Got to the hospital at 5am. saw 2 patients, wrote their progress notes and then started rounds at 6:30. Its the same residents but a different attending, an older man with a very stone face that definitely made me scared. Rounds went much more smoothly this morning as i had just done them the day before and informed my other 3 classmates about what the protocol was. It made it a lot easier on all of us though since it was their first time on rounds but i know they were still terrified as i was tuesday morning. dont get me wrong, i was nervous too but not as much as yesterday. when my patients came up i presented quickly and then got asked some questions by the attending which [not meaning to brag or anything] i got right. He didnt smile or say good job but its ok, i know he was probably either thinking “GREAT!” in his mind....that or, “wow, shes not entirely as dumb as she may look.” After that, I got a little bit more confident and answered a couple more questions that he threw at us. Then, i even asked him a couple questions as well as the residents and i think i have really started to show that i have a major interest in this specialty. Actually, Dr. B heard me talking to a friend about how cool yesterday was and he laughed saying “so your on your 3rd day of rotations and you already picked OB as your specialty?” There is another resident, Dr. H, that has been a great teacher as well. I ask her a ton of questions and she definitely can see that I really want to learn. Honestly, I could not ask for any more at this rotation site. I am so unbelievably happy with it.
Today after rounds and lecture, I worked in the women’s health clinic from 9am to about 5pm. I saw a bunch of patients, saw them put in an IUD, did a pelvic, a bimanual, and many other basic physicals. I am astonished at how much more comfortable i feel today vs Monday. Monday i was scared shitless and had NO CLUE what was going on in clinic. It was like being thrown into the middle of a busy street and having to work your way across it without any direction except ‘get to the other side.’ Today, i remembered the nurses names [some of them even remember my name], i knew where to get what, i knew what the order of things was, etc. Its not just me that feels this way, every one of us discussed today how quickly we are starting to gain confidence and knowledge of protocols in the hospital. Its the 3rd day, I cant imagine what the 6th week is going to feel like!!
Lastly, i had to mention my most memorable patient of the day. I had her in the AM and she took about 2 hours of my time. Basically, she was a non-insured, unemployed 25yo who had a son 6months ago with a man she is now divorcing because he has been cheating on her throughout their 10 month marriage. Basically, she was a very immature women how was now using sex to ‘get back’ at her husband by sleeping with others even though she was still occasionally having sex with him. She had just had an abortion 1 month ago and then admitted to me that she was still having unprotected sex since one week after and thus could very well be pregnant and if so, would have another abortion. Oh, and the reason for her visit was to get birth control so she could continue sleeping around. Oh, and she was not breastfeeding her baby because she was trying to lose weight and didnt want to get fat [which is retarded for so many reasons, 1 being obviously choosing vanity over your freakin baby, but 2, because breastfeeding actually increases the amount of calories you burn and thus helps you lose weight...]. anyways, i obviously cant judge the patient...she can do what she wants. but i had a lot of trouble learning how to speak to her and counsel her without sounding judgmental. i asked the doctor for advice on this and she straight up said that i should give her as much education as i can about the risks she is taking on her health but ultimately she is going to be thinking ‘white woman’ and will probably just think i dont understand. realistic approach. so i am gonna remember this next time and try to learn a more humorous way to approach the situation, the doctor recommended using sarcasm [im serious!]. i laughed and told her to not worry, i think i can do sarcasm :)
Things i learned today:
1- a cervix can be very difficult to find
2- my new shoes suck-- thus i went to purchase special comfy ones after my shift
3- resident are awesome
4- nurses are still even more awesomer
Wednesday, June 22, 2011
i could do this everyday and be happy for a very long time
3 deliveries- 2 of which i got to gown up and assist in, 1 of which i got to deliver the placenta. natural progression means i should be able to deliver the baby soon right?!
the day...
3:50am get up
4:10 leave the house in scrubs
5:00 get to hospital
5:10 want to take a nap but cant
6:00 see my patient on the antepartum floor, check in on how she is doing, do a mini physical and write her progress note into her chart
6:30 rounds... It is pretty much exactly what i though it would be. Scary and hectic. Picture the attending in the lead, residents a couple steps behind and then us 4 medical students running after wondering what the hell is going on. Each of us presented our patients and then got asked some questions and the attending ended up being very receptive to questions and was a very good teacher.
