2 posts tagged “internal medicine”

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IM blues

Feb 23, 2008
2 comments

I suppose it's true what a co-intern says. It's almost like I've been demoted. My exhilarating ER days were over 2 weeks ago. Last week I was stuck rounding at the ward, where when I go on duty I seem to be doing both the writing of orders in the chart and the actual carrying out of the orders. [Where are the good and efficient nurses when you need them? They've all gone away abroad to seek greener pastures leaving behind arrogant half-wits who think that charting is the priority above giving of meds and actual taking care of patients]. These days I'm stuck at the ICU staring through glass doors at patients who don't seem to be getting any better. On weekends and when I go on duty I become the ICU Medical Intern/ ECG Technician-on-duty for the WHOLE hospital. If I would get paid even a fraction of the cost for each ECG I take per duty I'd have enough money to celebrate on weekends and feed me on the weekdays. Alas, I'm still not getting anything from all the hard work. Even the learning I'm supposed to be getting is not commensurate with the number of hours I spend in the hospital.

These days I'm trying to get that bounce back in my steps -- a literal bounce I seemed to have lost after I left the ER. Truth be told, I'm tired and feeling bummed out about my low productivity. I have a week's worth of one-disease-per-day reading to catch up on. At the same time I need a weekend off to just chill.

I go on duty again this Sunday. I still think I should go into Internal Medicine for my residency training but lately I've been really worried. If the total lack of interest I am showing is any indication of what my outlook in residency will be I doubt that IM would be the best fit for me.

thoughts from previous rotations

Jan 31, 2008
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General Medicine rotation. Day 1. I was sitting attentively as endorsements started and the junior resident from duty ran down the admissions.

I always enjoyed morning endorsements even when I was a junior intern. For me so much learning occurs in that hour of grilling and review of patient's management. And every time a senior says something however cliche they may sound I swallow them whole like pearls of wisdom, because most of the time that's exactly what they are. Plus the fact that when you're so lost and you feel like you have no idea what you're doing those words are exactly what gets you through the day.

* * *

I have absolutely great respect for residents/interns' monitors who make it a point to teach. A lot can be learned from observing the residents as they work, but so much more is ingrained into one's system if the rationale behind each patient's management is explained. Which is why I make it a point to tail residents who do teach. Most interns I know don't like to do this because when you do rounds with residents there are a gazillion calls over the paging system and there is no way you can answer them while you're doing rounds. And even after 30 minutes of not answering calls I usually get buried under a ton of paperwork and errands to do. And of course, rounds with residents generally mean sleeping late into the morning or not sleeping at all. Because their work never stops. But I figured, one night's worth of lost sleep is the lesser evil compared to a week's worth of reading textbooks and never really understanding anything.

* * *

Always remember: Treat the patient . . . not the chart.

(Even with standing orders to be carried out automatically for specific patient complaints, symptoms, etc., go see the patient each and every time something new comes up. Never just add another order from the already long list of orders to be carried out without first checking up on them.)