Monday and Tuesday i worked nights. it sucked. worked 8pm to 12 noon the next day 2 days in a row with very minimal sleep. then worked day 8am to 8pm shift on Thursday. was definitely thrown off schedule. then yesterday we rounded and i had the afternoon off which i used to try scheduling rotations and of course, sleeping. now im on another 10am to 11pm shift which will be the same tomorrow. ohhhh joy. gonna head to the ER soon and spend some time there.

FMI/ ER rotation :)

Today was one of the best days I have had so far and its not because I am on family medicine, it is because I have so much down time during this rotation that I get to spend a bunch of time in the ER just hanging out watching whats going on. Today we started at 8am, saw our patients, wrote our progress notes then rounded till about 11:30. After that, we were just waiting for admits so I headed down to the trauma bay in the ER. It was pretty slow at first. A little 3yo boy came in with his mom after being attacked by a cat in the backyard...and by the looks of him the cat won. I helped clean him up with saline and bandages [it was all superficial so no permanent damage]. As i was cleaning him up, the trauma pager went off about a airlift coming in. 20-somethin yo M low BP, bradycardic with multiple injuries after a failed BMX stunt. he overshot a 125ft jump...oh, and he had lit himself on fire before it [had a fire retardant suit on]. ETA 15 minutes.

i watched the ER team suit up in protective gear and down came the trauma residents and another 3rd year on her surg rotation. i went out with 2 surgeons, a trauma nurse and the med student to the helicopter to get the patient. it was very dramatic. the patient came out of the helicopter and fortunately, his BP had risen and he was talking. able to tell us his name and what happened. then the nurse asked him what he was doing and he said he was shooting a movie, she responded "oh good, so you werent doing this just for fun cause i first we just thought you were a huge idiot." the rest of the trauma followed that tone.
pt was transfused, got 2 chest tubes, and a ton of x rays. ended up having some ridiculous fractures including a pelvic fracture. he was not in good shape. he made sure to ask for his 'fucking morphine' and also made sure 'we took care of his dick because it better work after this.' at one point when things had slowed down a bit but he was still surrounded by people, he looked at the doctor who was hovering above him and said "hey, hey doctor, i need to tell you something. everyone kinda looked around waiting for him to cuse us out or start yelling...but instead he said, "i love you"
pt was taken to ICU, im sure ortho surg would be busy with him for a while.

during this trauma, shit hit the fan and 4 other MVAs came in 1 after the other. the next to come in was an 18yo guy who was hit by another driver who ran a red light. after quick look over, he was fine except for a ton of lacerations on his face. he had blood and stuff all over his face so the intern asked me to clean him up. i ended up spending a lot of time with this guy as i washed out his face lacs. i also helped him called his bro and mom to come to the hospital. his nose and cheek were pretty messed up so we called the OMFS [oral maxillary facial surgeon] to come stitch him up. i watched/ helped while the resident [ a dental resident actually] fixed up this guys face. he was in the trauma bay for the entire afternoon. and i felt good saying good-bye knowing i helped a lot in his case.

i didnt get as involved in the other MVAs that came in or the other BMX guy with a broken leg. all i can say is that ortho was just about in the trauma pod all afternoon because of all the fractures that were coming in.

it was around 7pm and my resident texted me telling me I could go home. but, i ended up staying in the ER anyways because another trauma was coming in. the residents were getting 'suited up' again and while they were waiting one guy looked over and me and say hey, can you staple? "uh, yeah i guess, i have done it in the OR a lot." ok cool, go to trauma 8, clean out the guys scalp lac and staple it a couple times. we're pretty swamped and could use the help..... well shit, i got some stuff together and went to trauma 8. i cleaned up the laceration and grabbed the resident to take a look before i did the stapling. "ok, looks good, just put a couple in." i was confused because we hadnt put in any lidocaine yet and he said we dont need it, to numb him up will hurt way worse than putting in the stables. just be quick and do it.... so i did.  go ahead and add "stapling a guys head" onto my resume.

i loved my afternoon. i love the ER. this is pretty much the coolest specialty. this is def what i want to do on a regular basis :)

First day off in 33 days! Hello sunshine :)

Wednesday night turned into a later night then it was supposed to be.....I got an admit at 9:30pm and headed to room 18 in the ER. i was told by my resident that the pt was a symptomatic anemia pt with a Hg around 4. so, i walked i looked at the chart and that was what i found, went into the room and started my interview. I was just finishing up my H&P on her at around 10:30pm when the ER attending came into the room and said hi, who are you? I told him i was the family medicine student that was admitting his patient and he said, "think you have the wrong room because I just called medicine to admit her. there is another anemic pt in room 20 that is probably yours, i would go check that out." welp, i left the room feeling like a complete idiot only to find out that my pt had  been switched to room 20 and this pt had the same problem, symptomatic anemia with a Hg of 4. god damnit. i ended up spending a hour with a patient that wasnt even on our service. got done around 11:30pm having gotten to the hospital at 10am.


