In the Life of a Fickle Intern

June 29, 2011

Adjusting

Filed under: Daily Lowdown — dailymedicine @ 22:19

As I “ease” into my new role as an intern, I am quickly learning what my weaknesses and strengths are. In addition to having to reestablish my basic medical knowledge and relearning how to see patients and to assess their problems, the other half of the battle has been trying to learn how to use the system and to find where all the supplies are. I knew that the transition from medical student to resident would be difficult, but I was blown away by how much more paperwork residents have to do. As a student, we would write the note and that would be the extent of our interaction with charting on the computer. As a resident, I am probably on the computer the majority of time writing notes, writing orders, writing discharges, writing admission orders, writing something. Though I understand that I am incredibly (really, really, really) slow right now because everything is new and foreign, I still feel like I spend twice as much time going through a patient’s chart and documenting information than I do with the patient. Learning where everything is on the computer has been the bulk of my learning curve these first few shifts. Learning how to document properly is an ongoing task. The scary thing is that my signature is on all of these documents (and prescriptions)!

Apart from the actual paperwork aspect, I am learning how to deal with the nurses. There always has been a history of power struggles and turf wars between new residents and veteran nurses. On my very first shift, I definitely had multiple “Well, in my twenty something years of experience, we would do it this way…” responses to simple everyday questions, but due to my own realization that I have very little knowledge of what is going on, I have yet to take offense, but rather, I am probably overly appreciative of the “advise” whether they meant it that way or not. Older residents have passed down the slogan, “Kill them with kindness” which, fortunately, is how I approach most things in life anyways. There was definitely a noticeable change in how I was treated and talked to after the first shift by some of the nurses. Though many of the nurses could care less whether I am there or not , a handful of the staff have gone above and beyond to help me adjust. I am very grateful.

Though this whole process is overwhelming, I have been doing really well adjusting. It wasn’t until my fourth shift last night that I had my first near tear incident. With shift work, meaning that you are scheduled a specific block of time to work, there is always people coming and going. When you leave a shift, you have to transfer the care of your patients who are still in the Emergency Department to a colleague. During the nights, there is only one attending and one intern from around ten pm to midnight and because of my allotted time, I have been that sole intern receiving signs out from my colleagues these last few shifts. Last night it got really busy around the time that everyone left. I was “taking care” of about five patients, four of whom were not mine so I did not know much about their history; three of the four were to be admitted to stay in the hospital, meaning that they were sick. For about an hour, I felt like I had twenty things to do at once with nurses and consults asking for something different on every patient. As the primary caregiver for these patients, I had to put in all the orders for them. At one point in time, I had literally three nurses for three different patients asking me to do three different things all at once. I did not even know who to make eye contact with! I got yelled at by one of the nurses, who had been really nice all day, something on the line of “if you paid attention to your patient instead of sitting on the phone” because I did not respond quickly enough to a patient who was vomiting in the back because I was on the phone with radiology trying to arrange cat scans for two other patients. It was a mess. I was overwhelmed but I was fine. It wasn’t until he came up to me later when things calmed down a little bit to make peace, or so I assumed, making small talk about how calm I was that I started tearing up. I managed to stay focus on the computer screen and did not actually shed any tears, but after the adrenaline rush of madness wore off, it kind of dawned on me how overwhelming the whole situation was. I have never debt well with being yelled at. Though he didn’t apologize, his attempts at small talk was enough for me. Kill them with kindness, right?

So yes, these past few days have been exciting, overwhelming, stressful, but really fun. I am really enjoying myself though I think residency will permanently knot my shoulders from horrible posturing, constant stress, and crazy circadian rhythms.

June 23, 2011

Nerves

Filed under: Personal Ramble — dailymedicine @ 23:01

Remember that feeling of anticipation, preparation, and excitement that would develop every summer before school started? You didn’t want summer to end, but you wanted to go back to see all your friends, especially now that you were that much older and wiser. Well, I definitely feel older, but I do not feel any wiser. Tomorrow is my first day as an intern. Rather than that fun, nervous energy that I once had, I mostly just have nervous energy composed of anxiety, fear, and insecurity. In addition to losing my knowledge base due to brain stagnation, possibly atrophy, from lack of use, unfortunately, I think I might have lost that self-confidence that took all four years of medical school to develop. It would be one thing to start as a student again or even start in a  new, regular job, but it’s a whole different story to have to tell people that I’m their “Doctor.” Though I’d like to keep this blog as grammatically correct as possible, can I please just say, “OH MY FREAKING A!”

As I dug through my unpacked boxes for my dusty stethoscope that had been forgotten for the last six months, I debated pulling out some reference books to read, but under careful considering, I am pretty sure that the vast amount of information (that I do not know anymore) will most likely just overwhelm me. In order to calm down, I decided to occupy myself with mindless tasks. And by mindless tasks, I mean watching back to back episodes of Arrested Development on my computer.  Three episodes in and many pauses later to look up answers to questions that I am unintentionally quizzing myself with, plan A doesn’t sound so terrible anymore. Skimming random study guides for the rest of the night. Done.