7:45-8:00 time to breathe, eat breakfast and then meet back at the lecture room in the labor and delivery ward
8:00 Our first morning seminar starts. its basically all of us med students, a couple PA students and some residents. This morning they were giving us an intro to the labor and delivery ward. Right as they were getting into the paperwork we are responsible for, Dr. B our resident’s phone rings and all i hear him say is, “right now? ok.” Then he hangs up and asks who is on L&D today. Kavitha and I raise our hands and he goes “k, wanna see a delivery. lets go.” I have never moved so fast....i laughed in front of everywhere and said “right now?” and he goes yup, follow me. I pretty much ran toward the door and didnt remember at all that we were in the middle of a lecture [though it was very informal, i swear] and as i was about to exit the door i stopped, looked back at the attending and said “wait, is that ok” and she just said yeah go. I ran after the doc and Kavitha was behind me. She was obviously moving slower because i was the 2nd one in after the doctor and immediately he starts to gown me up [i was very confused]. He hands me a sterile gown and once its on i look up and see a couple nurses and a PA resident standing in front of a very, very loud screaming mom. It was pretty much what i expected only i was a little more frazziled as i had no idea what was going on. All i knew is that Dr. B was dressing me up so i could assist the PA. After getting my gloves on I stood back and watched as the baby flew out of mom and got handed to the nurses to get checked out. With the baby clear, i was told to go help the PA and she explained everything from there on to me. She is awesome. I watched and learned about how she delivered the placenta and then examined it with her after to make sure everything was normal. pretty damn cool. and that was my first day on L&D, second day of rotations at 8:45am. The day only got better from there.That day I watched the anesthesiologists give an epidural, admitted about 5 new patients, saw a ton of baby ultrasound [and learned how to estimate the baby’s weight with it] and then saw 2 more deliveries.
The 2nd delivery i saw i also assisted on and this one i actually delivered the placenta. The baby’s name was Madison, I dont think i will forget that. The 3rd delivery was performed by the doctor because it was a more complicated delivery. The great thing about it was the patient was on the ward all day so i saw and talked to her and her husband all day. It was a great experience to then watch their baby get delivered at about 4:30pm. I nearly cried, it was so emotional to watch their facces as they started over at their new daughter in the baby warmer getting checked out. The baby’s name was Chloe. She was gorgeous! I even helped take a picture of dad and the baby before she was given to her mom :)
Both those moms had some minor tears that had to be sutured up and one of the residents told us that if we work on our suturing and show that we are competent we may get the opportunity to do some later in the rotation. Im gonna start googling practice suture materials cause i definitely want that experience before i leave! Other things i may get to do are artificially rupture a membrane on an induced labor and i will soon get to scrub into surgeries.
So the crazy day ended at about 5:30pm after we handed off our patients to Tan [another med student] and filled him in on what was going on. Tan had the 5pm to 9am shift so the next time i would see him would be the next morning...
the day...
3:50am get up
4:10 leave the house in scrubs
5:00 get to hospital
5:10 want to take a nap but cant
6:00 see my patient on the antepartum floor, check in on how she is doing, do a mini physical and write her progress note into her chart
6:30 rounds... It is pretty much exactly what i though it would be. Scary and hectic. Picture the attending in the lead, residents a couple steps behind and then us 4 medical students running after wondering what the hell is going on. Each of us presented our patients and then got asked some questions and the attending ended up being very receptive to questions and was a very good teacher.
