Today is my first on call. I could not sleep very well last night because of the anxiety about today's call. So in the afternoon, I really began to feel drowsy, and my day has not even started yet.
4pm sharp, the day call team passed their pager to me, and my resident told me there were two admissions waiting for us already.
We went down to ER beginning the admission. During then, I got paged from nurses, change over docs, etc. I had to ask my resident about most decisions, luckily he has been quite patient with me.
The first on call day for an intern is a real challenge. Today I am the one wearing scrubs and carrying the pager, so everybody frequently asked me, Are you OK? I was really too busy to stop to chat, only a quick Oh Yeah and then kept walking.
10pm, we got a call from psychiatric department, saying they have a patient with multiple medical issues needed to be consulted. While we were talking with the patient, I got another call from the floor, so my resident asked me to go see the patient on the floor and she will meet me there.
Psychiatric ward is a special place, locked everywhere for security reason. I lost my direction when a nurse opened the exit door for me. It was not the way I came in with my resident. I followed the exit sign, but got more confused. Suddenly the door behind me locked down, so did the one in front of me. I was trapped in a 5 meter long hallway, with no phone, no light and I didn't have my cellphone with me.
My pager kept going off, my resident was looking for me, and nurses on the floor needed to talk with me. I kept pounding at the door, screaming like a real psychiatric patient. It's 11pm, and nobody was there. I stood in the dark, too scared to even cry.
I kept screaming for help and kicked at the door, after seems forever, finally a nurse opened the door. Not until I saw her, did I realize how traumatized I was. I hugged her with all my strength and began to cry really hard. She padded my back softly while I just cried and cried. Finally I collected myself, and said thank you, she asked me " Are you OK", I said yes.
When I finally found my way back, my resident already began to do my notes, she didn't ask where I have been, why I didn't answer pager, instead she just looked up at me and asked "Are you OK?" "Oh, yeah, thank you", I replied with a calm tone and took over the notes. She then smiled.
I guess it is not important what happened, it's I am OK really matters.
tabby 发表评论于
I am off this weekend. Next week I will have a double call during the night. That's it for all the calls in this block. Actually tomorrow will go to this good dim sum place in Chinatown with my co-residents. Outpatient block weekends are very precious to all of us. (Some are pulled to ward for weekend coverage) We have to have some fun. ;-)
Yes I also feel like having "expressive aphasia in medical English" from time to time. I guess practice is the only remedy for this. During my second patient encounter, I asked the guy to "Change into a gown. Keep your panty on, everything else off" He said to me "You don't say panty to guys, just say underwear". I was really embarrassed. I am sure my notes still sound weird sometimes. Well I guess it takes time to get better.
Once you are used to the system, your previous experience will kick in and you will be in great shape. Trust me.
落花飘零 发表评论于
thank you tabby, do you need to work tomorrow? hope not.
the ward month is really a harsh start for me, I am so overwhelmed, just like you said, when i am tired and anxious, i threw away my common sense and my basic knowledge i learned for years.
During the round, my attending asked me quesions which i should've known, but i just paused and could not find answers in my brain, when the resident spoke it out, i felt horrible because i knew it, i just somehow blacked out.
also my presentation was terrible, it was my post call, i didn't know the day is our team's formal rounding day, even pathologists and their residents were there. I could barely remember my patients' name because i admited them at 3am in the morning, god, all i know is they are still alive, hehe. the attending kept interrupting me because i either gave too much detail or missed something important, he did this in very polite way, but i still got very embarrassed, especially when docs from other department were present. all i could think is,oh boy, i screw up hard this time, i am dead.
actually my attending and the pathologist were really kind, they tried very hard to teach me the right way to think, to present, to conclude. it's me, who is not prepared.
when i see other interns speaking and writing fluently while i have to struggle for a short note, that feeling is killing me.
tabby 发表评论于
What you feel is quite normal. It's not easy for us to get into a residency program in this country, so it's natural we want to prove ourselves even on the first day. During my first day, I saw one young outpatient with gastritis symptoms and presented to my supervising attending. He asked me what I plan to do. I said we should scope him to rule out ulcer. I didn't know why I was saying that. The attending said for young patient we would just give a trial of meds first. Then I suddenly recalled "for young patient without alarming symptoms, meds first". It's so obvious yet I said the wrong thing. I felt horrible as I was really eager to impress my attending. I came home feeling a bit down. I was worried I didn't leave him a good impression.
The second day I saw 5 patients in one afternoon. At that time I wrote all notes after finishing the patient encounter, which later proved to be a bad strategy. When I presented my last patient of the day to another attending,I was tired and paused a few time during presentation. He said several times "keep it going, keep it going". I felt horrible again thinking I didn't do a good job at all. Yes I felt insecure and was very sensitive to attending's reaction, partly because I am singled out in this program.
I learned my lesson from first two days and changed the way I do things. On my third day I typed notes in computer while asking patient questions. I was must faster in keeping the clinic moving. That day when I presented to my attending about my patients, she said "you are very strong clinically". I was surprised to hear that. It was a great encouragement and I realized me being more relaxed helped a great deal.
Again it's harder to start off with ward. But believe me what you feel is not necessarily what other people think of you. We have disadvantage in language, but past experience gave us the advantage of knowing what to say to a patient or about a patient. This is way more important than how you say it. Don't kick yourself too hard. Just give yourself a few more days and I am sure you will be a great intern.
Just curious about the two doors. Is this a safety hazard? You should sue the hospital!
You will be OK!
rx300 发表评论于
1. You may want to ask the secretary for a map of the building. I was very frustrated on my first day of my new job. The building is huge and the hallways, rooms are numbered randomly. To my surprise, the secretary actually had a floorplan for the building and she made a copy for me.
2. You might need a cellphone for emergency. Prepaid plan might be a good choice. Write down your boss's phone number, your friends' phone number as emergency contacts.
Just my 2 cents.
Trust me, things will get better when you get used to your new environment.
流水浮萍 发表评论于
Sounds like what's slowing you down are logistical nits, rather than lack of substantive knowledge or clinical experience. The language barrier will become less of an obstacle over time once you become familiar with the medical jargons (or "river pilot" language according to Mark Twain). It seems to me the pressing task is for you to quickly know your way around the hospital to save you from further embarrassment, perhaps by walking around and mapping the various departments that you may frequent while on call.
Am I taking what you wrote all too seriously? Or is your piece literary fiction, in which case I apologize for this condescending post by pointing out the obvious. In any event, I wish you the best of luck and am sure you will excel in any endeavor you are and will be attempting.
xiaotutu 发表评论于
Dear Luohua, you have survived in your first chanllenge! You will do better and better! God bless you.
