sick

sick. just plain old cough, sore throat, nasal congestion, headache, sick. NOT sick, sick like some of my kiddos in the hospital. but for sure i got sick from one of those kiddos...

anyhow. just reflecting on my month of wards so far. starting on nights is way different. i like nights for the ability to talk to patients and do things at my own pace. i love the autonomy and the time i get to spend with the med students. i hate being tired and falling asleep while trying to write or dictate notes. i hate the groggy feeling of not caring anymore and just wanting to be home in bed already....

daylight savings night was especially hard. i had rode 60 miles that day for MS150 training so i was physically tired and i hadn't slept much the night before so i was running on only 4 hours of sleep in the past 24 hours going into the night and then because of spring ahead (yay, one less hour to work) i had one less hour to get everything done and we were busy. even my "easy" admit wasn't easy...  her mother only spoke Spanish and there were no Spanish staff to be found, the phone interpreter was hard to hear, the consulting service didn't want to be consulted, etc, etc. all night and morning long.  and then is started feeling sick with a scratchy sore throat and a cough but that was back seat to admits and progress notes to write. and my co-intern had the day off so that meant double the notes for the morning.. and before i knew it,  it was time to round and i had not finished a single note. At  10am when they force me to leave (duty hour violations) i was so tired i was falling asleep on my feet so there was NO way i could do notes then. i came home slept for a few hours and then work up to finish my work.  and when i woke up i was full on sick. but at least i have today to sleep and recoup before tonight.

nights are more than half over, just 3 more to go and then it is on to days and crazy, busy, admit, discharge, work.... but it is my last month of wards as an intern! next time i'm on wards i will be the upper, which is crazy to think about. but i'm feeling more confident and i think i'm ready, or will be. so long as i figure out how to function without sleep.

intern year is going to be over in a flash. just nursery, NICU and behavior and development to go. then i'll be a big, bad 2nd year! wow. time flies.

i'm sick. but happy.  i love my job. and that is all i have on this monday morning.

happy first monday after daylight savings to you!

Awash in Memories

Grenada.
The walk at sunset....

Medical school friends that became friends for life. An Island Away. Quiet spots. An early morning kayak.

Life is good. It is. I like being a resident and I like going to work (most days). I'm back on wards and I started on nights so it I have some free daytime to enjoy life while also getting back in the swing of things. Inpatient medicine is fast paced, stressful, full of admissions, notes and sometimes not the fun stuff. Sick patients, stressed parents, tired staff BUT there is also the nightly rounding, patient and parent interactions that happen and don't feel quite so rushed, autonomy, fun with other tired residents and a quietness that is just not possible during the day. So that is good.

But I've been nostalgic lately. Missing Grenanda. Missing San Diego. Missing the past. Not in an heartbreaking awful way just happy memories and reflections on the joy and simplicity that some of the past held.

That is all I have on this Thursday morning. Headed out to pamper myself with a mani/pedi and haircut. Much needed. And then nap. And then work.

Why I like working nights.... and shameless plug for the MS 150!

1. It is quiet.
2. I get to work on my own schedule.
3. Minimal BS. Skeleton crew and tired staff meaning people work more efficiently in hopes of getting a chance to nap/rest. But there is plenty of time to hang out too!
4. There is time to hold a baby, or 3 babies like I did last night.
5. There is time to talk to a patient's parents for as long as they want and answer as many questions as they want.
6. It is quiet and calm and you have an autonomy that doesn't exist during the day...
7. You get to backwards commute and parking is never an issue.
8. Breakfast with the hubby.
9. Daytime dog walks and trips to the dog park.
10. You get time off during the day to normal people things like shop or go to the post-office.

That's my short list. I'm just finishing a month of wards and then I go to clinic for the month. Life is good. Intern year in more than half way over and all is well over here.

Donate now and sponsor me to ride one or two of the 166 miles from here to Austin on April 12th and 13th.

Only 72 days until the MS 150! And sponsors that donate by the end of the month will have a chance to win a $25 Starbucks card, so what are you waiting on?!?

C is for...

team C!

I'm back on wards and starting on nights. I figure I kind of know what I'm doing this time around and instead of endure it, I'm embracing.

team C as in Cat!

I found our mascot.  And have plenty of Candy including Candy Corn. It may also be reason to Celebrate the month of Colorful Costumes and pumpkins with Candles!! And yes, I might be Crazy,

C is for Crazy, lets go Team C!

I need costume ideas... C is for Countdown and just 30 days until Colorful Crazy Costume Day!