7:45-8:00 time to breathe, eat breakfast and then meet back at the lecture room in the labor and delivery ward
8:00 Our first morning seminar starts. its basically all of us med students, a couple PA students and some residents. This morning they were giving us an intro to the labor and delivery ward. Right as they were getting into the paperwork we are responsible for, Dr. B our resident’s phone rings and all i hear him say is, “right now? ok.” Then he hangs up and asks who is on L&D today. Kavitha and I raise our hands and he goes “k, wanna see a delivery. lets go.” I have never moved so fast....i laughed in front of everywhere and said “right now?” and he goes yup, follow me. I pretty much ran toward the door and didnt remember at all that we were in the middle of a lecture [though it was very informal, i swear] and as i was about to exit the door i stopped, looked back at the attending and said “wait, is that ok” and she just said yeah go. I ran after the doc and Kavitha was behind me. She was obviously moving slower because i was the 2nd one in after the doctor and immediately he starts to gown me up [i was very confused]. He hands me a sterile gown and once its on i look up and see a couple nurses and a PA resident standing in front of a very, very loud screaming mom. It was pretty much what i expected only i was a little more frazziled as i had no idea what was going on. All i knew is that Dr. B was dressing me up so i could assist the PA. After getting my gloves on I stood back and watched as the baby flew out of mom and got handed to the nurses to get checked out. With the baby clear, i was told to go help the PA and she explained everything from there on to me. She is awesome. I watched and learned about how she delivered the placenta and then examined it with her after to make sure everything was normal. pretty damn cool. and that was my first day on L&D, second day of rotations at 8:45am. The day only got better from there.That day I watched the anesthesiologists give an epidural, admitted about 5 new patients, saw a ton of baby ultrasound [and learned how to estimate the baby’s weight with it] and then saw 2 more deliveries.
The 2nd delivery i saw i also assisted on and this one i actually delivered the placenta. The baby’s name was Madison, I dont think i will forget that. The 3rd delivery was performed by the doctor because it was a more complicated delivery. The great thing about it was the patient was on the ward all day so i saw and talked to her and her husband all day. It was a great experience to then watch their baby get delivered at about 4:30pm. I nearly cried, it was so emotional to watch their facces as they started over at their new daughter in the baby warmer getting checked out. The baby’s name was Chloe. She was gorgeous! I even helped take a picture of dad and the baby before she was given to her mom :)
Both those moms had some minor tears that had to be sutured up and one of the residents told us that if we work on our suturing and show that we are competent we may get the opportunity to do some later in the rotation. Im gonna start googling practice suture materials cause i definitely want that experience before i leave! Other things i may get to do are artificially rupture a membrane on an induced labor and i will soon get to scrub into surgeries.
So the crazy day ended at about 5:30pm after we handed off our patients to Tan [another med student] and filled him in on what was going on. Tan had the 5pm to 9am shift so the next time i would see him would be the next morning...
Monday, June 20, 2011
no sex in the on call room
I dont have internet at my apartment anymore so I am sitting by the pool write outside my building using the wireless from the complex. Im sitting here eating a bowl of ice cream watching people work out in the gym right next to me. hehehe oops.
thought i would just start with that. ok. so today...
5am- im up
5:45- pick up nicole
6:30- get to hospital
7am- orientation
7:08- ohhhhhh man, what have i gotten myself into
In a room full of 3rd and 4th year medical students, an administratior from the Graduate Medical Education Office has a few do’s and don’ts for us. Among the highlights, “no sex in the on call room, don’t pee in the trashcan, do not bring your pets to the hospital, do not bring your kids to the hospital, don’t put wet towels on the mattresses.”
Right,got it. so we learn the lay of the land, get our ID badges, and are given our schedules. Each one of us has different assignments for each day and the only constant is an 8am-9am lecture/seminar given by different residents or attendings each day. We are expected to be there for them every weekday. My schedule for the next 2 weeks is:
Tues- Labor and Delivery 12 hour call at AM. This means I will be at the hospital tomorrow from 5am to 5pm in the L&D ward with one other student.
Wed- Gyn notes/ Clinic. This means I will be at the hospital at 5am to see gynecology patients and write up history and physicals on them and then at 6:30am we will round on all the patients and I will present mine. Then from 8 to 9 I will attend the lecture and from 9am until around 6pm I will work in the women's health clinic on the first floor of the hospital.
Thurs and Friday- I will be in the clinic all day after 8am seminar
Monday-Labor and Delivery 12 hour call at AM
Tues- Clinic all day
Wed- Labor and Delivery 12 hour PM call but it is actually 16 hours at the hospital. THIS SHIFT SUCKS! I need to be at the hospital at 5pm on Wednesday, I stay there until rounds the next day at 6:30am and then have to stay for the lecture/seminar from 8-9am. At 9 I get to go home and then have the day to sleep and then
Fri- I have clinic
Sounds pretty fun, eh?
