Just got home from another clinic night at Montclair and had to recap the night. It was gooooood. I saw 3 patients and managed to flawlessly finish my patient's chart's first along with impressing the resident in charge. :)
The night started off at 5pm and first we ran through all the basics for the first years that were new to the clinic and shadowing us for the night. Then at 5:30, the first patients starting rolling in. My first pt was a 45yo female to check on her labs. She had hypothyroidism and hyperlipidemia for which she was on meds for. She then started to complain about sinus pressure. I felt very confident in asking all the appropriate questions that I needed to and then moved on to my physical exam where i checked her ears, mouth, palpated her sinus', etc to rule out any infection. After listening to her heart and lungs I went back and presented to the resident. We ended up giving her amoxicillin.
Ok, so that patient wasn't too exciting but the next one was. She was a 54yo female presenting with peripheral neuropathy [google it if you need to]. She had these symptoms for a while now and was waiting for a neurology consult and since she didn't have insurance, she had to wait for a while. So, she was instructed to come in every month to get checked on until she got this consult. It was an overwhelming case because not only did this woman have a million symptoms from the neuropathy [like loss of sensation, dizziness, blurry vision, shooting pain down her leg, etc] she was also on 10 drugs to control her hypertension, hyperlipidemia, rheumatoid arthritis, back pain, etc etc. Though a pleasant women, she was a walking disaster. So, I did a full neurological exam, listened to her heart and lungs, and then went to present to the resident. After discussing things with him we decided there really was nothing we could do until the neuro consult was done. At this point we were thinking multiple sclerosis [again, google if needed...] but we were also thinking she was a a bit of a hypochondriac. Either way, it was great practice for me to perfect my clinical skills!
The last patient was a hypertensive in for a BP check, blah blah, boring stuff. The cool part of the night came when I got complemented on my perfect chart notes. Both the resident and clinic coordinator said they were clear, concise and very well written notes and that i should be very proud of them. Actually, i believe the resident actually said, "beautiful." I realize this may sound like a very odd thing to be excited about but considering I have spent the last year and a half learning and fine-tuning the art of writing a well written history, physical, and assessment/plan on a patient, I am very excited to hear that things are finally making sense.
It is these kinds of experiences that reassure me I will be a great doctor and that I have the ability to kick ass on my rotations. I didnt get nervous at all tonight, I knew exactly what I wanted to ask to rule-out certain diseases, I knew what I was doing when I took their vitals, checked their ears, heat, etc., and I did all this while I got to know the patient and make them feel at east. The student I was working with had to be impressed because I didnt hesitate with anything, I just worked through things like I was already doing this everyday....I was CONFIDENT!
Yeah grades and board scores are important, but having confidence in your clinical skills and writing a good work-up in a patient's chart are vital in doing well on rotations and eventually getting into a great residency program! I am even more excited now then ever to start rotations and to come home everyday and reflect on the fact that I am learning how to cure people and save lives. How cool is that?!
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