Today I was on day admit so we rounded in the morning and then had the day to kinda do whatever basically waiting for admits. so, i decided to use my time wisely and spend it in the ER. I saw my old friend Krista from SDSU who was doing her ER rotation and hung out with her for the afternoon.  i ended up seeing a halo be put on to a man's head to stabalize his C spine fracture and then started an IV on another patient after asking the nurse very nicely if I could. hit it in one try, did a pretty good job i think. the nurse said i did a great job knowing this is only the 2nd one i had done.

waiting...

Well, day 3 of family medicine which is not family medicine, it is internal medicine. We admit patients, round of patients, follow them to discharge. Granted, I am sure I will continue to learn a lot and this will help me for fourth year but the hours suck. Monday I left "early" (around 4 but still had a 7 hour day). I was feeling sick and ended up throwing up in the ER bathroom right before I was going to do an admission. I left early which probably wasn't the best first impression on my team (4 med students and a resident) but whatever, I felt like shit. When I got to work on Tuesday I heard the students saying "we got slammed with admits" only to find out they added 4 patients- meaning they each did 1 admit. I'm not sure if it's just this service or what, but I've rounded, admitted, consulted on a lot more patients...by myself. i didnt feel too bad about leaving after that.

Tuesday I worked 8am till 4pm which was great. But sadly, this is the shortest shift I will have and it won't happen often.

Today I am working from 10am to 11pm. Got here at 10, wrote notes (I had 1 patient...not too crazy) rounded at 3 to 4:30 and then sat in the residence/student lounge and waited for admits.

Tomorrow I will do the same shift, 10am to 11pm. Then I have Friday off, work 8am to 8pm Saturday then off on Sunday. Then we start nights next week, 8pm to 8am.

I'm not really enjoying it but maybe I will later once I get the hang of it. Haven't done or seen anything too exciting yet

Family Medicine Inpatient

"FMI, or as i like to call it, FML" -resident

bittersweet

Wednesday was pretty remarkable as I did an I&D basically by myself and got to use the Bovie [the cauterizer]. that was a major power trip :)

Thursday Dr. B came back and we met him at clinic in the afternoon. There, we followed up with the gastrectomy patient from last week [the one in which i had my arm in her abdomen] and the lipoma man. I got to see my sutures and they looked pretty good. We took them out and Dr.B joked that my side looked better than his side [which obviously wasnt true but it was nice for him to try to boost my confidence]. This was my last clinic day.

Friday we had several breast lumpectomies and then we put in a central venous port for a women that was going to need constant venous access for her chemotherapy. I got a ton of suturing experience that day; did sub-cuticular running, sub-cutaneous running, and more vertical mattress'. I am proud to say my hand did not shake at all with nervousness on all of these! even the PA noticed and congratulated me :)

Saturday morning was my last surgery and it ended in a perfect way, a lap chole. I first assisted with Captain to my right and it was a very quick and easy gallbladder removal. Ironically enough, after the surgery, I found out that we had just operated on the circulating nurses girlfriend...the nurse that was in the room the whole time. All the joking everyone was doing with him before and during the surgery made a lot more sense when Captain told me this. For example, when Dr.B asked before the surgery if the preg test came back negative...

Today I went to the hospital, rounded on my patients and after meeting a new doctor [and getting her contact info to hopefully do a rotation with her], I was done. Surgery was over and it was a bittersweet feeling. I honestly loved the rotation and cannot explain how much confidence and strength it gave me as a student physician. But at the same time, it wore me down and by the end, I was mentally and physically exhausted. Doing this for 5 years in a surgical residency is out of the question. I would love it but I do not think I am strong enough for it.

I will have the chance to be in the OR again during 4th year because I have to do a sub-internship for 4 weeks.