The First Three Days

I've survived the first three days of residency - and, what is more important, so have all of my patients!

It's been crazy.

Day 1: Began with a largely oversized long white coat and introductions to the faculty and staff of the internal medicine department ("Hello, I'm a categorical medicine resident that looks ridiculously out of place in this ginormous white coat"). From there, I had my first clinic day in the morning, so I went to the office and met three new patients over the course of 2 hours. It wouldn't have been that bad had I known how to use the electronic medical records for outpatient services...(fingers crossed, all of the meds I ordered actually went through to the pharmacies intended...). I was given my pager at lunch (officially feeling like an intern). At noon, I had my first lecture before hitting the floors to finish rounding on our 40 patients on the nephrology service. Thankfully, my senior saw and evaluated my patients while I was in clinic (this will never happen again, so every Monday will begin by 5:30am for me!), so I didn't have as many responsibilities in terms of discharges or writing orders. But we did have about 10 new admissions, which kept me and my co-interns barely breathing. The day finally ended after rounds were complete at 6pm and we handed off our patients to the night service at 8. Day 1: 14 hours. About what I had expected.

Day 2: I saw my 9 patients for the first time, wrote notes, and placed a few orders all before 9am. Hectic to say the least. We rounded with our attending until noon, went to lecture, finished rounding by 2 then set off to work on discharges/new admissions/updating patient lists/filling in what we didn't have time to do in the morning. Surprisingly, I was out of the hospital by 6. As I was walking to my car at the end of the day, I thought to myself, "Am I really getting paid to do this?!" The conversion from student to doctor isn't so drastic, aside from being held accountable for the patient. But the work I'm doing mirrors what life was like as a student (except now I'm the one writing the orders). I love this job! Day 2: 12 hours. I'll take that.

Day 3: I was doing so well, seeing all of my patients quickly and feeling a little bit more confident when I realized I had to see 3 new patients along with my list of 8 before rounds started at 9. And it's always during those times that patients decide to talk with you about feeling depressed or making long conversation - not great timing. I did what I could and made my way to rounds at 9:30 (with all patients seen). Definitely feeling more competent and like I can almost handle life as an intern. Finished rounding at noon, went to lecture, then worked on completing some medicaid forms for a patient ("wait, am I really allowed to write on this legal form? Oh, I guess I am a physician now...") and put together discharge orders for patients who are likely to go home on July 4th. We finally had most things finished by 6, when my co-interns and senior resident went home while I stayed behind to take short call. Short call means that from 5-7, an intern takes the service's main phone and handles all patient problems. My heart skipped a beat every time the phone rang (I was praying that no patients would crash on me!), but it turned out to be easier than I thought to answer questions and make clinical decisions on our patients all on my own. Of course if I had questions, I could contact my senior on-call (or my nephro fellow), but I handled it. Day 3: 13 hours.

   -   July 3rd was the fifth year anniversary of meeting my husband, so we went out for dinner and celebrated with one of our left-over bottles of champagne. I fell asleep (passed out from sheer exhaustion) in a chair at 10:30, with a glass of champagne in my hand (which spilled all over my new dress). Life of a physician, eh?

By the third day, I felt like a real intern. There hasn't been any time to read or study, we're just trying our best to keep our heads above water and to keep our patients alive. I'm hoping the service slows down a little so I can actually find some time to study, but I don't think that's going to happen any time soon.

Today's my first day off, and it's already been amazing. I got 10 hours of sleep last night and feel like a new woman! I'm finally going to go for a run (haven't been out since work started July 1st), and we're going to a friend's house for a huge July 4th party later this afternoon. It's nice to be outside of the hospital with regular, healthy people!

3 days down, 362 to go!