After a couple of weeks in, I felt like I was doing a fairly decent job of shrugging it off. Yes, it is challenging to work with a dozen different doctors in one week that have a different style of doing things, but it wasn't that hard to remind myself that these same folks had the challenge of working with two new students virtually every day.
Clinic Week
Day One: Resident A, "You did well by going in to see the patient. When the card is on the door, you know they are ready. Don't keep them waiting. Bring one of us the card when you are done."
Day Two: Resident B, "Why is the card not on the door?" Me, "I took it off when I went in to see the patient." Resident B, "Always leave it on the door."
Day Three: Resident C, "Why did you go in to see the patient without me? That's inappropriate."
Day Four: Resident D, "Yes, go ahead and start a clinic note while I'm seeing the next patient."
Day Five: Resident E, "Medical students are not supposed to write notes. You can for practice, but I won't read it. It's a waste of time."
I just accepted that fact that I would do something in the first 10 minutes of each shift that annoyed the physician I was assigned to. No big deal; adapt and move on.
During week four, I was fortunate enough to work with just one chief resident with two junior residents and four attending physicians. By late Tuesday, I was in a good rhythm. I had a sense of what I could do to be helpful to the chief and how to not irritate the attendings too much. I found myself looking forward to beginning my night rotation in labor and delivery. The other student and I would work with the same two residents the entire week. It seemed like life as a clerk would become monumentally more simple. But I was wrong.
L&D Week
Day One: Resident F, "I'm not going to tell you when I'm going into a room, so you should just follow me." I nodded, despite finding this statement a bit bewildering. There were over a dozen delivery rooms. Half of the patients during any given night were in the care of our team, the others were not. We also had triage rooms to manage. To improve patient comfort, the other student and I divided the caseload so that the patient wouldn't have to deal with unnecessary people involved in her care. Follow the resident everywhere, but not into the rooms of private patients, and not into the rooms of the patients the other student was working with. It seemed as though simply saying "triage two" or "room six" could make things run a little more smoothly, but this doctor was committed to not telling us where he was going.
Later: Resident F, "Where are you going?! Don't go see a patient in triage without pulling up and reviewing her chart."
Later: Resident F, "You don't need to follow me everywhere...I'm just getting coffee."
Later: Resident F, "I'm not going to warn you again. It's not my job to tell you who I'm going to see. You'll just need to follow me."
Day Two: Resident G, "Go into her room and check on her Pit." Me,"She is a private patient; is that ok?" Resident G, "Yes, of course."
Later: Resident F, "You're a midwife?" This question has plagued me since one of my friends casually mentioned it to the Department Chair during week two. Me, "Yes, sir." F, "Oh."
Later: Resident F, "No, no...stay out; this patient is private."
Even later: Resident F, "Why are you keeping the patient in triage waiting?" Me, "I was looking at her chart for her dating ultrasound." Resident, "You don't need to do that--hurry and see her."
Day Three: Resident F, "Go get the ultrasound." I head back to triage and push the power button on the machine. Ten seconds later, F appears, "What is taking you so long?" Me, "I'm sorry. I was told to let it power down before unplugging." F shakes his head, "This is urgent." He pulls the plug, hurries down the hall, plugs it in by the patient's bed, and then begins a conversation about increasing her pitocin or maybe going into the OR for a cesarean. A bit later, he scans her and walks out of the room.
Later: F, "Where did her ultrasound say her placenta was?" Me, "I didn't look at that before seeing her in triage, but I can look that up." He rolls his eyes at me.
Day Four: While walking out of triage room 3, F tells me, "Go plug the ultrasound in so we can scan her." Fifteen minutes later he asks, "Where is the ultrasound?" "I plugged it in for the patient in triage 3." F then rolls his eyes at me, unplugs the machine and moves it into triage 1 with the patient we had seen an hour ago. Again, highlighting his unyielding commitment to not telling students where.
Day Five: Resident G, "Sorry. Sometimes things just work out that way and you don't get a delivery." This came after I reminded her that I still needed to do a delivery and this was my last night there. And then fortune smiled upon me. The clerkship director happened to be the attending on call that night. As we were leaving a patient's room, I swallowed hard and spoke up. "Dr. Clerkship Director, I haven't been able to do a delivery yet and my shift ends in an hour. I understand that these things are beyond anyone's control, but I just wanted to make sure that was ok since a delivery is a requirement." She looked appalled. Resident G tried to explain to the director that I really shouldn't go into the next one since she was the patient I was following last night and not tonight (yes, it was a very long pitocin induction). The director scoffed, "Of course we want you to do a delivery." I stayed past dismissal time and waited for it. I stood there, with F on my right-hand side and the director on my left, each whispering different and sometimes conflicting instructions to me. But after the baby's head emerged, I naturally stepped to my right to facilitate the delivery of the shoulders and serendipitously caused F to take a single step backwards. I was in that moment...that wonderful moment when a baby takes her first breath. The world just seems to stand still and all is right. It was a beautiful ending to one of my ugliest weeks as a med student.
