Learning curves

My intern year has been full of learning curves. I can cruise along some of them, but others come pretty close to throwing me off the road. The good thing about intern year is that you don’t really suffer alone. You always (or at least you should) have upper levels watching your back. I’m on internal medicine wards right now and I take comfort in knowing that if I miss something, my upper level will catch it, and if she misses something, my attending will likely catch it. Of course, I try not to miss things. But it never fails everyday that there’s something with a patient that I completely missed or wasn’t thinking about. I count them all as learning opportunities though, because once I miss something, I’m not going to miss it again.

In the first few days of the rotation, I was struggling with my efficiency. Things run very differently from the OB service I came from, so there was a learning curve to adjust to the internal medicine way. I always managed to get all of my work done (consults, orders), but then I would have all the documentation to finish after I got off. And my attending works so fast so I would just picture him waiting at his computer for my notesbored still here GIF by Andrew Deitsch Podcast to come in lol. After I got some advice from a couple of friends (shoutout to MarQuenda and Hiral), things finally turned around! I started doing my notes while I was pre-rounding in the EMR. I go ahead and make amends to the plan and put some orders in before I even go to see them. Then after I would see the patients, I would come back to my computer and just fill in the subjective, make changes to the PE, and plan as needed. I’m getting [a tad] sharper with my medical decision making, so I’m finding that I don’t have to change as much after rounds. Especially since I’m carrying patients for many days, I have an general idea of what’s going with their course. Although, sometimes I come back after rounds with a WHOLE new plan than what I left with lol.

I’m one week in and about 3 more to go. The cap for patients I can carry as an intern is 8 patients, and I currently have 7. I think it’s so interesting how we graduate medical school and somehow rise to the occasion of intern year once the expectation is placed on us. As a 4th year, even when doing my SUB-I and trying to impress people, the max I carried was 5 and I was SKRESSED. Now I’m carrying 7, actually managing everything about them, and I’m relatively chillin. I don’t get it. Nothing has really changed about me! I guess maybe my mindset is different, I’m holding myself to a higher standard. I just operate at a new normal. I think it’s so interesting though, our mental capacity to do more than we imagine ourselves doing. It makes me feel confident for the day when I’m the upper level managing all 15 or so patients on the list.

Anywho, I’m looking forward to discharging some folks so that I can have a lighter load before we’re on long call again. We’re on long call admitting patients for 24 hours every 5 days (which is great!). We’re on short call for 8 hours every 5 days. I definitely cannot complain about the call schedule. At all. Especially because as you may recall, I was on call every other day when I was on pediatrics in July. Another good thing is that the team is 2 interns, an acting intern, and one upper level. When we get admissions, they rotate between the three of us. So I’m not mad at it!

Tomorrow is another day, another opportunity to learn and make patients feel better. I have family medicine clinic in the afternoon. So I’m going to get an early start to make sure I finish all of my inpatient duties before heading out. On my schedule is an 18yo, 58yo, and an 18mo. Gotta love it!

That’s the update for me! Hope you guys enjoy your week ahead!

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