In one week I'll be finished with my Primary Care rotation. I can't believe that I'm about to finish my second rotation already. I've been working in a small private practice run by two doctors and two PAs. I've realized there is a huge difference between working in a hospital versus working in a private office. I've been more relaxed and have gotten more sleep during this rotation! It has been less stressful overall mainly because I've been working very closely with only one PA. At the hospital during my Internal Medicine rotation I worked with a different PA almost every day and that increased the stress level exponentially.
One of the most difficult aspects of these rotations is being able to adapt to working in different environments as well as with different personalities every 5 weeks. I have worked with some very interesting characters over the last 8 weeks and I've learned from each one of them.
The PA that I'm working with now has given me a lot of opportunities to learn. She told me on my first day that if she trusted me, she'd let me do everything that she does. She said that during my 4th week of the rotation i would be given a prescription pad and would be seeing patients on my own, taking a history, performing a physical and developing an assessment and plan. I remember doubting if I'd be able to reach that point by the 4th week. Well, I was given the prescription pad the first day of my 2nd week and my confidence in my abilities has increased as a result of the added responsibility. During the second week, I was treating mostly colds, sinusitis, flu shots, and general physicals. At this point, I just pick up the next chart and roll with it.
After I come up with my assessment and plan, I present the patient to the PA or doctor and if they agree with my plan, they sign off on the prescriptions. If they don't agree, they explain their reasonings and explore my own thought process about the disease state. Unlike the hospital experience, these healthcare professionals have provided more of a nurturing, supportive environment and that's why I've been less stressed and have gotten more sleep!
BUT...I found working in the hospital to be more exciting. And I have a better chance of bumping into a Mc Dreamy in a major metropolitan hospital than I do in a small, private practice!
;)
Tuesday, October 31, 2006
Tuesday, October 10, 2006
A Tree Grows in Brooklyn
I started my Primary Care rotation yesterday and I've seen more patients in the last 48 hours than I saw during my 5 weeks in Internal Medicine! I've also done more procedures! It's been crazy.
I've been getting emails asking about what I get to do. I basically get to do whatever my preceptor is comfortable with me doing. The preceptor could be a doctor or PA. During my internal medicine rotation I did some blood draws, two ABGs, and a foley catheter on a female. The foley catheter was placed on a woman who was being treated for acute respiratory distress. I had to insert the foley while being surrounded by 8 doctors...they were part of the emergency pulmonary team. My prior experience with foleys was on a PLASTIC model. Needless to say, my hands were shaking but I managed to do it successfuly and then was nicknamed "Foley Queen" for the rest of my rotation. I nearly passed out afterwards when I realized that all 8 docs were watching me.
Within the last 48 hours I've seen 90 patients! I've given countless numbers of flu vaccine injections as well as Vit. b12 injections. I gave trigger point and Hyalgon injections too. I conducted EKGs on four patients and interpreted the EKGs...my initial interpretations were correct...and two of those 4 patients were sent to the Emergency Room! I've listened to all of their hearts and lungs and conducted focus physical exams based on their complaints. I've written in their charts. I've done all of this with the PA at my side. She promises that by the 4th week of this rotation, I'll be doing all of this alone and she'll come in at the end and double check my work...as well as the prescriptions that I choose to write.
This stuff still amazes me.
Today was even more amazing because I was at a clinic in China Town. The majority of patients were Korean the rest were Chinese. We saw 31 patients and NONE of them spoke fluent English! We had an interpreter with us but she only spoke Korean, Japanese, and English...no Chinese. I felt like I was back in Japan! Some of the Korean patients also spoke Japanese so I had fun speaking with them. I am not fluent in Japanese by any means...but I can understand the basics and mannerisms. I had a great time but was exhausted by the end of the day. The clinic treated a record number of patients today...and it was only staffed by the PA and me. The nurse had to go to China for a funeral! It was insane.
When I was living in Japan a lot of people encouraged me to learn Japanese so I could use it in the business world. But, I knew I had zero interest in working in the business world. I've known that my whole life. But, I never thought I'd be speaking Japanese as a healthcare provider!
Crazy.
I love it. And did I mention that I L-O-V-E Brooklyn? I may have to name my firstborn "Brooklyn". And no...this doesn't mean that I've met the man of my dreams. That's not what I'm looking for right now. I've been meeting people from all around the world...different cultures, languages, beliefs, and outlooks on life. I find living here to be fulfilling and inspiring.
I had no idea that would happen.
Since Brooklyn is the most populated borough of NYC...there are plenty of hospitals and doctor's offices!
The seed has been planted.
I've been getting emails asking about what I get to do. I basically get to do whatever my preceptor is comfortable with me doing. The preceptor could be a doctor or PA. During my internal medicine rotation I did some blood draws, two ABGs, and a foley catheter on a female. The foley catheter was placed on a woman who was being treated for acute respiratory distress. I had to insert the foley while being surrounded by 8 doctors...they were part of the emergency pulmonary team. My prior experience with foleys was on a PLASTIC model. Needless to say, my hands were shaking but I managed to do it successfuly and then was nicknamed "Foley Queen" for the rest of my rotation. I nearly passed out afterwards when I realized that all 8 docs were watching me.
Within the last 48 hours I've seen 90 patients! I've given countless numbers of flu vaccine injections as well as Vit. b12 injections. I gave trigger point and Hyalgon injections too. I conducted EKGs on four patients and interpreted the EKGs...my initial interpretations were correct...and two of those 4 patients were sent to the Emergency Room! I've listened to all of their hearts and lungs and conducted focus physical exams based on their complaints. I've written in their charts. I've done all of this with the PA at my side. She promises that by the 4th week of this rotation, I'll be doing all of this alone and she'll come in at the end and double check my work...as well as the prescriptions that I choose to write.
