Thursday, September 24, 2009
SOAP notes and Sunday Fundays
I never wrote about my last simulated patient encounter so I will go ahead and start with that. Thursday (September 10th) I had my 3rd 'clinic' encounter. Its pretty cool to say that considering we have only be in school for 6 or 7 weeks. We again worked on our patient history taking (the S of the SOAP note). S is for Subjective (what the patient tells us as we ask questions) is for Objective (the physical part of the encounter ie Heart Rate, Blood Pressure, etc) A is for assessment (what we think is wrong) and P is for Plan (what we are going to do for them). Soooo, as you can see we have a hell of a long way to go but its ok, one step at a time. We are given 20min with the patient to fill out a patient history (S part) and then after the encounter we were given 7 minutes to fix it/perfect it before we turned it in for grading. We were allowed to bring in a basic rubric for what questions to ask so it wasnt to difficult but being on the spot makes it a lot damn harder.
The funny part about simulated patient encounters is that the actors are pretty much the same. I personally dont get the same person every other week but we see them walking around the school and halls during the day so its starting to get harder to 'pretend' that they are real patients. It would be great if I saw one of them out and about in Claremont of Pomona one day.
The following Thursday (the 17th...last week) we began practicing the O (objective) of the SOAP note on each other. The hard part is we have to listen to a lecture and then arent given very much time to practice the technique before we are lectured about the next week. Needless to say I still dont know how to take blood pressure without fumbling the cuff or looking stupid. Also, im pretty sure i will never be able to use an ophthalmoscope properly (the thingy that the doctor looks into your eye with). its impossible...there i said it.
Back to anatomy...my favorite thing to write about because i could write details about it forever. But i think i will spare some considering we have been dissecting reporductive organs and the pelvic 'area' and i know that my family reads this....and thats just weird. yes, i am going to be a doctor and should be more mature about it but no, thats ok. use your imaginations on these dissections people!
Saturday was awesome as i attended a Healthcare conference hosted by the California Medical Association (a division of the American Medical Association). I listened to a couple speakers discuss the methods of healthcare reform and these are some details i wrote down that hopefully will interest you:
Sunday was a library day.....my new definition for SUNDAY FUNDAY!
Ill write about this week later because I have already procrastinated enough for the evening. Back to the books..i swear....well maybe after checking my facebook another 5 times and chatting on gchat. ;)
Wednesday, September 23, 2009
SOAP notes and Sunday Fundays!!
I never wrote about my last simulated patient encounter so I will go ahead and start with that. Thursday (September 10th) I had my 3rd 'clinic' encounter. Its pretty cool to say that considering we have only be in school for 6 or 7 weeks. We again worked on our patient history taking (the S of the SOAP note). S is for Subjective (what the patient tells us as we ask questions) O is for Objective (the physical part of the encounter ie Heart Rate, Blood Pressure, etc) A is for assessment (what we think is wrong) and P is for Plan (what we are going to do for them). Soooo, as you can see we have a hell of a long way to go but its ok, one step at a time. We are given 20min with the patient to fill out a patient history (S part) and then after the encounter we were given 7 minutes to fix it/perfect it before we turned it in for grading. We were allowed to bring in a basic rubric for what questions to ask so it wasnt to difficult but being on the spot makes it a lot damn harder.
The funny part about simulated patient encounters is that the actors are pretty much the same every week for every different college (physician assistants, podiatrists etc). I personally dont get the same person every other week but we see them walking around the school halls during the day so its starting to get harder to 'pretend' that they are real patients. It would be great if I saw one of them out and about in Claremont or Pomona one day. I would def buy him or her a beer so they would like me :)
The following Thursday (the 17th...last week) we began practicing the O (objective) of the SOAP note on each other. The hard part is we have to listen to a lecture and then arent given very much time to practice the technique before we are lectured about the next week. Needless to say I still dont know how to take blood pressure without fumbling the cuff or looking stupid. Also, im pretty sure i will never be able to use an ophthalmoscope properly (the thingy that the doctor looks into your eye with). its impossible...there i said it.
Back to anatomy...my favorite thing to write about because i could write details about it forever. But i think i will spare some considering we have been dissecting reproductive organs and the pelvic 'area' and i know that my family reads this....and thats just weird. yes, i am going to be a doctor and should be more mature about it but no, thats ok. use your imaginations on these dissections people!
