A Difference

A few hours ago I would have rushed at the chance to be done with this elective. But, as I left the emergency room for a final time and looked back at the impressive building that held it, I couldn't help but to feel a bit of sadness.

Yes, it was rough. Yes, I did cry more than once. Yes, my parents called a few times to make sure I was still alive. But, it was worth it.

After the initial week of terribleness everything slowly got better. By the time I got to the final week I felt like "I've got this." I finally knew what I was supposed to do, how I was supposed to do it, and I could present patients to the attending like a boss. My last shift was SO much better than the first, I felt like a completely different person. 

There was one lady who really made my day this week. She was being admitted and I got to talking with her about some of her medical problems. Near the end of our conversation she said, "I wish all my doctors were like you and would listen to me. Make sure you never change." I wanted to hug her. After the last few weeks, one lady made everything seem possible. 

It didn't hurt that the same night my attending said I did, "amazing work."  

Yeah...it was a good night. 

  

Right Now

Things aren't going well.

I think I made that pretty clear in my last post.

I'm really trying hard to improve and I think I have in some areas. Which for just a week of being here, is really great. But it's not enough.

Today I got a phone call.
It was my elective coordinator.
She wanted me to come in to go over how the elective was going.

Not good.
I spent the hour before the meeting spazzing out (figuratively and literally- I've had some twitching issues lately). I spent about 30 minutes crying before I marched up to the office resolved to face the music.

You see, I knew exactly what she was going to say. I know, probably better than anyone, how much I need to improve and what needs work. Pretending that I don't would be ridiculous. I might suck clinically, but I'm not stupid.

I walked into the office and she told me to sit down. I did.  She smiled and asked me, "How's the elective going so far?"

I knew she'd ask. I might as well tell the truth: "Challenging" I replied.
That's a nice word, had I of been in other company I would have said, "miserable." But I think she got the gist. It's not what you say, but how you say it.

From there she delved into the issue as nicely as she possibly could.
I wish everyone would just stop being nice and say it. Beating around the bush just makes it worse when it does come out.

Basically, the attending's are used to treating 4th years like interns and having them be able to take patients on their own. I obviously am NOT ready to do that yet. I'm not yet at the point where I can make any sort of diagnosis or treatment plan or anything like that on my own. And quite frankly it sucks, because I want to be there and I am trying to be.

So today was spent, "reassessing the goals of the elective."
Her words not mine.
An e-mail is also going to be sent out telling all of my future attending's that I'm basically incompetent, okay well not incompetent but inexperienced (same difference). And that they should expect less of me than they do for other students in the same year.

And even though these are all things that I already knew, it hurts.

It hurts...

Elective #2

I finished my first elective last week. I had so much fun and learned a lot! I know it looks like I spent a lot of time not doing clinic type things, but I assure you during the week I was in the office everyday either treating patients or learning about x-rays, or other random things.

On Saturday last week I flew from that elective to a big city on the East Coast to start my second elective. Talk about a huge difference!

The elective that I'm in now is Emergency Medicine. I've only done a few shifts, but so far it has definitely been the a$$ kicking I thought it would be. The ED is massive, there are 4 wards associated with it and every ward has at least 15 beds, that's not including the beds they usually have to put in the corridors and waiting area when it gets busy.

I walked in the first day bright eyed and bushy tailed with absolutely no idea of what to expect. I left 8 hours later with my tail between my legs feeling quite a bit stupider than I have in a while.

Over the course of my first shift I spent the first few hours following one of the PA's around getting the lay of the system after that I started taking my own patients.

I feel like every time I was talking with them I would forget to ask something important. And then when I headed to report about them to the attending I'd get nervous and totally (pardon my french) f*** up the presentation or leave something out. Granted considering I've never had to fully present a patient up until now I think I'm doing okay, but it could use some improvement.

And forget about patient management or procedures. That's one thing my school really screwed us over with as far as teaching- they did a great job teaching history and physicals, but patient notes and learning how to do little things like suturing is something they never really emphasized that would have been VERY helpful. I've never written a real patient note until last month and no one said anything about what I wrote, so I didn't know if I was doing it right or wrong.

I only had 3 patients the first day.

I felt like such a failure as I left.

My second shift I had 4 patients (the shift was only a few hours) which I was much happier with. But, I know the Attending's were talking about me. Eventually they asked me where I go to school and as soon as I said "Poland." They exchanged these looks and one said, "well that explains it."

I feel like I'm not doing well. I want so badly to be good at this and I'm trying as hard as I can, but I'm so far behind and it's painfully obvious to anyone who watches me. I have no idea what I'm supposed to be doing, I don't know how to improve quickly when I'm so far behind.