OK, back to our schedule today
8-9:45 we have more orientation, get our ID badges, and get a tour of the hospital.
10am- we get dropped off at the clinic and go to work... There are 9 of us total, all 3rd year students from Western. We are shown around a lil bit and then the next thing i know, I am in a clinic room. I saw 4 patients today, 2 of which spoke english. The other 2 did not...at all... God i wish i still remembered my spanish from high school. For those of us who cant communicate, there is a translator service.
There are 4 wireless phones and we use one to call up the serive using a code and then after a few rings we push what language we want and a translator will come on the line. We give them our name and the patients name and then you put the phone on speakerphone. From then on, you ask the translator to ask the patient a question and when they respond, the translator tells ya what they said. It is great! Very impersonal though, i really wish i didnt have to use it. The patients dont even look at you when they are talking, they talk to the phone. its kinda akward but very very useful. There are lots of nurses around that speak spanish but we are told not to ask them because they have enough work to do as it is.
12:10- you have 30 minutes to go to the cafeteria and get food. readyyyyy, go! [i have never eaten a chicken burger so fast]
the rest of the afternoon: patients patients patients. On the board that has all the staff names and doctors written on it that are working that day, it says how many patients are scheduled for the day. Today it said 66/46. That means 66 patients for the morning and 46 patients for the afternoon! This is going to be a loooooong month!
We got done around 6 and I got home around 7. I am tired, my feet hurt [note to self, why the hell did i wear new shoes???] and i have to be in bed pretty much right now in order to get a good nights sleep.
It was scary, intimidating, and thrilling. At some points I was so confused and felt very stupid and at others I felt great. I know I have the skills, now I just need to learn all the knowledge. I should already be reading some OB/ GYN books in preperation for the next couple weeks and to make myself sound smarter to the attending physicans but right now all i can think about is getting in bed and watching an episode of ER before I fall asleep.
1 day down, lots more to go :)
Oh and lastly, things i learned today:
1- nurses are a medical students saving grace. i love them. they are great.
2- an endometrial biopsy looks like the most painful thing a women has to go through and i refuse to ever have one done on me
3- i need to learn spanish
4- i need more nice dress clothes
thats all for now... im gonna get in bed soon and then wake up in the AM, put on my scrubs, and head to labor and delivery. eeeeee so freaking excited! :)
thought i would just start with that. ok. so today...
5am- im up
5:45- pick up nicole
6:30- get to hospital
7am- orientation
7:08- ohhhhhh man, what have i gotten myself into
In a room full of 3rd and 4th year medical students, an administratior from the Graduate Medical Education Office has a few do’s and don’ts for us. Among the highlights, “no sex in the on call room, don’t pee in the trashcan, do not bring your pets to the hospital, do not bring your kids to the hospital, don’t put wet towels on the mattresses.”
Right,got it. so we learn the lay of the land, get our ID badges, and are given our schedules. Each one of us has different assignments for each day and the only constant is an 8am-9am lecture/seminar given by different residents or attendings each day. We are expected to be there for them every weekday. My schedule for the next 2 weeks is:
Tues- Labor and Delivery 12 hour call at AM. This means I will be at the hospital tomorrow from 5am to 5pm in the L&D ward with one other student.
Wed- Gyn notes/ Clinic. This means I will be at the hospital at 5am to see gynecology patients and write up history and physicals on them and then at 6:30am we will round on all the patients and I will present mine. Then from 8 to 9 I will attend the lecture and from 9am until around 6pm I will work in the women's health clinic on the first floor of the hospital.
Thurs and Friday- I will be in the clinic all day after 8am seminar
Monday-Labor and Delivery 12 hour call at AM
Tues- Clinic all day
Wed- Labor and Delivery 12 hour PM call but it is actually 16 hours at the hospital. THIS SHIFT SUCKS! I need to be at the hospital at 5pm on Wednesday, I stay there until rounds the next day at 6:30am and then have to stay for the lecture/seminar from 8-9am. At 9 I get to go home and then have the day to sleep and then
Fri- I have clinic
Sounds pretty fun, eh?