Saturday was awesome as i attended a Healthcare conference at USC School of Medicine hosted by the California Medical Association (a division of the American Medical Association). I listened to a couple speakers discuss the methods of healthcare reform and these are some details i wrote down that hopefully will interest you:
- 1/5 of california residents use MediCal
- a doctor is given $18-$24 reimbursement for an office visit by a MediCal patient
- thus, only 50% of doctors in California will see a MediCal patient
- there are only 5 HMOs that control 90-95% of all the insured people in california
- The increase in ER patients is by insured people (with insifficient insurance) NOT by the uninsured
- There are NO physicians in the California legislature but there is a ex-used car salesman and an actor
- if a federal health reform bill does not get passed by this January or February, it is estimated that it will be another 10 to 15 years before any other health reform bill will be sought after
I obviously learned much more but these are some interesting details. If you are interested in the progress of the federal government, please visit www.hsreform.org for a DAILY updated website.
Moving on...
Sunday was a library day.....my new definition for SUNDAY FUNDAY!
Monday was a easier day as we didnt have much scheduled so of course, i used my time to study. i have been spending more and more of my time at school, starbucks, and random libraries. i find that studying at home is the least productive way to study as i usually find myself cleaning, organizing (i refolded all my clothes a couple nights ago) or just watching the cat and dog piss each other off. my thought process at home is usually "ok, back to the books. I have already procrastinated enough for the evening. Back to the books..i swear....well maybe after checking my facebook another 5 times and chatting on gchat." :)
i pretty much only see dad in the morning (while he makes my lunch...thanks dad) or in the evening during a quick dinner. my kitten continues to bite me. i see him lounging with dad more often. its a sign that he is slowly picking favorites and i think i am on his shit list. just the other day i swear i saw him roll his eyes at me as i walked by him without feeding him. hahaha
im beginning to despise my 25 minute commute to school and hate that i never get to hang out with my classmates during the week. i will most likely be moving soon closer to pomona. dont know where and dont know when but i have a couple options that (fingers crossed) work out.
ok, im off to bed. i had a lovely evening once again eating dinner at Alissa's (love you girl!) and now i need to get to sleep so i can wake up early tomorrow. to gym or not to gym in the morning, that is the question....
The funny part about simulated patient encounters is that the actors are pretty much the same every week for every different college (physician assistants, podiatrists etc). I personally dont get the same person every other week but we see them walking around the school halls during the day so its starting to get harder to 'pretend' that they are real patients. It would be great if I saw one of them out and about in Claremont or Pomona one day. I would def buy him or her a beer so they would like me :)
The following Thursday (the 17th...last week) we began practicing the O (objective) of the SOAP note on each other. The hard part is we have to listen to a lecture and then arent given very much time to practice the technique before we are lectured about the next week. Needless to say I still dont know how to take blood pressure without fumbling the cuff or looking stupid. Also, im pretty sure i will never be able to use an ophthalmoscope properly (the thingy that the doctor looks into your eye with). its impossible...there i said it.
Back to anatomy...my favorite thing to write about because i could write details about it forever. But i think i will spare some considering we have been dissecting reproductive organs and the pelvic 'area' and i know that my family reads this....and thats just weird. yes, i am going to be a doctor and should be more mature about it but no, thats ok. use your imaginations on these dissections people!
Saturday was awesome as i attended a Healthcare conference at USC School of Medicine hosted by the California Medical Association (a division of the American Medical Association). I listened to a couple speakers discuss the methods of healthcare reform and these are some details i wrote down that hopefully will interest you:
- 1/5 of california residents use MediCal
- a doctor is given $18-$24 reimbursement for an office visit by a MediCal patient
- thus, only 50% of doctors in California will see a MediCal patient
- there are only 5 HMOs that control 90-95% of all the insured people in california
- The increase in ER patients is by insured people (with insifficient insurance) NOT by the uninsured
- There are NO physicians in the California legislature but there is a ex-used car salesman and an actor
- if a federal health reform bill does not get passed by this January or February, it is estimated that it will be another 10 to 15 years before any other health reform bill will be sought after
I obviously learned much more but these are some interesting details. If you are interested in the progress of the federal government, please visit www.hsreform.org for a DAILY updated website.
