This week was our final week of unofficial orientation, the residency in which I am likes to put people in the shallow end before throwing them into the deep end. It's nice to know that one month of residency has been successfully completed, but I shudder to think that, next month, I'll be doing everything "for realsies". I'm going to do my best to clear as many questions as I can on the online question bank (something that every medical student reading this, if any, should get used to) and I'm going to try to chalk out time every day for reading. I'm not sure whether or not my great magnificent idea of commuting to work by bike is actually going to work out, but I intend to start riding in tomorrow and I hope it does work. It would be so legendary if I rode in every day, and I would lose so much weight.
I found a new app for calorie counting, something I seem to wax and wane myself into every now and then. I guess only time will tell how long that will last, though it seems as though it will last longer this time because I don't seem to be eating a great variety of food.
We went to the club the other night ( something I shall not be doing again for a while ) and I got a sense of how others feel when they are in my shoes. One of my friends was entertaining a visiting friend, and they were both drunk upon entering the club, a club that the first friend had suggested. Then this guy's friend gets drunk and leaves, and starts walking around outside. My friend was forced to pursue him, and then, upon leaving, I learned that they had left the club for a good hour. I didn't have all the information because I was angry at them for suggesting the club (to which I did not initially want to go) and then leaving shortly after making us all go in.
I couldn't believe when my friend told me that he was fine, and his friend was really drunk, and he had spent the entire night just taking care of that guy. He was not happy with how his night went, but that's how every night goes for me. I hadn't noticed how irritating it could get.
Sunday, 28 July 2013
Monday, 22 July 2013
Residency week 3
Last week was a whirlwind.
Productivity-wise, I am at least 15% better at typing up notes now and navigating the system. Things are taking less time than they would otherwise take.
Bike-commuting-wise, I still haven't officially begun commuting to work by bike, which is something I plan on starting July 29th. I have, however, managed to sink even more money into this endeavour. I returned some stuff and bought some other stuff, will only provide details on everything if it actually works out for more than two weeks. I'm going to park my bike in the resident's lounge instead of locking it up outside, which brings me to my next point.
I've started to cut myself more and more slack as this last month has progressed. I'm still reading, but not stressing about it as much as I previously did, setting impossible goals. Now, if I get something done, good. If I want to get some sleep instead, that's fine too. The main current concerns for me are organizing my readings around whatever patients I am to see in clinic the next day, or around whatever patients I am to follow in hospital; pathophysiology, management algorithms, co-morbidities, side effects of medications, reading up on any relevant diagnostic tests, and even going through the patient's file and reading about how different radiological scans are interpreted. Nobody in this residency is out for blood, nobody wants to see me fail.
I have spent more money this week than I would like, but it honestly has just been for the picnic that we are having on Wednesday. It amuses me to envision returning all the picnic-related items at Target. I think I will need to bring a shopping cart to my car to fit the 5 chairs, the poker chips, the table,...I don't think we'll be playing with the poker chips though. I'll just set it up on S Note. Which brings me to my next point.
I bought my device. It's the Samsung Galaxy Note 8, and I hope to use it for absolutely everything possible. I just realized I may have forgotten to buy a screen protector for it.
I finally completed all my assignments for my first month, so now there's just reading remaining. Reading and reading and reading...
Today the Medical Assistant came up to me and said that a patient walked in to schedule an appointment with the clinic. When asked if he had a preference for whom he wanted to see, he specifically mentioned my name and said that he only wanted to see me. I guess I'm still doing some things correctly.
Productivity-wise, I am at least 15% better at typing up notes now and navigating the system. Things are taking less time than they would otherwise take.
Bike-commuting-wise, I still haven't officially begun commuting to work by bike, which is something I plan on starting July 29th. I have, however, managed to sink even more money into this endeavour. I returned some stuff and bought some other stuff, will only provide details on everything if it actually works out for more than two weeks. I'm going to park my bike in the resident's lounge instead of locking it up outside, which brings me to my next point.