What are you going to be dear reader?

mimosa, samosa... life after wards

Wards is over, I made it! There were many times in the past month that I doubted my desire to do this. To be a doctor. To complete residency. Multiple days/nights when I just did not want to go to work.... But yesterday at 10am when I walked out of the hospital I felt accomplished. And my spirits climbed as I brunched and shared multiple pitchers of mimosas and good company.

My collapse into bed followed by wonderful sleep before meeting my awesome wards team for outdoor theatre fun in the form of Bollywood dance made yesterday the perfect ending. I had a good day, a good month. I am now that much more confident that I can do this job. And more importantly that I still want to.

Nights were difficult for me. I feel into a semi depression and despite the actual free time I only slept and worked. It is only now as the nights and memories of them recede that I feel myself again. The reading, the to do list, that didn't happen... but it is okay, because I survived and came out the other side and I'm still here. And now I have energy and optimism once again.

A sampling of what I saw last night, I just LOVE Indian culture/dance/food!

Night after day after night...

Residency day 57.

Well actually night 2, as I am officially on nights. We have kind of an odd system when on wards where you work every other night for two weeks. Saturday was my first "night" and it was rough because I haven't had to stay awake for 30 hours straight in a very long time. I was falling asleep while writing up my H&Ps and that was an awful feeling. I will be prepared tonight with gum, candy and an extra cup of coffee for 3am. The every other night off is kind of odd. 16 hours on. 30 hours off. In theory that sounds nice but it hard to get on a schedule. I had planned to simply sleep all day and then use my off night to read, do things around the house, etc but I guess that residency caught up with me because I simply slept for 18 out of the last 24 hours. Ooops. Now I have all day "off" before I got to work tonight and it is not the weekend and so Dr Boyfriend is at work and I have the house to myself. So what to do...  Finally, I can read! I am so behind in everything, it will be nice to read about medicine and not medicine. I need to go join the Houston Public Library. And grocery shop and bake and lounge and do laundry. And exercise. And finish my graduation thank you notes. Yes, residency  has kept me busy. My to do list is long. So I'm thankful for the time right now to catch up.

Otherwise I really don't have much to say. Inpatient wards is busy, good, horrible, awful, scary and/or fun depending upon the moment in time. I hated my first week and rather enjoyed my second week. I like the patient care aspect of it and struggled with the documentation aspect. There is never time to write good thorough notes and yet I know that notes are super important and without good documentation it is difficult to practice good medicine. And yet I struggled with this daily.  I can only hope I get more efficient as time goes on. I am trying to dictate but that has pitfalls too. Being an intern is about doing paperwork, calling the consults, updating the lists and admitting/discharging patients. I ended up staying  late to talk to parents, answer questions, etc because there really just isn't time during the day for that aspect and it is the education part of doctoring that I so love.

Time to work on my to do list, and maybe walk my dog. Happy Monday to you!

Residency, day 48... feels like 539

I am now about to start my eighth week of residency, crazy huh?

I finally get today off after 12 days on and it is a glorious feeling to have an entire day to myself without  a pager or need to set foot in the hospital! (Minus those delinquent discharge summaries to finish.) Thursday was maybe the second hardest day of residency.... more lows, more tears, a migraine, a screaming child, not enough hours in the day to take care of everyone and myself. But then it was Friday and I had one of the best days of residency. I utilized my medical students and I took the time to pre-round with them. We were efficient on rounds and I made it to noon conference with a hot lunch in hand. I made decisions by myself. I admitted two patients, discharged three, supervised my med student talking out his first PICC line and almost made it out in time with only an hour worth of notes to finish when I got home. I survived my first week and half of inpatient wards and I see the light... five more days on and then I switch to nights for the rest of the month. So all in all, I'm okay.

More than okay. I'm surviving despite what I felt like was going to be the worst month of my life. Some days have been quite craptacular. I feel like a glorified secretary. I haven't been reading like I know I should. My sick patients scare me. I think the medical students know more than I do. I feel slow and have yet to finish my progress notes before rounds or even before lunch time.  I am not good at multi-tasking. I am an intern. But I notice that I'm faster than I was a week ago and more confident each day than the day before. I am figuring out the little things and those make a big difference.

Residency is hard. I'm awake at 5am on my single day off in two weeks. I could complain about many things. But I also realize that I'm lucky. I'm doing what I have always wanted to do and the little things add up. The educating patients and supervising med students and being responsible for my own time.

I'm happy. Exhausted. But happy. Enjoy your Saturday, I know I will enjoy mine!