OK, back to our schedule today
8-9:45 we have more orientation, get our ID badges, and get a tour of the hospital.
10am- we get dropped off at the clinic and go to work... There are 9 of us total, all 3rd year students from Western. We are shown around a lil bit and then the next thing i know, I am in a clinic room. I saw 4 patients today, 2 of which spoke english. The other 2 did not...at all... God i wish i still remembered my spanish from high school. For those of us who cant communicate, there is a translator service.
There are 4 wireless phones and we use one to call up the serive using a code and then after a few rings we push what language we want and a translator will come on the line. We give them our name and the patients name and then you put the phone on speakerphone. From then on, you ask the translator to ask the patient a question and when they respond, the translator tells ya what they said. It is great! Very impersonal though, i really wish i didnt have to use it. The patients dont even look at you when they are talking, they talk to the phone. its kinda akward but very very useful. There are lots of nurses around that speak spanish but we are told not to ask them because they have enough work to do as it is.
12:10- you have 30 minutes to go to the cafeteria and get food. readyyyyy, go! [i have never eaten a chicken burger so fast]
the rest of the afternoon: patients patients patients. On the board that has all the staff names and doctors written on it that are working that day, it says how many patients are scheduled for the day. Today it said 66/46. That means 66 patients for the morning and 46 patients for the afternoon! This is going to be a loooooong month!
We got done around 6 and I got home around 7. I am tired, my feet hurt [note to self, why the hell did i wear new shoes???] and i have to be in bed pretty much right now in order to get a good nights sleep.
It was scary, intimidating, and thrilling. At some points I was so confused and felt very stupid and at others I felt great. I know I have the skills, now I just need to learn all the knowledge. I should already be reading some OB/ GYN books in preperation for the next couple weeks and to make myself sound smarter to the attending physicans but right now all i can think about is getting in bed and watching an episode of ER before I fall asleep.
1 day down, lots more to go :)
Oh and lastly, things i learned today:
1- nurses are a medical students saving grace. i love them. they are great.
2- an endometrial biopsy looks like the most painful thing a women has to go through and i refuse to ever have one done on me
3- i need to learn spanish
4- i need more nice dress clothes
thats all for now... im gonna get in bed soon and then wake up in the AM, put on my scrubs, and head to labor and delivery. eeeeee so freaking excited! :)
Sunday, June 19, 2011
OMSIII
Not sure how, but I made it. I made it through what was quite possibly the hardest year of my life and the worst two months of my life. I have never been so mentally and emotionally challenged and although I broke at times and had to reach out for help along the way, I made it. I now know how strong of a person I am and that I can make it through anything, i’ve pretty much been through mental bootcamp and survived. After having multiple exams thrown at me at the end of the year and then given the task of studying for board exams, there is really nothing else I can imagine to be more difficult. I spent 37 days, approximately 11 hours a day, memorizing a book that was a culmination of information that was not just information for the last two years of medical school, it was a culmination of all of my years of science education. To understand and not just memorize but LEARN and conceptualize the vast amount of information that I was tested on, I had to pull from my years and years of schooling and to be honest, I believe my last 20 something years of schooling were preparing me for these two exams.
Correction, I spent 36 days studying. On Wednesday June 8th, after not taking one day off, my brain went on strike. I woke up in the morning and just could not get out of bed. I decided to let myself sleep in until 10am. Then after pressing the snooze button a bunch of times, I got out of bed around 11am. I made some breakfast, watched a bit of TV [first time in a month] and then decided I was not ready to study...so I went back to bed. Then, I went to sleep from 12 to 5pm. I woke up and my brain had re-set. So I went to school, put in about 5 hours of studying and then called it a day. Needless to say, my brain went back to working order the next day...
I still dont know how i did, i wont get my scores for about a month. But it really doesnt matter at this point as long as I passed both of them. There is nothing more i could have done, i could not have given more of myself to this subject and however I did i will be happy because i made it. I am here, a 3rd year medical student, having been taught as much as school could cram into my head, and I am now being ‘set free’ into the real world of medicine.
