Being the first day of the month, the ID team got a new intern and attending (the senior resident changed yesterday). This meant no more working with Dr. Para (he was one of my attendings when I was on ID last year, and wrote me a letter of recommendation for residency), and finally figuring out what my responsibilities will be for the month.
The day got off to a rocky start. Since I didn't know what time my new intern was going to be showing up for sign-in (hearing from the night team how the patients did overnight), I pre-rounded on my patients ("my patients" being the six people on the service who the third year med students are not following). Pre-rounding is one of my least favorite things to do. You go in at some ridiculous time to the patient's room, wake them up, check their vitals, listen to hearts and lungs, and chat with them when they'd rather be sleeping. Then, an hour or so later, they get woken up again and asked the same questions when the rest of the team comes by for rounds.
Anyway, so I pre-rounded, then introduced myself to the new intern, and then it was time to "run the list". That means going down the census and discussing how each patient is doing before rounds. I figured this would be a standard running of the list, which means you just give the vitals and say if they had any complaints overnight. I have been doing this for two years, after all--I know what the resident needs to hear. Well, my resident decided (without telling me beforehand) that he wanted us to practice our presentations before the attending showed up for rounds. So I had given a very concise summary of the last twelve hours, and he proceeded to correct my presentation. I've been giving patient presentations for awhile now; I think I know what I'm doing, but the resident then corrected everything I said and painstakingly walked through how I should present to the attending. Grr.
As it turned out, Dr. Maher has a great sense of humor and only likes pertinent points, so my presentations were pretty much exactly what he wanted.
Anyway, that was how we spent the morning ("morning" being 6:30-2). Then I grabbed lunch, wrote patient notes, filled out discharge instructions (which the resident then felt the need to show me how to do, even though I had already done it). We got a couple of new patients in the early afternoon, which the med 3's picked up, and then another new one, which I picked up (too many new patients in one day makes third year med students nervous). It was a great case for me, too: a patient with TB, transferred from another hospital. So I had to contact the Ohio Department of Health, get his TB records, figure out his treatments, and try to decide why he hasn't been getting better (he has been on treatment for two months; should be showing some signs of improvement). Figuring all of that made for a late afternoon (I left the hospital at 6:30), but at least I was doing something that I'm good at.
Hopefully the resident will realize that I'm a semi-competent medical student soon. This could get very frustrating very fast.
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