Moving on...
Sunday was a library day.....my new definition for SUNDAY FUNDAY!
Monday was a easier day as we didnt have much scheduled so of course, i used my time to study. i have been spending more and more of my time at school, starbucks, and random libraries. i find that studying at home is the least productive way to study as i usually find myself cleaning, organizing (i refolded all my clothes a couple nights ago) or just watching the cat and dog piss each other off. my thought process at home is usually "ok, back to the books. I have already procrastinated enough for the evening. Back to the books..i swear....well maybe after checking my facebook another 5 times and chatting on gchat." :)
i pretty much only see dad in the morning (while he makes my lunch...thanks dad) or in the evening during a quick dinner. my kitten continues to bite me. i see him lounging with dad more often. its a sign that he is slowly picking favorites and i think i am on his shit list. just the other day i swear i saw him roll his eyes at me as i walked by him without feeding him. hahaha
im beginning to despise my 25 minute commute to school and hate that i never get to hang out with my classmates during the week. i will most likely be moving soon closer to pomona. dont know where and dont know when but i have a couple options that (fingers crossed) work out.
ok, im off to bed. i had a lovely evening once again eating dinner at Alissa's (love you girl!) and now i need to get to sleep so i can wake up early tomorrow. to gym or not to gym in the morning, that is the question....
Thursday, September 17, 2009
Tomorrow should be fun...
It has been very difficult to get back into the swing of things after mondays test. i swear it felt like a friday since i was studying all weekend and on campus on sunday!
on a good note, we got to take out and bag up all the internal organs in Lucy (we have started calling her Lucy since she has Ricki tattooed on her butt). Lucy smells better (better...but still not good). Tomorrow we get to saw off her leg. no seriously, we are dissecting one leg and dissecting through the pelvis of the other. loose your appetite yet?
on a good note, we got to take out and bag up all the internal organs in Lucy (we have started calling her Lucy since she has Ricki tattooed on her butt). Lucy smells better (better...but still not good). Tomorrow we get to saw off her leg. no seriously, we are dissecting one leg and dissecting through the pelvis of the other. loose your appetite yet?
Tuesday, September 15, 2009
Vicks vapor rub does not work
SO my last post was on Wednesday and a lot has happened since then. a lot of digging through cadaver fat and guts (this post is going to be hard on the stomach so i'll warn you upfront)....
Wednesday during lab we had the unique opportunity to split apart the upper abdomen by cutting a long line down the stomach and two horizontal cuts across. then we dug around to find the different muscles layers. After going through tons of fat (which is NOT like cutting through a piece of butter) we reached the inner organs. the GUTS. the best part about it is that we have the worst smelling person in the entire lab. no joking, one of our professors walked by and make the comment that our body looks pretty 'red and fresh' and that she 'most not be embalmed properly.' Take a second to visualize this, yes i know...GROSSSSSSS (it is Gross Anatomy, right?! haha) So here we are, 4 students around a very very smelly and pink body. Well, it actually ended up being 2..me and my dissecting partner Brendon. The other two couldnt stomach it. that made me feel like such a champ HAH. but i did have to walk out of the lab twice to stop myself from projective vommitting after getting several strong whiffs of poop and formaldehyde (we cut into the large intestine to look at structures....i wont describe this, it was pretty bad). Later in the week one of my lab partners brought in Vicks vapor rub to put underneath our nose to smell something over then body juices. i didnt think it worked very well but some other people liked it.
So after lab needless to say i was not hungry, but i ended up getting a sandwich for lunch and was able to eat just fine. I guess after going through all that and being able to eat means I am a good medical student :)
Thursday I got to sleep in a bit (8am...sweet!!) and then headed to school to study before class. In the afternoon I had my 3rd simulated patient encounter. A man around the age of 45. He was nice. It was nothing difficult, we just had to take a patient history and do a 'review of systems.' Then, i went to the lab to end my afternoon starring at dead bodies. Again, another regular Thursday afternoon.
Friday was an extremely overwhelming day. We had lab (digging through more fat to find small arteries that took forever to find) and then 3 lectures. Two new material powerpoints and a third 'review.' I left lecture in a nice panic and immediately drove home to get myself out of the school environment. I had a LOT to learn and review as our second exam was the upcoming Monday (yesterday!!)
