So I guess a good question is what is a normal day on the Private Surgery? I'll use a good surgery Robert/ bad surgery Robert scenario:
Good: Show up early so you can pre-round on your patients, a good amount is usually 4-5 patients. To beat our residents, this could be showing up anywhere from 4a-5a.
Bad: My best time has been 515a, but I'm usually on the floor with my printed list anywhere from 525a-540a....you'd think this wouldn't be a huge difference but depending on the day it can be. See if the residents have any early meeting or the both of us have conference.. then rounding commences early and one day I wrote only 1 progress note up
Good: After rounds, we usually have some sort of lecture(s)
Bad: I attend my lectures , I guess the bad is only when I get sleepy...
Good: After lectures/morning stuff, you check the OR schedule, pick a doc and kinda tag along with them.
Bad: Robert loves the floors and consults, so I've actively tried to avoid the OR by signing on to do histories on consult patients and assisting the intern. See the interns get least priority to go to the OR, they're obligated to the floor so help them = more floor time. Of course, this doesn't always work when you're asked to scrub in on something or your chief expects you....
Really, for me I tried to be on the floors as often as possible. If I wasn't there, I was reading in our student lounge. The perfect student would somehow be in the OR all the time and study between cases.. yeah not so much for me....
Here's how most OR experiences go. You wait around for the doc to show up. Then he does, usually 30mins-1hr30mins after the posted time... then the procedure starts. The doc / resident might tell you to scrub in or you may not scrub in. So let's discuss pros/cons scrubbing in vs. pros/cons of not scrubbing in but observing
Scrubbing
Pros:
You can get pretty close to the procedure, if not immediately adjacent depending on the patient and how many other people there are.
You can assist.
You can suture ate the end.
You can feel stuff... like "feel this thingy here"
Cons:
It's not so easy to leave, because you'd have to scrub out.. and that's very conspicuous.
You can break sterility... so you have to stay in a certain area and when you can't rest your hands on the drape.. you have to hold them in front of you like a Trex or crossed in front of your chest like a gang sign. [one of my classic breaks in sterility was touching a tube that was in the field.. but the tube itself wasn't sterile... so then I moved in the observe category]
Observing
Pros:
You can leave when you want to
You have more freedom of movement
You can answer phone calls and hand stuff in like a scrub nurse
Cons:
You can't get close, so sometimes observation = endless pacing/standing .. pretending to see things
So after the OR day has ended, random things can pop up like consults or floor jank. Some attendings round, some don't. I've enjoyed rounding.
So some notable moments in my week:
The colorectal surgeon that wasn't an ass:
So I was semi-warned that this particular surgeon was kinda mean and not worth scrubbing in on. Too bad my chief was all about me scrubbing in, but it turned out great. I mean I got some of the questions right and I mean the doc was really nice. I'm guessing he's either turned a new leaf or I'm just crazy. One of the funniest moments in rounding with him was walking in on a patient dropping a deuce , we totally just pretended like that was totally normal.. which I guess if you're a colorectal surgeon.. makes sense.. kinda
Floor doodie (duty):
So one day the OR was just not on and poppin like usual, so there was more random floor stuff to take care of. My intern thinks it was tedious but I was always just running to go do a consult or a decompression (= finger in butt, scooping poo). My intern was much humored by my enthusiasm as I rolled in the observation unit with gloves in hand and "let's do this"...
She really hit the nail on the head when she saw me with our other intern. She asked if I'd like to scrub into a breast case.. I was like errrr... I was helping with something else.. and she said " Yeah, you love that floor and consult stuff.. not the OR, you're weird like that" - truer words haven't been spoken
Night call:
I love night call for the most part. First , it's at night... I feel like a vampire roaming the empty halls and because there's less docs, you look even more balla in the scrubs/white coat combo... My last call night was awesome. First of all I had the chillest call team ever.. hard working dudes and gal but just chill.... I was doing some random stuff from 630ish to 1030ish Consults : Car V Tree and GSW to neck, then slept till 145a... totally didn't feel my pager go off in my pocket but woke up and rolled on down the ER. My last case that night was a young dude, got stabbed .with this really ridiculous story... ... hmmmm...... but that lasted till 430a.. just checking the CTs... etc... making sure he didn't have a pneumo.. turns out he had some pneumomediastinum but no reason for a chest tube so he was sent to the floor and a swallow study was ordered to make sure his esophagus isn't perforated....so then I grab a shower... and then I'm rounding by 530a on the floor to help out my team... then I get the "go home dude, you've been on call from my senior resident and I peace out" and begin Labor Day weekend, no more surgery call.. kind of bitter sweet...
The nurse on the 9th floor without a ring:
So my friends have explained to me the importance of checking for a ring.. and I happened to be rounding on the 9th floor where the bulk of my team's patients are and I notice her. She was the cutest, shyest, most amazing thing before 6am ... So I totally wanted to talk to her. Bear in mind, I usually have an open invitation to talk to any nurse if I want to "check on my patients" or ask about labs or something but she didn't cover any of my patients. My classic Robert/awkward moment was trying to find a computer to pull up some labs to stick in my progress note. I ended up finding one of those portable stations without a chair.. and it was right behind that nurse sitting down. I couldn't sit so I awkwardly leaned against the wall with my chart on the mini desk and tried to write my note.. looking like a tard..Then on my way back to the nurse's station, I ran into something... Smooth.....
Perirectal abscesses
For some reason, I have knack for ending up with all the clinic patients with perirectal abscesses. There's nothing much to add to that except the smirk the residents give me before I go into examine these patients...
Ah, being a junior medical student... is awesome
No comments:
Post a Comment