday and 9 hours today...and this was supposed to be an 'easier' rotation, phew. At least I am learning lots! I call this hard learning (vs classroom learning which is definitely soft learning).
Well, off to bed to catch some zzz's and do it all over tomorrow!
Sunday, September 11, 2011
Entering Clinicals
Tomorrow morning marks my first day out on clerkship and in the hospital. I am both excited and scared at the same time. This is finally the time that I begin to learn about real medicine and how to do doctor things. I have dreamed of this for the last two years! Studying endless hours, telling myself, 'get through this part and the next part will be more fun.'
I have lectures every morning at 7:30 AM followed by working with radiology in the morning, then noon hour lecture followed by working back on radiology in the afternoon. I am so excited to get my feet wet, yet, at the same time, I am frightened. I feel like I don't know anything. Honestly, I couldn't tell you one thing that I have learned from my first two years of medical school and now I have to use my knowledge. Frightening.
I will definitely update tomorrow after my first day and I apologize for not posting in nearly a month. That is a long time! I've been trying to enjoy the last bit of my medical leave but now I am ready to move on. Let's hope my brain and body kick into gear here soon too! :)
Subscribe to:
Comments (Atom)