Wish me luck! And no worries, my mother has reassured me that I will not have enough power to actually hurt anyone anytime soon. This was established during my moment(s) of mild panic the week before graduation. My goal is to not look like a complete idiot. Totally do-able, right? Keep your fingers crossed!

June 18, 2011

Crabs

Filed under: Personal Ramble — dailymedicine @ 22:04

Now that I am a Marylander (sort of), it is very crucial that I learn how to eat crabs the proper way. Surprisingly, coming from a very seafood oriented family, I was not too far off on my techniques. For those interested, here are some quick, easy to follow instructions on what to do: How to eat a Maryland crab. 🙂

June 16, 2011

Orientating

Filed under: Daily Lowdown — dailymedicine @ 22:17

Orientation started on Monday, and I am already worn out. It’s been a while since I’ve had a nine hour day, not to mention nine hours of sitting in one spot listening to people talk. They are throwing a lot of information at us, everything from health insurance  to computer access, and it is all very overwhelming . I am sure that everything will sort themselves out as I get going, but as of this moment, I think I am about done orientating myself.

These last two days have been ACLS, Advance Cardiovascular LIfe Support, training. Though every new doctor has to be certified in BLS, Basic Life Support, and ACLS training, many people don’t take it too seriously. However, for EM physicians, it is kind of our job. The course was awfully long and boring, but it did very unkindly remind me of how much I don’t remember. Learning the algorithms for resuscitation was really helpful, but I still feel completely incompetent. Knowing that my decisions and actions can literally determine whether someone lives or not freaks me out! I chose this field partly because of this aspect of the job, but I really hope that I have more time to learn everything (!!) before I actually have to put any of this into use. Ah!!

We have some more life support training next week in addition to other orientating activities. I am really grateful that they care enough about us to ease us into the program, but it’s still incredibly boring. On a more positive note, I really like my fellow interns. They’re impressively smart! My brain is going to have to come out of hibernation and go into full overdrive mode, hopefully sooner than later, so I can keep up with my colleagues!

June 11, 2011

Relocation

Filed under: Personal Ramble — dailymedicine @ 22:12

It’s official. Moving sucks! It sucks even worst when you have to start over completely on a time and budget limit. Just had to get that out there.

Leaving the comfort of the REAL south and moving a little further north and much further east, I can definitely feel the differences. Streets are smaller. Houses are older. Roads are bumpier. And prices are much higher for everything! People don’t smile when they make eye contact, if they make contact, and they will NOT let you change lanes despite the fact that you have your blinker on, which is a rarity nowadays. Parking is mainly on the streets and YES, parallel parking is a real skill, a skill which I have not mastered. Apart from these minor details, I have a really good feeling about this new city. Now that I am semi-settled into my new place, I can finally start looking forward to exploring the neighborhoods a little bit.

For the past few days, I have been on a mad shopping spree (with a tight budget) trying to furnish my new apartment. It’s amazing the things you take for granted on an everyday basis. I love my new place, but it is definitely lacking in a few things, mainly storage spaces. Luckily, Ikea is just outside the city. It has been both a friend and a foe to me. I love their stuff and their prices, but my hands have been sore from the massive quantity of tool-handling that I have had to do. My bed (with drawers!) is the first real thing, not including bookshelves, that I’ve ever had to assemble and it took me literally five hours. I apparently cannot tell the difference between left and right, which I found out the hard way when pieces wouldn’t fit together properly. Lesson learned. Always look at the material before you screw all the nuts and bolts in as tightly as possible because it might take your whole weight to unscrew them. Just letting you know.

My roommate from Memphis made the sixteen hour drive with me and one of my good friends from college came down from Philly to help me unpack. Though I am usually a loner when it comes to this type of stuff, packing and unpacking, because I am kind of cranky and irritable, I really appreciated both of their help tremendously. When my friend got here from Philly, he became the official furniture assembler. It was amazingly helpful. He was much better at it than I was. I guess having guys around can be useful after all. 🙂

Either way, I am about three-fourth done unpacking. My apartment is starting to come together nicely. Orientation starts on Monday, and I start work in two weeks. It’s really happening!

Oh, notice the nice, subtle change in the title?

June 3, 2011

Schedule

Filed under: Daily Lowdown — dailymedicine @ 08:16

My schedule for intern year! I don’t know what all the acronyms mean, but I’m sure I’ll learn during orientation so I will save myself some embarrassment by not asking before that starts. My first block is at the VA hospital, which is kind of nice because at least I’m semi-familiar with the system since all of the VA hospitals are on the same network. Besides, old men are my favorite patients! They’re the most fun to talk to, most of the time. 🙂

 

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