Day Two: Resident B, "Why is the card not on the door?" Me, "I took it off when I went in to see the patient." Resident B, "Always leave it on the door."
Day Three: Resident C, "Why did you go in to see the patient without me? That's inappropriate."
Day Four: Resident D, "Yes, go ahead and start a clinic note while I'm seeing the next patient."
Day Five: Resident E, "Medical students are not supposed to write notes. You can for practice, but I won't read it. It's a waste of time."
I just accepted that fact that I would do something in the first 10 minutes of each shift that annoyed the physician I was assigned to. No big deal; adapt and move on.
During week four, I was fortunate enough to work with just one chief resident with two junior residents and four attending physicians. By late Tuesday, I was in a good rhythm. I had a sense of what I could do to be helpful to the chief and how to not irritate the attendings too much. I found myself looking forward to beginning my night rotation in labor and delivery. The other student and I would work with the same two residents the entire week. It seemed like life as a clerk would become monumentally more simple. But I was wrong.
L&D Week
Day One: Resident F, "I'm not going to tell you when I'm going into a room, so you should just follow me." I nodded, despite finding this statement a bit bewildering. There were over a dozen delivery rooms. Half of the patients during any given night were in the care of our team, the others were not. We also had triage rooms to manage. To improve patient comfort, the other student and I divided the caseload so that the patient wouldn't have to deal with unnecessary people involved in her care. Follow the resident everywhere, but not into the rooms of private patients, and not into the rooms of the patients the other student was working with. It seemed as though simply saying "triage two" or "room six" could make things run a little more smoothly, but this doctor was committed to not telling us where he was going.
Later: Resident F, "Where are you going?! Don't go see a patient in triage without pulling up and reviewing her chart."
Later: Resident F, "You don't need to follow me everywhere...I'm just getting coffee."
Later: Resident F, "I'm not going to warn you again. It's not my job to tell you who I'm going to see. You'll just need to follow me."
Day Two: Resident G, "Go into her room and check on her Pit." Me,"She is a private patient; is that ok?" Resident G, "Yes, of course."
Later: Resident F, "You're a midwife?" This question has plagued me since one of my friends casually mentioned it to the Department Chair during week two. Me, "Yes, sir." F, "Oh."
Later: Resident F, "No, no...stay out; this patient is private."
Even later: Resident F, "Why are you keeping the patient in triage waiting?" Me, "I was looking at her chart for her dating ultrasound." Resident, "You don't need to do that--hurry and see her."
Day Three: Resident F, "Go get the ultrasound." I head back to triage and push the power button on the machine. Ten seconds later, F appears, "What is taking you so long?" Me, "I'm sorry. I was told to let it power down before unplugging." F shakes his head, "This is urgent." He pulls the plug, hurries down the hall, plugs it in by the patient's bed, and then begins a conversation about increasing her pitocin or maybe going into the OR for a cesarean. A bit later, he scans her and walks out of the room.
Later: F, "Where did her ultrasound say her placenta was?" Me, "I didn't look at that before seeing her in triage, but I can look that up." He rolls his eyes at me.
Day Four: While walking out of triage room 3, F tells me, "Go plug the ultrasound in so we can scan her." Fifteen minutes later he asks, "Where is the ultrasound?" "I plugged it in for the patient in triage 3." F then rolls his eyes at me, unplugs the machine and moves it into triage 1 with the patient we had seen an hour ago. Again, highlighting his unyielding commitment to not telling students where.
Day Five: Resident G, "Sorry. Sometimes things just work out that way and you don't get a delivery." This came after I reminded her that I still needed to do a delivery and this was my last night there. And then fortune smiled upon me. The clerkship director happened to be the attending on call that night. As we were leaving a patient's room, I swallowed hard and spoke up. "Dr. Clerkship Director, I haven't been able to do a delivery yet and my shift ends in an hour. I understand that these things are beyond anyone's control, but I just wanted to make sure that was ok since a delivery is a requirement." She looked appalled. Resident G tried to explain to the director that I really shouldn't go into the next one since she was the patient I was following last night and not tonight (yes, it was a very long pitocin induction). The director scoffed, "Of course we want you to do a delivery." I stayed past dismissal time and waited for it. I stood there, with F on my right-hand side and the director on my left, each whispering different and sometimes conflicting instructions to me. But after the baby's head emerged, I naturally stepped to my right to facilitate the delivery of the shoulders and serendipitously caused F to take a single step backwards. I was in that moment...that wonderful moment when a baby takes her first breath. The world just seems to stand still and all is right. It was a beautiful ending to one of my ugliest weeks as a med student.
*Any first-years out there? How I wish those two simple concepts were in front of my mind as a first-year! Keep reminding yourself that you need to know (1) what can go wrong and (2) how to fix it, and you will be ahead of the game in figuring out which information is your highest priority to learn.
POST-ROTATION UPDATE: Despite feeling like there were a healthy number of folks in the department hoping to see me fail, I honored this rotation. Elation!
POST-ROTATION UPDATE: Despite feeling like there were a healthy number of folks in the department hoping to see me fail, I honored this rotation. Elation!
