Learning curves

I have been amazed at how much I have learned in just the past three days. I have gone from a timid first-day intern to almost a seasoned resident! Just kidding. But I think a lot of the challenge of internship is just learning how and where things get done-- the medicine is really the same. I floundered around a bit in the medical record, charting the visits from my patients this morning, but felt more like a "real doctor" than I did yesterday. I think I might have even introduced myself as "Dr. Arness." Anyway, so that I don't spend a lifetime at the computer, I will probably learn that my notes need not be that detailed... I will learn to be more efficient and get just the essentials across (although I've gotten better at things like this, I will never be as fast as Hans!).

This afternoon, I spent time with the lactation consultants who see newborns with feeding problems and moms with questions about breast feeding. It was incredibly educational. I really (obviously, not having had a child or done it myself) do not know all that much about the intricacies of breast feeding-- how much (ounce-wise) and for how long (each time, per breast) is normal at each age, intricacies of supplemental methods such as finger and cup feedings, why certain bottle nipples are bad because they lead to "flow sensitivity," how to work all the accessories such as nipple guards and pumps, and how to deal with moms' complaints of pain or soreness. In just a few hours, I felt much more comfortable with all those things and in counseling parents of newborns who may come into my clinic with feeding questions or problems with their babies' weight gain (in fact, just this morning, I saw a little two-week old who was a little slow to grow but who had finally regained her birth weight and seemed to be turning the corner).

I am actually getting quite nervous for OB call on Friday. I talked to Kyla (who's in Connecticut right now) for a good long while tonight about trying to stay calm and "do things right" and all that and felt somewhat comforted after our conversation-- she reminded me that everyone goes through this and feels this anxiety upon starting new things (although I think I probably have more anxiety than most people). I know that I may get slammed on Friday, covering the laboring patients and deliveries, running triage, and cross-covering gyn-onc (speaking of cross-cover, I think I will really hate it. I do NOT feel comfortable answering questions on patients I don't know). I am not sure whether to hope for a "busy night" to quickly get me acclimated to what goes on there or whether I should hope for things to be kind of slow so that I "ease in." In any case, I will learn from whatever happens. The learning curve now is really, really steep and I think, even one week from now, I will feel much more comfortable, confident, and also smarter :)

Other things I have learned recently:

• I learned today that Grandma is going to have another stent placed tomorrow, this one in the right coronary; this was not able to be accomplished during the last cath. She seemed to be doing okay when I talked to her this evening-- it's hard with all of us on different coasts and no one to be right close by.
• I learned that it is not rude to pass slow bikers. Yesterday, I was biking to work behind some really slow girl but didn't think it was polite to pass her, even though she was making my commute much longer than it needed to be. As I was coasting along, this other guy came up behind us and zipped by both of us. So, from now on, I'm passing when I feel like it (when it's safe, of course).
• I have $49 on my ID card to get me through meals through January. This doesn't sound like a large sum. Now, granted, 2 of those months are at the VA hospital, and technically a small sum of money means not a lot of call (they ration money based on your average call schedule, so I should be happy!). But I still don't think it was very generous.
• Believe it or not, Rite Aid is quite a good place to buy alcohol on sale (I love checking the ads and clipping the coupons)-- I got some rum and some irish cream for cheap! :)
• Netflix got wind (maybe they read my blog. Hah!) of Blockbuster's lower rates and special deals like Total Access... so they are lowering their monthly rate by a dollar. Hmm. Now a quandary of what to do.
• Okay, enough blogging. I need to review a few little things like pelvic anatomy, IUPC placement, lac repairs, and the "OB intern survival guide". Time to get my learn on! :)