This stuff still amazes me.
Today was even more amazing because I was at a clinic in China Town. The majority of patients were Korean the rest were Chinese. We saw 31 patients and NONE of them spoke fluent English! We had an interpreter with us but she only spoke Korean, Japanese, and English...no Chinese. I felt like I was back in Japan! Some of the Korean patients also spoke Japanese so I had fun speaking with them. I am not fluent in Japanese by any means...but I can understand the basics and mannerisms. I had a great time but was exhausted by the end of the day. The clinic treated a record number of patients today...and it was only staffed by the PA and me. The nurse had to go to China for a funeral! It was insane.
When I was living in Japan a lot of people encouraged me to learn Japanese so I could use it in the business world. But, I knew I had zero interest in working in the business world. I've known that my whole life. But, I never thought I'd be speaking Japanese as a healthcare provider!
Crazy.
I love it. And did I mention that I L-O-V-E Brooklyn? I may have to name my firstborn "Brooklyn". And no...this doesn't mean that I've met the man of my dreams. That's not what I'm looking for right now. I've been meeting people from all around the world...different cultures, languages, beliefs, and outlooks on life. I find living here to be fulfilling and inspiring.
I had no idea that would happen.
Since Brooklyn is the most populated borough of NYC...there are plenty of hospitals and doctor's offices!
The seed has been planted.
Monday, October 02, 2006
I've got a million stories that run through my head on a daily basis that I want to write about. But, for some reason, I can't find the time lately.
Here's a quick update: MY FIRST ROTATION ENDS IN TWO DAYS!!!
I can't believe how fast time as gone by. So, I've been busy preparing and studying for the end of rotation exam on Thursday. I am NOT looking forward to that exam. Since my rotation is Internal Medicine...it covers everything! So, I'm trying to read as much as possible, but there are no specific handouts or specific books that outline everything I need to know. So, I'm taking my readings from several different books, notes, and on-line sites. Basically, I'm all over the place.
Unfortunately, this rotation was not as good as it could have been. I'll go into that more later. Basically, the hospital is understaffed and the PAs are overworked and inexperienced (1-2 years) so that doesn't add up to a good teaching experience. Some days were really frustrating. My classmate and I have been basically teaching ourselves. So, it's been great having him there with me. We laugh during our lunch break everyday...if I were alone, I probably would have been crying!
The most important thing that I've learned is that I love working with patients. My patients have been very sick and I wasn't sure how I would cope with that...but I've been coping just fine. It's strange how you walk into a room and you can smell death...but then you walk out into the hallways and see life. You bounce around all day and walk the line between life and death. It's a very strange position to be in and some of the things I've seen have really made me contemplate end of life issues. These experiences have made me think a lot about my own mortality and that's something I've NEVER thought about before. (or perhaps it's because I turned 30?!?! haha)
The greatest realization....I LOVE BROOKLYN.
I guess if you started reading this blog in the beginning it doesn't come as a surprise. But, I'm actually surprised at how much I really do LOVE it here. I love the apartment I'm living in. I love the park that is down the block. I love the different cultures and religions...the different foods and languages. And most of all, I love that two of my best friends are running a successful restaurant and they've welcomed me as family and have provided me with space to study and delicious food to keep me full. As well as cutie patootie waiters and busboys from all over the world!
I've got six more weeks in Brooklyn and then I move back to the 'burbs.
I'm trying to make the most of it. (hence, the lack of writing in this blog!)
www.bogotabistro.com
Here's a quick update: MY FIRST ROTATION ENDS IN TWO DAYS!!!
I can't believe how fast time as gone by. So, I've been busy preparing and studying for the end of rotation exam on Thursday. I am NOT looking forward to that exam. Since my rotation is Internal Medicine...it covers everything! So, I'm trying to read as much as possible, but there are no specific handouts or specific books that outline everything I need to know. So, I'm taking my readings from several different books, notes, and on-line sites. Basically, I'm all over the place.
Unfortunately, this rotation was not as good as it could have been. I'll go into that more later. Basically, the hospital is understaffed and the PAs are overworked and inexperienced (1-2 years) so that doesn't add up to a good teaching experience. Some days were really frustrating. My classmate and I have been basically teaching ourselves. So, it's been great having him there with me. We laugh during our lunch break everyday...if I were alone, I probably would have been crying!
The most important thing that I've learned is that I love working with patients. My patients have been very sick and I wasn't sure how I would cope with that...but I've been coping just fine. It's strange how you walk into a room and you can smell death...but then you walk out into the hallways and see life. You bounce around all day and walk the line between life and death. It's a very strange position to be in and some of the things I've seen have really made me contemplate end of life issues. These experiences have made me think a lot about my own mortality and that's something I've NEVER thought about before. (or perhaps it's because I turned 30?!?! haha)
The greatest realization....I LOVE BROOKLYN.
I guess if you started reading this blog in the beginning it doesn't come as a surprise. But, I'm actually surprised at how much I really do LOVE it here. I love the apartment I'm living in. I love the park that is down the block. I love the different cultures and religions...the different foods and languages. And most of all, I love that two of my best friends are running a successful restaurant and they've welcomed me as family and have provided me with space to study and delicious food to keep me full. As well as cutie patootie waiters and busboys from all over the world!
I've got six more weeks in Brooklyn and then I move back to the 'burbs.
I'm trying to make the most of it. (hence, the lack of writing in this blog!)
www.bogotabistro.com
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