Monday, May 30, 2005
What a nice weekend! I cannot believe it's almost gone and I only have 2.5 days left at the VA!!! And I just got into the swing of things, but that's how it goes they say.
I had my third call shift last Thursday and Friday. A total of 37 hours. Took a new patient and spent a lot of time writing up the report. For a while I was up to four patients, but now I down to two. Not sure if I'll get any more since there is such little time left.
For those of you who don't know, which apparently included my big sister, I did pass Step1 of the boards. I did not do as well as I had hoped, but considering I could not sleep before the exam, it could have been much worse! Actually, two of my classmates that were working with me at the VA did not pass. I'm not sure of the total number of people that did not pass, but I know of 3 so far. So, I'm counting my blessings.
We had this weekend off, which was great but I slept most of it away. Friday, after the shift, I slept for about 4 hours until ML came home and then 12 hours that night. Next month I will be on a cardiology rotation and it's going to KILL me because I'll be Q4 instead of Q8. (That's call every fourth night instead of every eighth like it is now.) Yikes!
ML and I rented a little garden plot from the housing and now it's time to go water! See ya' in a week!
I had my third call shift last Thursday and Friday. A total of 37 hours. Took a new patient and spent a lot of time writing up the report. For a while I was up to four patients, but now I down to two. Not sure if I'll get any more since there is such little time left.
For those of you who don't know, which apparently included my big sister, I did pass Step1 of the boards. I did not do as well as I had hoped, but considering I could not sleep before the exam, it could have been much worse! Actually, two of my classmates that were working with me at the VA did not pass. I'm not sure of the total number of people that did not pass, but I know of 3 so far. So, I'm counting my blessings.
We had this weekend off, which was great but I slept most of it away. Friday, after the shift, I slept for about 4 hours until ML came home and then 12 hours that night. Next month I will be on a cardiology rotation and it's going to KILL me because I'll be Q4 instead of Q8. (That's call every fourth night instead of every eighth like it is now.) Yikes!
ML and I rented a little garden plot from the housing and now it's time to go water! See ya' in a week!
Monday, May 23, 2005
Wow, where did the week go? Okay, here are the major highlights:
-Worked my first 36 hour shift without sleep
-Went to my first code. We (the code team) were on the 7th floor and the code was on the 1st floor. We all ran down the stairs and when we got there, the code was cancelled (the person was fine, not really in a code).
-Took on a new patient who has liver disease. I am currently following three patients
-Got a passing score on my step 1. Not as good as I would have liked, but it'll have to do
Today, I drew blood (cultures) without any superior's assistance. Drawing blood cultures is a little more difficult than just drawing blood, but still not too bad. Those of you who know me: no, I have not passed out but I have sweat when I do it.
Tomorrow we will get new interns as our original pair just left for their next rotation. So it will be up to us three medical students with the Senior and Attending to "break" them in!
Now, I must go study and, hopefully, get to sleep early. I have to get up at 4a to get all of my morning stuff done (including seeing my patients) before morning rounds at 7a. Surgery rounds are going to be really tough seeing how you have to rounds AT 4a. But that will be next calendar year.
-Worked my first 36 hour shift without sleep
-Went to my first code. We (the code team) were on the 7th floor and the code was on the 1st floor. We all ran down the stairs and when we got there, the code was cancelled (the person was fine, not really in a code).
-Took on a new patient who has liver disease. I am currently following three patients
-Got a passing score on my step 1. Not as good as I would have liked, but it'll have to do
Today, I drew blood (cultures) without any superior's assistance. Drawing blood cultures is a little more difficult than just drawing blood, but still not too bad. Those of you who know me: no, I have not passed out but I have sweat when I do it.
Tomorrow we will get new interns as our original pair just left for their next rotation. So it will be up to us three medical students with the Senior and Attending to "break" them in!
Now, I must go study and, hopefully, get to sleep early. I have to get up at 4a to get all of my morning stuff done (including seeing my patients) before morning rounds at 7a. Surgery rounds are going to be really tough seeing how you have to rounds AT 4a. But that will be next calendar year.
Sunday, May 15, 2005
First seven days are behind me now. We (the students on my team--there are three of us) have tomorrow off. Tuesday will be an interesting day because the interns will both be off and then Wednesday will be my second call night. I am completely exhausted! Exhausted to the point that even an hour nap does not refresh me. (Some of you may not know that I (was) the KING of the 15 min nap, well, no longer!)
My more ill patient is doing better today but still fighting the good fight. My new patient that I picked up yesterday also seems to be doing better, outwardly, but his blood panel tells a different story. Hopefully it was just a blip in the road-map especially since he seems so much better.
