thumbs down

2 thumbs down!

i have just survived my first medical call - all thanks to my lovely resident!
if not for him i would have collapsed myself, completely clueless and lost as to what was happening.

after 8 months in OB/GYN and ortho, my brain has really rotted away. can barely remember how to do a physical examination (feeling womb size and lie of baby comes easily though!), can barely remember things like dysdiadochokinesis, can't remember how to clerk patients, etc.

felt so wholely inadequate, management plans for patient are very basic are really quite stupid, (but i am sure i will improve with time!) i take ages to do anything, i am so very slow. goodness.
thankfully my resident was such a nice guy, who agreed to see the new admissions with me, who patiently explained, who encouraged me, who went down to buy me a drink whilst i did the passive ward work, who reviewed my patients without me asking, who clerked new admissions for me when he realised i was so swamped, and who never made me feel stupid or dumb.
BEST RESIDENT EVER!!!!! love him to bits. his writing is incredibly neat and nice too, like printing. whoa. couldn't have asked for a better resident on call with me :) :) :) super duper mega thankful. :D :D :D

wasn't too bad a night call by medical standards, 14 new admissions, i clerked 8, my resident clerked 5 without me, my senior resident clerked 1 (omg, yes, i am in disbelief at her utter niceness). plenty of passive things like blood cultures, set plugs, take cardiac enzymes, review results etc. but no matter! no collapses on call, only 1 quite sick patient who remained stable throughout the night. SUPER THANKFUL.

med is a whole new thing from ortho! history actually makes a big difference, examination actually may reveal something you didn't know. treatment plans are of utmost importance. you need to think hard about what blood tests to order, not just the usual PFO orders you write in ortho.

i'm learning some things in medicine, but it's hard to learn when your workload is overwhelming. very thankful that the residents are understanding and do try to help a bit, but after 2 postings where i'm expected to do everything by myself, i really don't expect their help so any help at all is a bonus. in ortho, lunch used to be at 12 or 1 pm, now lunch (if at all!) is at 3 to 4 pm, just a quick bite before exits and then a mad rush to finish things before going home around 7 pm. if i'm on call, it's even worse!

no sleep at all on calls, sigh. but at least i got to leave post-call at 3 pm, got home and crashed promptly from 5 pm all the way till the next morning, exhausted!

4 more months of this. eeks!

happy new year everyone!

this new year, i'll be moving on from one posting to another - from orthopaedics to general medicine (GM).

suffice to say it strikes terror into my heart! in ortho, i have practising "voodoo medicine" and the patient's medical management is left almost entirely up to ME. and when in doubt, refer!

furthermore, this will be my last posting (provided i don't fail!) as an intern and hence, i'm expected to know more than a fresh intern out of medical school. i have completed 2/3 of my intern year!

the scary thing about doing OB/GYN and ortho first is that your patients are generally well patients. collapses are few and far between. sick patients are usually sent to HD or ICU for anaesthetists to manage. but in GM, sick patients are everywhere!
my friends in medicine have told me to expect a minimum of 1 collapse/resus/code blue a night. OH DEAR ME! i have never run a resus before. i can only hope my resident will be by my side or else it will be terrible.

i have no idea how to manage hyperkalaemia/DKA/AMI/fluid overload/etc etc by myself!!! i mean, i know the theory of it all but i have no idea how to do it practically. how much iv insulin do i give in DKA????? it all boggles me!

thankfully my next hospital is a small garden hospital which is supposed to be one of the best places to do internship in as the patient load is lighter and the profs are really pro-teaching and very forgiving. i hope it's reputation holds! :)

i am extremely sad to leave ortho - the orthopods have become friends and they are really some of the nicest/most easygoing/funniest people i know. (let's not talk about medical management here haha) at our farewell, the attendings came up to us one by one to wish us good luck for the future postings and expressed thanks for us working in their department. i was pretty touched! more than one attending has told me to come back to work them in the future as a resident (i'm the only one out of the outgoing interns with a surgical slant), and a few have said they can possibly see me in ortho.
i find that all very nice but i'm rather dubious about my own skills in ortho! then again, after doing step up calls i suppose word has gotten out.
i will really miss 2 of the senior residents though - they were more like friends to me rather than bosses. i remember texting one of them after my first ever mortality in despair, and he called me up instantly after to ask how i was, and patiently listened whilst i sobbed my head off over the phone. i was incredibly touched!

the thing i will miss the most about ortho is the nurses and my fellow interns.
finding such a great bunch of nurses elsewhere is near impossible, and these nurses are really good! they will call families/surgeons/pacify patients/set plugs/take bloods etc for you, and they buy me food and drinks on call too. much love!!!! being on call in my favourite ward is like being surrounded by a huge extended family, they even cook me dinner! :)

as for my fellow interns, i will greatly miss our bitching sessions and much laughter and hilarious stories. it was amazing working with you guys and i think having people whom you get along well with is such a boon! :)

a new year brings new hope, but this year i'm cutting the new year resolutions, pretty pointless for me to do them because i never follow them anyway hahaha.

may the new year bring you new dreams/hopes, and may you all never be short of kindness, goodness and love :)