Tomorrow I start my first rotation...it is my first day of 2 years of clerkships in which I will trade in my books and powerpoints for patients. I will be learning from individuals who are kind enough to let a student learn on them. I will be supervised thoroughly and will never be completely responsible for someone’s help...so im not too scared. But, i will have input on their care and my opinions will be taken into account.
My first rotation is at Riverside County Regional Medical Center in the department of Obstetrics and Gynecology and it is 6 weeks long. Apparently it is one of the best hospitals to rotate at in the area because it is so big. I have to be there at 7am and it is about a 45min commute as the hospital is 40 miles away so I will be leaving at 5:45am to make sure I am there on time and where I am supposed to be. The best part about the whole situation is that my good friend Nicole is working at the same hospital, in the same department. Nicole and I studied for boards together for weeks and are very comfortable working alongside each other so knowing that support will be there is making this whole new transition much easier. We will be carpooling to the hospital tomorrow and will experience all these brand new situations together.
I am so excited for the USMLE and COMLEX to be behind me. I feel like a brand new world is opening up...a door has been opened to the next chapter of my life. I have been preparing for this day for so long....it is here. Student Doctor Dorothy is ready to soak up as much information as she can!
I cant wait to document all the new experiences!!! Should be some damn funny stories. Well, they may not be funny now but I know they will be funny years to come when I read this again...
"we're all set. 3rd year starts tomorrow. setting us free into the wild. now we just have to try not to look like idiots. IM SO EXCITED!!! :)"
Correction, I spent 36 days studying. On Wednesday June 8th, after not taking one day off, my brain went on strike. I woke up in the morning and just could not get out of bed. I decided to let myself sleep in until 10am. Then after pressing the snooze button a bunch of times, I got out of bed around 11am. I made some breakfast, watched a bit of TV [first time in a month] and then decided I was not ready to study...so I went back to bed. Then, I went to sleep from 12 to 5pm. I woke up and my brain had re-set. So I went to school, put in about 5 hours of studying and then called it a day. Needless to say, my brain went back to working order the next day...
I still dont know how i did, i wont get my scores for about a month. But it really doesnt matter at this point as long as I passed both of them. There is nothing more i could have done, i could not have given more of myself to this subject and however I did i will be happy because i made it. I am here, a 3rd year medical student, having been taught as much as school could cram into my head, and I am now being ‘set free’ into the real world of medicine.
Tomorrow I start my first rotation...it is my first day of 2 years of clerkships in which I will trade in my books and powerpoints for patients. I will be learning from individuals who are kind enough to let a student learn on them. I will be supervised thoroughly and will never be completely responsible for someone’s help...so im not too scared. But, i will have input on their care and my opinions will be taken into account.
My first rotation is at Riverside County Regional Medical Center in the department of Obstetrics and Gynecology and it is 6 weeks long. Apparently it is one of the best hospitals to rotate at in the area because it is so big. I have to be there at 7am and it is about a 45min commute as the hospital is 40 miles away so I will be leaving at 5:45am to make sure I am there on time and where I am supposed to be. The best part about the whole situation is that my good friend Nicole is working at the same hospital, in the same department. Nicole and I studied for boards together for weeks and are very comfortable working alongside each other so knowing that support will be there is making this whole new transition much easier. We will be carpooling to the hospital tomorrow and will experience all these brand new situations together.
I am so excited for the USMLE and COMLEX to be behind me. I feel like a brand new world is opening up...a door has been opened to the next chapter of my life. I have been preparing for this day for so long....it is here. Student Doctor Dorothy is ready to soak up as much information as she can!
I cant wait to document all the new experiences!!! Should be some damn funny stories. Well, they may not be funny now but I know they will be funny years to come when I read this again...
"we're all set. 3rd year starts tomorrow. setting us free into the wild. now we just have to try not to look like idiots. IM SO EXCITED!!! :)"
Friday, June 3, 2011
Sooooo....i decided 100 hours was not enough and changed my date. It cost me $50 but i'm pretty sure its the best 50 bucks i've ever spent [or at least the best career decision i have made]. Now I will be taking the COMLEX on the 13th [as planned] and the USMLE on the 15th. Best part is I get to take the USMLE down in San Diego [where i took my MCAT] so i'll feel right at home AND get to go to the beach soon after :)
Thursday, June 2, 2011
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