I've started to cut myself more and more slack as this last month has progressed. I'm still reading, but not stressing about it as much as I previously did, setting impossible goals. Now, if I get something done, good. If I want to get some sleep instead, that's fine too. The main current concerns for me are organizing my readings around whatever patients I am to see in clinic the next day, or around whatever patients I am to follow in hospital; pathophysiology, management algorithms, co-morbidities, side effects of medications, reading up on any relevant diagnostic tests, and even going through the patient's file and reading about how different radiological scans are interpreted. Nobody in this residency is out for blood, nobody wants to see me fail.
I have spent more money this week than I would like, but it honestly has just been for the picnic that we are having on Wednesday. It amuses me to envision returning all the picnic-related items at Target. I think I will need to bring a shopping cart to my car to fit the 5 chairs, the poker chips, the table,...I don't think we'll be playing with the poker chips though. I'll just set it up on S Note. Which brings me to my next point.
I bought my device. It's the Samsung Galaxy Note 8, and I hope to use it for absolutely everything possible. I just realized I may have forgotten to buy a screen protector for it.
I finally completed all my assignments for my first month, so now there's just reading remaining. Reading and reading and reading...
Today the Medical Assistant came up to me and said that a patient walked in to schedule an appointment with the clinic. When asked if he had a preference for whom he wanted to see, he specifically mentioned my name and said that he only wanted to see me. I guess I'm still doing some things correctly.
Sunday, 14 July 2013
Residency week 2
I just finished my second week of residency, and this week was mostly clinic. It was considerably more difficult than I thought it would be, because I didn't realize how much research a doctor actually has to do every time they encounter a new patient in clinic.
Whenever we have a new patient in clinic on our list, which right now would mean any patient at all since we are new to the practice, we have to go onto our online database and dig up every test, every hospital visit, every medication change, every single shred of information in this patient's medical history that we can find. That way, when the patient actually arrives in our exam room, there should be no surprises, or minimal surprises anyway. These patient lookups take me quite a bit of time the night before, and some days end late since there are a variety of things to do in the evening. Sometimes there is short call at the hospital and sometimes there is duty at the free clinic, so the scenario arose where I came home around 8 45 pm and had to chart-review 3 patients for the next day.
I haven't been keeping up with any of my actual medical reading because there's been all this clinic research and scattered other things to do, so the plan for next week is to do all the research today (based on however many patients are already posted on my list) and then, during the week, have time to review medical knowledge as the need presents itself. An additional problem is that I am not getting everything done despite having only one patient to see each hour, so I'm trying to work out a better system for that. So far, the best I have managed to come up with is
1) Start the skeleton while the patient is being roomed and then
2) Walk in and start blasting out an HPI and PMH while simultaneously talking to the patient, and then obviously review all the meds and problems with the patient, then
3) Do as much of the note as possible based on a skeleton so I don't have to type anything fresh out.
4) After 30 minutes (really hoping the first three things get done within 30 minutes) precept to the attending and tell them only the History of Present Illness and Past Medical History relevant to the problems that have to be dealt with by us, at this visit
5) Furiously copy down the plan in its entirety and make to-do check boxes for all the orders to be placed 6) Place all the orders quickly while the attending is talking to the patient.
I went out yesterday and, despite the usual shoddiness where eligible females are concerned, managed to land the number of a human resources manager, who thankfully was only 1 drink deep at the time. I don't know if we'll actually end up going out, but for some reason my friends were very impressed, borderlining on shocked. We'll see if anything happens with that, will update either way.
Whenever we have a new patient in clinic on our list, which right now would mean any patient at all since we are new to the practice, we have to go onto our online database and dig up every test, every hospital visit, every medication change, every single shred of information in this patient's medical history that we can find. That way, when the patient actually arrives in our exam room, there should be no surprises, or minimal surprises anyway. These patient lookups take me quite a bit of time the night before, and some days end late since there are a variety of things to do in the evening. Sometimes there is short call at the hospital and sometimes there is duty at the free clinic, so the scenario arose where I came home around 8 45 pm and had to chart-review 3 patients for the next day.
