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27th February 2008

*loved*

You know you have really really good friends when they call you up to say that they want to see you on your day off…and they are coming over with cleaning supplies and expect to be put to work.

My kitchen, bathroom and living room looks fabulous. Still have laundry to do, but will have fresh scrubs to wear tomorrow.

*loves*

So glad that this month is over. It has been difficult and frustrating in many ways that I could have never predicted. I liked my interns individually but we never became a team, and I really struggled with how to improve things. I was in change of 15-20 patients every day, we rarely seemed to make any progress in discharges, and I think I set the record for the number of patients transferred to the unit (12). I was rarely done and home before 7 pm…when my interns usually left by 5, I was still there making sure everything had gotten done.

Tomorrow will be met with a new set of challenges: new interns and students, new hopsital, new system, new rules, (and I get to start by being on call! Yay!) but I’m glad to get a fresh start on things. Plus, all of the other residents keep teasing me with promises of work days ending by 3 pm, and that sounds unbelievably alluring.

Night all.

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8th February 2008

stuck in a rut

I spent my day off today sleeping in and lounging around the house. I only left to get pancakes, because after this past week, I deserved pancakes. I transferred yet another patient to the ICU (who by the time I finally managed to talk to the fellow (who has to see and agree to admit patients before they get transferred), didn’t look quite near to death as he did mere minutes before, so the fellow thought I was quite off my rocker. Especially since I had a tearful breakdown in the middle of the hallway, because I couldn’t find anybody to help me out. I’ve never ever done that before at work, and I’m still horrified by my behavior.). My team was on “daytime admissions” so we were admitting patients who I had to see and discuss with my interns, while this other patient was slowly funneling down the tube. I was at the hospital until 10:30 last night running around seeing everyone.

It had, as forecasted, dropped 12 inches of snow (luckily, not 18: I don’t know what I would have done), and I managed to drive home, only to get stuck in middle of the very much not plowed side street that I live on. I trudged back to my house, got out my shovel, and tried to dig myself out with no luck. Finally, somebody with a truck (I LOVE TRUCKS), came back and pushed me out to where I could slide my car in front of my car. Of course, I get out today to get my pancakes to realize that the plows had finally come through and had plowed me in again, so I was stuck again and had to be pushed out again. Argh. Getting tired of this snow thing. If I have time before heading to work, I’ll try to take pictures.

The only saving grace in this, is that yesterday morning as I was fractically trying to snowblow before heading off to work so that I’d only have 8 inches to plow through, is that my neighbor offered to do my place. So I at least came home to mostly cleared sidewalks. I’ll have to see what I can offer in terms of homemade goodies to entice him to do it again. 🙂

They’re going through with the plow again right now, hopefully it’ll be more driveable in the morning.

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5th February 2008

weight of the world

Since I started as the senior resident on the wards (ie inpatient medicine) team a week ago, I’ve:

– done 2 lumbar punctures (spinal taps – one of them was on a guy who had a seizure as I was inserting the needle. I did manage to get it, but it was no champagne tap)
– supervised 1 paracentesis (abdominal fluid tap)
– Managed 2 encephalopathic (confused and almost coma-like states) patients who became so because my interns continued home medications that the patients really weren’t on (and should have been on in this hospitalization because of their various illnesses affecting how their bodies metabolize drugs) which I didn’t catch until after we had problems waking the patients up (both are living, one has completely recovered, the other is slowly, slowly, slowly waking up). I’ve agonized for hours over their cases.
– Attempted to work up a patient with the strangest brain lesions I’ve ever seen on MRI, and finally, finally managed to get neurosurgery to get a biopsy, only to have the radiologist call me and state that they thought all of the lesions were “congenital” and didn’t need the biopsy after all. Um, too late, bozo, you could have informed me of your “expert” opinion two weeks ago. Grrr.
– transferred five patients to the ICU, because they all seem to crump the moment I lay eyes on them. (Two of these, I transferred this afternoon. Yeah, there went my plans to leave early as I am very very very close to violating work hour restrictions)
– I’m too tired to remember the rest. All I know is that I’m usually not leaving until after 6 at night even when we’re not admitting patients.

Did I mention that I’m responsible for a team of 18 patients? And that we’ll be admitting 6 more tomorrow?

To add to it all, my attending is very disappointed in my intern’s performance and it’s becoming my responsibility to take her aside. I’m not good at these things, especially when I don’t think she’s quite as behind as my attending does, but I really don’t seem to have any other choice. I’m also having problems with my other intern, as he doesn’t listen to me, barely updates me in what’s going on in his patients and to top it off is very serious and stuffy and I just don’t get along with stuffy. It’s stressing me out, I’m having problems sleeping (I end up dreaming about all of the tasks and problems that are going on)

I had started an entry last Tuesday when I was post-call but satisfied at the smooth transition into being a senior resident. Life was good (even though I was exhausted and irritated at having to admit all of the roll-over patients). I had great interns (including one with the most bewitching eyes and sardonic smile) and a great attending and I was so overjoyed at being back in the medicine department and NOT having to write daily progress notes (the bane of my existence). It was lovely. Even though it freaked me out every day of how much responsibility I have and how much I still have to learn to really effectively direct my interns and students in the care of their patients, I could see how much I’ve learned in this past year (I can be taught!). And my patients, even though they were rocks and refusing to leave the hospital, didn’t sap me of my compassion either. It’s all changed this week. I’m exhausted and weary and I’m tired of feeling the weight of responsibility and (my) ignorance.

In other news, I’m slowly making my way through Season 3 of LOST. I think DVDs are definitely the way to watch this show, the instantaneous answers providing the forest big picture so everything makes sense. Still love Charlie. FInally starting to feel the Sawyer/Kate love. Can’t figure out Locke’s motivation. Didn’t even recognize Boone (Boone! I miss you!).

I didn’t vote today. That’s because Wisconsin’s primary is in two weeks and since I always register as an independent, I will actually get to vote in a primary for the first time because it’s open here. Yay! I could even waste my vote and select between the candidates for the green party if I so chose. So what if everything’s going to be decided by then, I’ll still have my say!

It’s supposed to snow 12-18 inches in the next 15 hours or so. It’s going to be great fun sliding to work, I’m going to have to wake up early to snowblow just so I won’t be completely snowed in. The best part is that it’s been warmish the last 2 days, up to the mid thirties and melted all of the snow, which has now frozen on my sidewalks. If I manage not to kill myself by falling in front of my snowblower tomorrow AND make it to work on time, it will be a miracle.

And on that note, to bed I go.

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