Saturday and Sunday were spent responsively with my face in books and starring at powerpoint slides. I did take some time out to get lunch with dad on saturday and play some tennis. Boy was it nice to smash the hell out of those tennis balls and get out my stress and frustration!!
Then yesterday come around faster then i wanted it to! The exam was another combination of written clinical questions, image identifications, and then a lab practical in the afternoon. I thought the exam was pretty tough and the lab practical to be fair. Afterward, my classmates and I again celebrated by going to Characters Bar by school and then we went to a mexican restaurant for margaritas and dancing. It was a GREAT night...fun people, strong shots, and lots of dancing. Perfect way to end that pretty terrible monday.
Now it is back to the books. No rest for us, lab started up again at 9am today and lecture at 1. We also had OMM in the afternoon and learned some more manipulative techniques. Its a pretty relaxing class I must say.
Wednesday during lab we had the unique opportunity to split apart the upper abdomen by cutting a long line down the stomach and two horizontal cuts across. then we dug around to find the different muscles layers. After going through tons of fat (which is NOT like cutting through a piece of butter) we reached the inner organs. the GUTS. the best part about it is that we have the worst smelling person in the entire lab. no joking, one of our professors walked by and make the comment that our body looks pretty 'red and fresh' and that she 'most not be embalmed properly.' Take a second to visualize this, yes i know...GROSSSSSSS (it is Gross Anatomy, right?! haha) So here we are, 4 students around a very very smelly and pink body. Well, it actually ended up being 2..me and my dissecting partner Brendon. The other two couldnt stomach it. that made me feel like such a champ HAH. but i did have to walk out of the lab twice to stop myself from projective vommitting after getting several strong whiffs of poop and formaldehyde (we cut into the large intestine to look at structures....i wont describe this, it was pretty bad). Later in the week one of my lab partners brought in Vicks vapor rub to put underneath our nose to smell something over then body juices. i didnt think it worked very well but some other people liked it.
So after lab needless to say i was not hungry, but i ended up getting a sandwich for lunch and was able to eat just fine. I guess after going through all that and being able to eat means I am a good medical student :)
Thursday I got to sleep in a bit (8am...sweet!!) and then headed to school to study before class. In the afternoon I had my 3rd simulated patient encounter. A man around the age of 45. He was nice. It was nothing difficult, we just had to take a patient history and do a 'review of systems.' Then, i went to the lab to end my afternoon starring at dead bodies. Again, another regular Thursday afternoon.
Friday was an extremely overwhelming day. We had lab (digging through more fat to find small arteries that took forever to find) and then 3 lectures. Two new material powerpoints and a third 'review.' I left lecture in a nice panic and immediately drove home to get myself out of the school environment. I had a LOT to learn and review as our second exam was the upcoming Monday (yesterday!!)
Saturday and Sunday were spent responsively with my face in books and starring at powerpoint slides. I did take some time out to get lunch with dad on saturday and play some tennis. Boy was it nice to smash the hell out of those tennis balls and get out my stress and frustration!!
Then yesterday come around faster then i wanted it to! The exam was another combination of written clinical questions, image identifications, and then a lab practical in the afternoon. I thought the exam was pretty tough and the lab practical to be fair. Afterward, my classmates and I again celebrated by going to Characters Bar by school and then we went to a mexican restaurant for margaritas and dancing. It was a GREAT night...fun people, strong shots, and lots of dancing. Perfect way to end that pretty terrible monday.
Now it is back to the books. No rest for us, lab started up again at 9am today and lecture at 1. We also had OMM in the afternoon and learned some more manipulative techniques. Its a pretty relaxing class I must say.