I haven't been keeping up with any of my actual medical reading because there's been all this clinic research and scattered other things to do, so the plan for next week is to do all the research today (based on however many patients are already posted on my list) and then, during the week, have time to review medical knowledge as the need presents itself. An additional problem is that I am not getting everything done despite having only one patient to see each hour, so I'm trying to work out a better system for that. So far, the best I have managed to come up with is
1) Start the skeleton while the patient is being roomed and then
2) Walk in and start blasting out an HPI and PMH while simultaneously talking to the patient, and then obviously review all the meds and problems with the patient, then
3) Do as much of the note as possible based on a skeleton so I don't have to type anything fresh out.
4) After 30 minutes (really hoping the first three things get done within 30 minutes) precept to the attending and tell them only the History of Present Illness and Past Medical History relevant to the problems that have to be dealt with by us, at this visit
5) Furiously copy down the plan in its entirety and make to-do check boxes for all the orders to be placed 6) Place all the orders quickly while the attending is talking to the patient.
I went out yesterday and, despite the usual shoddiness where eligible females are concerned, managed to land the number of a human resources manager, who thankfully was only 1 drink deep at the time. I don't know if we'll actually end up going out, but for some reason my friends were very impressed, borderlining on shocked. We'll see if anything happens with that, will update either way.
Saturday, 6 July 2013
Residency week 1
The first week of residency is nearly done, and it rolls right into the next week. I was on floor duty the entire week, and managed to learn just how much procedural knowledge is required to become a functioning resident on a medical inpatient unit.
I have this tendency to not observe the order behind things; when a 1st year resident is allowed to speak, when they should, to whom they should speak, what they should mention, etc. I've managed to keep that in check for the most part today simply by stopping myself before I say anything and by placing a premium on whatever I say.
I don't know everything about my patients, and anyone who's following this who's in the medical field will tell you that, in medicine, it's imperative that you know everything that's going on with all of your patients. If you have been assigned a patient, the senior should not know more than you do about a certain test that was ordered for the patient, or about a consult that was put into the chart, or anything for that matter. You should have all the raw data available, so that you can hand it to your senior and your attending who will, in turn, teach you valuable medical knowledge that you add to your knowledge base. Hopefully.
The toughest thing for myself and my colleague to do has been to balance basic intern duties (writing notes and reading about diseases) with other incidentals that fly in our faces (admissions, floor calls, fall codes, code blue scenarios). This juggling act is at the very heart of residency, and it's something I plan to polish tomorrow with an early start in order to get my readings done in the morning before I head to the hospital, and a fresh to-do list with plenty of space on it for additions and cross-outs. That and the detective work I have to do every time there's a new admission, those are two things that I could really improve on the most.
I ran to a code today and ended up doing chest compressions. She didn't make it.
I have this tendency to not observe the order behind things; when a 1st year resident is allowed to speak, when they should, to whom they should speak, what they should mention, etc. I've managed to keep that in check for the most part today simply by stopping myself before I say anything and by placing a premium on whatever I say.
I don't know everything about my patients, and anyone who's following this who's in the medical field will tell you that, in medicine, it's imperative that you know everything that's going on with all of your patients. If you have been assigned a patient, the senior should not know more than you do about a certain test that was ordered for the patient, or about a consult that was put into the chart, or anything for that matter. You should have all the raw data available, so that you can hand it to your senior and your attending who will, in turn, teach you valuable medical knowledge that you add to your knowledge base. Hopefully.
The toughest thing for myself and my colleague to do has been to balance basic intern duties (writing notes and reading about diseases) with other incidentals that fly in our faces (admissions, floor calls, fall codes, code blue scenarios). This juggling act is at the very heart of residency, and it's something I plan to polish tomorrow with an early start in order to get my readings done in the morning before I head to the hospital, and a fresh to-do list with plenty of space on it for additions and cross-outs. That and the detective work I have to do every time there's a new admission, those are two things that I could really improve on the most.
I ran to a code today and ended up doing chest compressions. She didn't make it.
Subscribe to:
Posts (Atom)