End of the Rotation on the Floors !

It has been nearly 9 months since I started my internship. When I started my internship, I was full of energy and I could do anything. Now It seems like that It is taking a huge toll on me. I feel exhausted both physically and mentally. I am glad that the vacations came on time. I have been back home in Pakistan and enjoying the company of my parents. They always teach me about life which I can not learn from other people. I can share with them a lot of stuff. Hopefully by the end of my vacations, I will share some stuff which I will acquire from them. 

For now, lets talk about the Medical Floor. The hardest part of the IM rotations are the floors. During 4-5 months consecutively on floors. I learned that you can not control everything. Your job as an intern should be to learn but it is so different out there in the real world. Your learning should be done by the attending and the senior residents; more so by the senior resident. Some days I got really sick of the fact that all I was doing were social admissions and admissions which other specialties dump on IM. There were no learning at all. Some days I would run after Nurses either for the patient's urine or sputum or stool. Even then, the collection rate of these specimens is so low. I have talked to few of my friends who are doing residency is other US Hospitals and they were saying that this is never been a problem at their hospitals. Then, there is a huge problem of getting peripheral IV access on patients at my hospital. Almost every other day, I would get a call from the nurses that they don't have an IV access on the patient. It drives me crazy as an intern. Since I have not done my ICU rotation, so I do know how to put a central catheter. Also, I do not even know how to use an Ultrasound machine(which I intend to change by watching youtube videos)! So, ultimately it comes down to begging the on-call resident, the ICU resident and the surgery resident to help me with the IV access. Yes! this happens especially on weekends when I can't get a PICC line. I have to make so many calls to so many people. I feel really helpless and I can not control anything for now. All I want to do now is to learn how to do Femoral Lines in my ICU rotation. On weekdays, life has been easy since I get a PICC line on such cases.

So, my last rotation was with a great senior. Some of the things I learned from him are as following:

1- Incoperate Uptodate in the management of every single patient

2- Check for Drug Interaction from Lexicomp on every single medication 

3- Try to learn at least something from your patient. Read! Read! Read! 

4- Never trust what you are being taught. Always open Uptodate and double check

5- Before discharge the patient, make sure you help him understand everything. It is his right to know. Prepare a good discharge paperwork and if possible, hand it over to him personally. 

As an Intern, I have realized that I have my limitations and I can not save everyone. A lot of patients in my team have went to ICU and some of them have died in rapid responses as well. No matter how good you are, you are helpless before death and disease. If you are a religious person, then I would recommend that you start your day with a prayer. If you are not, then I do not know how you can explain the amount of strange stuff. People die. It is all rational and logical. But some days when It won't make sense, then  you will search for meaning and you wont find that in any science journal or text book. So, begin your day with a prayer. Remember that you have to return to the Almighty Allah one day!