Last night was my first night of call as an intern. I was truly terrified going in. While I've gotten comfortable in clinic and with the flow of patient care and doing the notes there, this was my first day in the hospital and I worried about everything that could go wrong. I spent Friday morning at the FP clinic and then the afternoon working with one of the reproductive endocrinologist/infertility specialists (very interesting! We did two IUIs and talked a ton about all the various "assisted reproduction" options. I already feel very well-educated on this topic because of Wendi [you're awesome, Wen!], so our discussion was very focused and mature. I also feel that, having watched Wendi go through all this [I really do feel like I have done it myself!], I was very empathetic with the patients. I love endocrine stuff, so I definitely can see why REI is an attractive fellowship after OB/GYN residency. I think I spend Friday afternoons for the next month over in that clinic). In any case, after all that, I found my way over to L & D for board signout and everything that ensued.
It initially felt a bit like my experience on my ER rotation in the past (which I didn't like at all at the start). I just felt stressed out most of the time-- like things were out of control. I had to remember to follow-up on gyn labs and do post-op checks for women who'd had surgeries (i.e. hysterectomies) during the day, try to quickly see patients as they came into triage so that that didn't get backed up, keep up with cervical checks and monitoring the labor patients, etc (we had one G11 so things like that can go fast). I had to answer all these pages on patients I didn't know and always was second-guessing my plan. We have these "vocera" things we wear around our necks on L & D which are kind of like intra-unit walkie-talkies, which I had to figure out (you say things like, "Call OB Chief," and it does!). I am not a very good "juggler" and typically like to do one task at a time, crossing it off my little list of things-to-do.
Matt and Hao, the upper-level OB residents, helped me a ton. They were very patient. They were there to guide me as I figured out how to do wound checks/packing and formal ultrasound measurements like AFIs (amniotic fluid indices), identifying the placenta, etc. I had no shame about asking the nurses where stuff was or how to do stuff. I think everyone generally sets the bar low as far as expectations of interns go (which is good, believe me!) :) This was my "first day," after all. Although Aline oriented me a little the week before last, I hadn't gotten the opportunity to spend days on L & D during the week to get adjusted and everything-- I was just thrown into call.
So, despite the help, it was still kind of terrifying. I had to create the "list" for rounding today. It took me about 2 hours to round on (half of) the post-partum patients (Gaea, my day co-intern, helped with the other half), one of whom I'd delivered, but none of the rest of whom I had ever seen before. After board signout, it took me almost half an hour to dictate two discharge summaries because I didn't know the right buttons to press (i.e. to pause, etc.-- ESSENTIAL) but more because I wasn't good with gathering all the info. I needed -- antepartum course, maternal labs, course of labor, C/S operative reports, anesthesia procedures, etc.... I was just there overnight and knew nothing about these women and their hospital courses, so at one point, I was close to tears with frustration with my own slowness, but fought it off :)
I think things will be smoother next time. I got my feet wet without anything devastating happening. No one died (phew) :) It is very frustrating to me to not be efficient, comfortable, confident, good, and ontop of everything right now, but I know I need to be patient and less of a perfectionist. At this point, it doesn't seem possible that I will, one day, get to the point that the other "experienced" residents are now, where I will be as calm, confident, and collected as they are. But I hope it does happen! I got home around 10:30 and slept for most of the afternoon. I wonder when my body will recover from last night. Till next time...
OH! GOOD NEWS: When we did "GI rounds" (break for dinner-- don't you love that phrase?) last night, I rechecked my food balance and I really have $509, and not $49, on my card! I don't know how I got the wrong amount last time! I am super excited about this! :) But uh oh... this means I have quite a lot of call in the next 6 months.
3 comments:
Tara,
Although in different professions, I completely empathize with you on what you are saying. I think one of the most frustrating things for me is feeling disorganized, slow, and not efficient at all because I don't know where things are, don't know exactly how to do something, etc. I feel like I deal with this often at school during new procedures, etc.
I always try to remind myself that everyone feels this way at one time or another and that with time, it will get better and I won't feel so overwhelmed and frustrated. Easier said than done, I know!
Anyway, it sounds like you are doing some very exciting things and I'm sure that this blog will be great to look back on, even in just a few months, and you can see how you felt on your "first day" and how far you've come in terms of confidence! :-)
Thanks for blogging often...I love to read what you have to say!
Rachel-- I'm glad you understand! I remember feeling this way in med school, and it got better, so I'm hoping it works out that way this time too :) It just seems more scary and "real" now that I actually have to be authoritative and "make the calls," if you know what I mean.
Tara, I'm blessed that you felt "educated" by my story. Seriously, that might have just been a passing comment on your blog but I cannot TELL you how much it helps me feel that what I went through (and am going through) might help someone else and that people are learning through it. That is so comforting to me.
Thanks!
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