Thursday Born

The everyday life of a psychiatry resident (who was born on a Thursday).

Archive for December 4th, 2010

Right. That’s why I’m here!

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I finally started my hospital sessions! I hadn’t been in the hospital at all yet this year, and it’s been weird. But no longer!

We’re partnered off for these (one doctor; two students) and for the first session, one of us was to do the physical and one of us to do the history. For the next four sessions, we’ll each do a complete history and physical. I was really nervous as it’d been so long since I’d done a physical and just as long since I’d taken a patient history. To top it off, as I waited for the metro train to school, I got a text message from my partner saying that she wouldn’t be able to come because she was sick…

I waited by the nurse’s station for about twenty minutes until my preceptor found me; she’d just gotten my partner’s email or she would have gone ahead and cancelled earlier. So she let me decide; I could cancel the session and make it up later with my partner, or I could do it on my own today and pick if I did the history or the physical. It was kind of tempting to put it off, but I’ve enjoyed my occasional one-on-one experiences with doctors/residents/fourth years, so I decided to go ahead and do the session.

I still don’t have a good plan for a default general physical, so I picked to do the history. I’m good with the history, though I really need to memorize the “Review of Systems” questions. The review of systems is a check-list of symptoms you ask a patient if they have. It’s like a final “just making sure we haven’t missed anything!” step to the history. I’ve always been a little put off when it gets asked of me when I’m going in for just a check-up but I understand why it’s used.

We had to wait another twenty or so minutes while the patient she’d scouted out for me finished eating. Considering how long it’s been since I’ve done a history, and my patient was hard of hearing, I think I did a good job. I need to get better at using simpler language though. I’m usually pretty good at that but there’s a few questions that I just didn’t have an alternative for in my head yet.  I really liked my patient though. She kept asking me if she was being helpful or if she was answering the questions right, and she was a really good sport throughout the whole thing.

For the physical, my preceptor was great and walked me through it. She had a really accurate idea, somehow, of what I could do on my own and what I’d need guidance for. I didn’t feel babied and I didn’t feel lost. It was just the right pace and now I have a much better idea of what constitutes a quick but still pretty thorough physical.  I also got to feel what a “thrill” is. My patient needs dialysis and she has a maturing Arteriovenous fistula. When you put your fingers over it, you can feel the blood rushing through it, instead of pulsing. Sometimes medical terminology is bizarre and it’s hard to connect the word with the phenomenon. This time? Dead on. Thrill really fits what I felt.

Looking forward to January! My preceptor (a fourth year EM resident) is doing an away position through December, so we’ll start again when she gets back.

Written by Aba

December 4, 2010 at 12:50 pm

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