Last month, I worked in an inner city hospital, blocks away from the city's homeless shelter and adjacent to the most crime filled neighborhood in the city. Needless to say, I saw some interesting cases...
A few take away points from this month:
1.) Never underestimate the power of a great social worker. I have so much respect for them. Some of the things they have to deal with and attempt to fix in a social complex is absolutely crazy. I don't know how they do it, but they can always seem to find a way to find cheap or free meds for patients without insurance or money; they find them assistance in other ways, such as transportation to and from appointments and free outreach programs and cheap to free therapy and home health services. I'm so thankful for them - just the thought of trying to solve these social issues makes me want to run far away from the hospital. Thank god for their patience.
2.) Always, always get a tox screen and alcohol level.
3.) DTs and other drug withdrawals are terrifying to witness. I would include in these patient's differential diagnosis "possession by evil spirits", they just go nuts. Really nuts.
4.) There are so many good-hearted people in the world who are in health care for the absolute right reasons. That is so refreshing to see.
5.) Your team can make-or-break the month. Having a strong senior resident makes life so much nicer for an intern. Having a really poor senior resident scares the life out of a brand new intern. For the entire first week, I had so much anxiety and worry over my care given to the patients, because I was fairly certain that my senior (and attending) wasn't even watching over me. For the first time in my life, the patients' lives were completely in my hands. It was terrifying. But I discovered that I can handle that, and that patients were getting better with my treatment plans, and I'm more capable than I thought I was at this point. Not bad for a one-month-old intern.
6.) Patients can refuse to take any responsibility for their health, and will return to the hospital and expect you to patch them back up before you send them home, only for them to return again in a few weeks' time with the same problems needing fixing. That can be such a frustration, especially when you take the time to ensure everything is set out as clearly and easily as possible for the patient and they still remain noncompliant. I have had so many noncompliant patients this month, it can really make you feel jaded and you lose a lot of your professional satisfaction.
All in all, it was a positive experience. The food at the cafeteria was nicer than I'm used to (that's a big deal when you eat in the hospital for breakfast, lunch, and dinner six days a week), and I'm definitely more confident of my abilities. I feel as though I'm more clearly making the transition from student to physician. But I sure am happy to be back at my hospital again!
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