Wednesday, September 9, 2009
Not a great day...
today was the most disgusting day of dissections so far. i walked out of the lab twice and was pretty sure i was gonna pass out/ vomit but i didnt. i put on a brave face. i would love to write about the details but will have to save it for another night as i have a ridiculous amount of material to cram into my already full brain. sweeeeeeet
Monday, September 7, 2009
Week 4: Holding a human heart, no big deal
Wednesday was my birthday and I was blessed with no anatomy lab. Instead, we were in the lecture hall for most of the day. What I thought would be a nice break from the lab turned into a very dull day that made me actually miss dissecting (well not so much the dissecting as more the finding and reviewing actual anatomy versus pictures on powerpoints). We finished up around 4 and some friends took me out to get Thai food. This was my first time eating Thia (everyone was shocked to hear this as I am apparently the last remaining person on earth to have eaten this type of cuisine) and after a great meal we all branched off to study. I went home and hung out with dad for a while and got about an hour of studying in before I feel asleep around 10:30. I tried to make up for this by waking up very early the next day and getting to school to review in the morning.
Thursday we dissected out the heart in the morning and in the afternoon we had ECM. This week we brought in our materials and got to ‘learn’ how to use them. I am pretty competent at taking blood pressures but everything else I am going to need a LOT of practice on. This coming week we have another patient encounter. We are perfecting the art of taking a comprehensive patient history and this time will be timed both seeing the patient and then after as we fill out their ‘chart.’
Looking back at my posts, I realized I haven’t really mentioned our Osteopathic Manipulative Medicine (OMM) class yet. We have it every Tuesday from 1 to 5 and this is where we get to learn the special techniques osteopathic doctors use. We are still learning the basics of what is ‘normal’ and how we can determine it, so we haven’t really gotten into the cool stuff yet.
Friday was a shorter day which I filled by going to the anatomy lab and reviewing everything we had learned that week. I spent the night with my second family and started off a relaxing labor day weekend J
Tuesday, September 1, 2009
Well, I passed!
After an agonizing afternoon of thinking I failed because I read my score as a percent rather then the total number of points I gained....i realized my mistake at about 2am that next morning while i was in a 'must get an A on my next exam' study session. I put myself through hell for nothing, but hey...now i know what it feels like to fail an exam, even though I actually did just fine. Dont get be wrong, I probably should/could have done waaay better but passing and getting minimally above the average is good for me for right now :) This whole med school thing is pretty damn tough i SWEAR! annnnd, that grade was only for the written portion, our lab practical hasnt been graded yet (insert nervous laughter here)
So monday group A dissected until 11am and then we only had one lecture from 1 to 2 so i found it to be the perfect 'at home study day' :) it was nice to spend time with alissa and kristin and give kk a big hug before she took of to switzerland to play volleyball like the champ she is. today (Tuesday), i came in to lab and took out our cadaver's lungs...just another tuesday in my life.
oh, did i mention that she has fake acrylic nails? Yeah, and they are painted bright pink. How the hell am I supposed to put it out of my mind that she is a actual person when I can see her nails like that? Also, while observing/learning about the lungs and thoracic cavity, we discovered many tumors all over her. They are calcified tumors which means they were actually boney tissue growing on her diaphragm and thoracic wall. Also, her lungs were so congested from heart failure...this poor lady suffered so much before she passed, its hard to learn about the pathology without thinking about that side of the science.
On a lighter note, my birthday is tomorrow. number 24 I think…
p.s. i hate my kitten at the moment because he is not my friend anymore and is a pretty wild beast, im thinking of letting him explore the great outdoors....just to see if he can come back alive or at least in one piece. just kidding.....not really....
So monday group A dissected until 11am and then we only had one lecture from 1 to 2 so i found it to be the perfect 'at home study day' :) it was nice to spend time with alissa and kristin and give kk a big hug before she took of to switzerland to play volleyball like the champ she is. today (Tuesday), i came in to lab and took out our cadaver's lungs...just another tuesday in my life.
oh, did i mention that she has fake acrylic nails? Yeah, and they are painted bright pink. How the hell am I supposed to put it out of my mind that she is a actual person when I can see her nails like that? Also, while observing/learning about the lungs and thoracic cavity, we discovered many tumors all over her. They are calcified tumors which means they were actually boney tissue growing on her diaphragm and thoracic wall. Also, her lungs were so congested from heart failure...this poor lady suffered so much before she passed, its hard to learn about the pathology without thinking about that side of the science.
On a lighter note, my birthday is tomorrow. number 24 I think…
p.s. i hate my kitten at the moment because he is not my friend anymore and is a pretty wild beast, im thinking of letting him explore the great outdoors....just to see if he can come back alive or at least in one piece. just kidding.....not really....
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