As you can tell, I am taking care of very ill people. People where you're happy to come into the room and see them sitting in a chair instead of being in bed. You're happy when they have a bowel movement for the first time in about a week. Happy, because they're still there name is still on the door when you walk up to perform your morning rounds. All of which happened to me today. Some day that happiness will run out, I suppose, but I can hope it does not.
We all got a "good" progress report today from our senior resident. That was nice, but it seems less important. I really don't care to much what they think about me...not to be disingenuous. Yes, of course I want to do well, but in the big picture it seems so trivial. Trivial. Boy, that word really has a sliding scale.
My more ill patient is doing better today but still fighting the good fight. My new patient that I picked up yesterday also seems to be doing better, outwardly, but his blood panel tells a different story. Hopefully it was just a blip in the road-map especially since he seems so much better.
As you can tell, I am taking care of very ill people. People where you're happy to come into the room and see them sitting in a chair instead of being in bed. You're happy when they have a bowel movement for the first time in about a week. Happy, because they're still there name is still on the door when you walk up to perform your morning rounds. All of which happened to me today. Some day that happiness will run out, I suppose, but I can hope it does not.
We all got a "good" progress report today from our senior resident. That was nice, but it seems less important. I really don't care to much what they think about me...not to be disingenuous. Yes, of course I want to do well, but in the big picture it seems so trivial. Trivial. Boy, that word really has a sliding scale.
Thursday, May 12, 2005
Ha! My more ill patient was sitting on the edge of the bed watching TV when I went to see him this morning. A very good sign! He asked me what I was so happy all the time. I told him that I had not been working long enough to be jaded! (That was also the longest string of words he has put together since admission. Another good sign.) I also told him that he is getting better and that makes me happy. The AM labs showed a three fold jump in neutophils and the PM labs were even higher. Again, a good sign. We discharged my kidney stone pt as there really was not much we could do for him. His stone must have moved in the night because he had a big-old pain flare-up!
Tomorrow, I round and see patients until noon and then I have seminars, lectures and a quiz until 5p. At least I know I'm done at 5p. Oh, did I mention that wearing my clogs while I was on call has killed my right foot? It hurts and tingles...never injury...NOT a good sign. Obviously, I did not wear the clogs today.
Night!
Tomorrow, I round and see patients until noon and then I have seminars, lectures and a quiz until 5p. At least I know I'm done at 5p. Oh, did I mention that wearing my clogs while I was on call has killed my right foot? It hurts and tingles...never injury...NOT a good sign. Obviously, I did not wear the clogs today.
Night!
Wednesday, May 11, 2005
Finished my first on-call day around 1pm today! Was up all night working with/on my two patients for which I was responsible. I'm happy to say that I think I already have had a positive impact on at least one of my pt's health. Normally, during the night, the nursing staff will take vital signs once or twice. I was especially worried about this pt because he is very ill and we suspected bacteremia (bacterial infection of the blood). His blood pressure and temp were okay at 8p but his temperature was pretty high. I got antsy around 8:30p and went to see my pt. He looked a bit worse and I (politely) asked the nurse to take another set of vitals. Sure enough his pressure had dropped (considerable!) and he was heading into sepsis which would have been BAD. So, we started aggressively hydrating and watching him closely. Within 30 mins his pressure was back up and his temp was finally dropping. Today, he was feeling so much better that he took himself outside for a cigarette--which I actually take to be a really good sign despite the irony that smoking is the cause of many of his current problems. (For those of you in-the-know, his ANA was right at 500 (due to recent chemo cycle) so he was under neutropenic precaution.)
About the only thing with my other pt is that I was cleaver enough that when they took out the Foley catheter today, I had him tell the nurse (who paged me) when he peed on his own. (The whole reason he had the Foley was because he could not pee.) What made this simple observation special is the interns, residents and attending all missed this. You should have seen me when I got the page the he peed!
When I came home, I took a 2h nap and now I'm ready for more! Night!
About the only thing with my other pt is that I was cleaver enough that when they took out the Foley catheter today, I had him tell the nurse (who paged me) when he peed on his own. (The whole reason he had the Foley was because he could not pee.) What made this simple observation special is the interns, residents and attending all missed this. You should have seen me when I got the page the he peed!
When I came home, I took a 2h nap and now I'm ready for more! Night!
Sunday, May 08, 2005
Hawaii was great! I was hoping to have pictures posted before I start the wards, but I don't think that's going to happen. Sorry!
Tomorrow is the first day on the wards for me. I start at the VA internal medicine and I've got to go get all of my ducks in a row before going to bed. I'll try to post when I can....but it's crunch time!
Tomorrow is the first day on the wards for me. I start at the VA internal medicine and I've got to go get all of my ducks in a row before going to bed. I'll try to post when I can....but it's crunch time!
