Friday, July 29, 2011

plastics

so now i've been on plastics for one week. got to a rough start, but i think things are smoother now. i'm the only resident on, so that means more responsibility, but also tons of OR time! i've finally gotten to scrub into cases and do some suturing (and of course a ton of retracting). i'm starting to get the hang of the different styles of the attendings, and am officially on texting basis with one of them.

this week has been tough, but i think next week will be better. it's always better after you know the schedule and what's expected of you. and i think that as an intern, i'm not expected to know or do everything perfectly, but of course i am expected to acknowledge where i'm wrong or need improving and fix it for next time.

i've heard that med school is like "drinking water out of a fire hose", but apparently the person who applied that phrase never went to residency. i know that i'm never going to know enough, but i'm looking forward to when at least i'll know how to do all the paperwork shuffles and all that kind of stuff. because knowing how to navigate the system saves so much time, and seconds are precious.

i was on call last night, and it wasn't that bad actually. i feel like i'm starting to get the hang of everything...i'm comfortable handling more and more on my own. i'm getting better at managing post op pain. people that need to pee? straight cath! haha! critical values? NOTED! people wigging out and spazzing? CONSOLED! see? not so hard...it's nice that i have excellent co-residents and i must say that overall i'm quite impressed with the nursing staff too.

so let me put these two last things down...today i got two compliments, and they made my day. thus, documentation on le blog for INTERNET ETERNITY. one of my senior residents told all the other ones during our administrative time that he thought i did a great job getting sign outs from all the teams, and that i "aggressively" sought out people to get sign out by calling them up and inquiring on their statuses. (we have been having some issues of people not getting/giving sign out to the on call folks, and i have made it a personal goal of mine to try and do good sign out and then when i'm on call to get good sign out. because how the heck am i supposed to know what's going on if i haven't gotten sign out?) so that made me feel good.

second thing...one of the patients we did a flap closure of a wound on had gotten his jp drain clogged up for whatever reason. i sewed the drain in, and i probably did it too tight so i thought that was the problem. the attending told me to go and fix it, so i gathered up my supplies, numbed up the patient, took out the old stitch, and did a little bit of blunt spreading at the incision. turns out, the incision for the drain was a skosh too tight, and my spread action worked wonders! the effect was immediate, we had drainage, and i was like YEAH I FIXED THAT SHIT! sewed the drain back in (looser this time), added some mesentery tape to keep everything in place and put the the dressing back on. called the attending, wrote my note. and i know that fixing a clogged drain is NOT the hardest thing ever, but it was something that i did by myself and felt comfortable and confident in doing so. and then this morning the attending told me "strong work on that drain!". yes. strong work indeed!

and since a lot of my days are spent going "omg i just screwed up" or feeling a bit overwhelmed, i try to focus on some of the good things that are going on. the joys of intern year.

and now i will go to bed soon, since being post call is AWESOME. but i have to work in the morning, alas. holla!

1 comment:

Just an Intern said...

way to be an asskicker. nice job with the sign out. it is much appreciated I am sure. And you totally owned the drain situation. Doesn't matter if it is complicated or not. Take your compliments where they come!!

Congrats...but I thought only medicine people said "strong work"...not surgeons :)

Don't surgeons have their own lingo??