WOOOOOOOOOH!!! first offical ER rotation.
Since this is what I want to do this is important. It's called an audition rotation. Since everyone in medical school studies the same information, we have to choose what specialty or path we want to take in medicine. And fourth year we do special rotations called 'audition rotations' where essentially we work for a month for free and they see if they like us and we see if we like them.
This first one is in a suburb hospital so its not as hardcore as it could have been, but i wanted something more low key since its my first rotation in this area. Now most people are asking how do you want to do it if you haven't been there, but the answer is easy. It all the rest of the rotations i went down to the ER to admit patients or work traumas all the time. So i've been down there alot. And honestly, of all the types of doctors, an ER doc is the one I respect the most and would be most proud of if I could do it. That said, i don't know if i'm particularly well-suited. But I suppose we will find out...
So I had to move states for this one month and its challenging to find my way around and find a grocery store and find places to study. I live in the hospital housing with other people and its just a two bedroom apt with bunkbeds in random places and NO INTERNET. It's killing me slowly... :( Luckily I found a panera but am rapidly becoming sick of panera (being i do all my studying there).
I was a little nervous but not as much as I thought I would be. I mean, it was awkward as all first days are trying to figure out where to go and what they want. And though I feel vastly behind the other students auditioning (how do they know so much more than me?), I think my 'give-a-damn' broke and am just trying to improve over the course of my time here and learn as much as I can. That's it. Nothing fancy. I realize I'm not the brightest crayon in the box and tho I am envious toward them, I will be happy ultimately as long as i'm not that doctor that all the nurses say 'i would never take my family members to them.'
This is a place with a bit of smaller residency in the ER than I'm used to and its not a trauma center so they don't get the big crazy cases. I did this on purpose so i could learn the 'bread and butter' cases, the simple ones that most ERs see. We got a kid with his fingers chopped off and a few overdoses. One case I thought was an overdose but turned out to be atypical presentation of a NSTEMI (heart attack). It was pretty interesting.
The hardest part about this rotation has been doing presentations to the docs. They don't want to hear about the case, they want to hear your differential and your plan. And I don't mean "give pain meds" or "do some imaging" I mean they want you to know to give "4mg of zofran for nausea" and "do a upright abdominal xray because we want to look for water fluid levels to rule out small bowel obstruction." If you order one test or have a certain differential they want to know why you are ordering that test or why you didn't order another test. They ask dosages which I know NONE.
They think i spend forever in the patients room when I actually run down one of the back halls and frantically look up things on the books in my pockets or the iphone that runs SOOO SLOW. It never really helps me much but I try hard to organize my thoughts. My challenge has also been including the negatives in the presentation. I can't just say rest of exam was within normal limits. I need to say no tearing back pain, no murmers and other negative finding related to specific diagnoses that I ruled out. I had no idea 'risk factors' and criteria were so freakin important!!! why are boards information not as helpful as i thought! Its exhausting. and i can't believe that one day i'll know all this stuff. because.... i can't possibly know it now.
And to top everything off they put me with the program director who pimps alot (asks questions in a demeanding way) about things I know nothing about. I've been yelled at twice about not being confident enough and that i should fake it until i make it. But i don't know ANYTHING. its so frustrating. I have no idea how to change my whole personality for this one rotation. I should have picked my rotations more carefully because i might have shot myself in the foot when it comes to getting jobs at these places. They think i'm slow and shy and stupid. But they also started me out on nights. So whatever.
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