Thursday, July 17, 2008

July Update

My most recent posts have been on the bike trails that I've been on and not much else about what else has been going on these past couple of months.
There's been a lot going on in school since June. We gone through a lot of interesting training exercises and labs to prepare us for the upcoming clinical year. One of those was proper scrubbing techniques and maintenance of sterile fields. This picture is of us, not maintaining sterile fields. Since this training I've watched many medical TV shows (House and Scrubs mainly) and critiqued their scrubbing in procedures. It's actually quite funny to see media portrayals of such things after one has gone through proper training.
We have recently started our ER module and with this comes training in Basic Life Support (BLS [also know as CPR]), Advanced Cardiovascular Life Support (ACLS), and Pediatric Advanced Life Support (PALS) skills. We have completed the BLS training and will start ACLS and PALS training in the next couple of weeks. I've started going over the ACLS stuff to be prepared for the training and I'm really looking forward to it. Recently we went through a mock trauma scenario where a team of us were in charge of taking care of a gun shot wound (GSW) patient. I was elected team leader in this scenario because of my experience in the ER; which makes no sense to me because I didn't work in the ER under as a medical provider but as an interpreter, so I had exactly the same training/experience as everyone else on my team. However, I enjoyed taking this responsibility and the experience that followed. For those not familiar with team resuscitation techniques the team leader assigns tasks to members of his/her team and uses information provided by the team to make decisions on care for the trauma patient. Before our mock patient "arrived" we were given all the information from the EMS team bringing the pt in and from there I was able to assign tasks to my team. Although knowing this was just a mock pt and we hadn't received all the ER training necessary to fully run a trauma code I felt nervous at first. However, when the pt arrived things started to come and I feel that our team worked smoothly. There were many secondary small simple things that I blanked on but my team was there to help out and remind me of those little things. We nailed the primary concerns and were able to stabilize our pt for Life Flight transport. I really enjoyed that setting. I enjoyed the fast pace of the treatment and the on the spot thinking necessary for patient stabilization. I enjoyed taking charge and directing the care. I liked that setting when I was able to participate in it when working in the ER and really enjoyed being a part of that pt's care. I'm looking forward to actually be able to do it coming up in the clinical rotation year.
Another skill that I enjoyed learning and practicing was the placement of an endotracheal tube (ET tube), known as intubation. This skill was actually a lot easier than I thought it would be, well, practicing on dummies anyway.
Other skills we've gone through or will go through have been catheterizations, IV placement, digital blocks, and much more. I don't plan on being a big fan of catheter placing but the others ones I won't have a problem with.
In two weeks we will be officially over with the didactic year of school. No more sitting in class 8 hrs a day 5 days a week. No more sitting through lectures and trying to stay awake (for now). However, that doesn't mean that this next year will be any easier. I'll still be studying a lot for end of rotation tests, but I'll also be studying during the rotations to learn all that I can and be prepared for whatever might come my way. I feel really inadequate for a lot of these rotations because I've forgotten a lot of information that I've supposedly learned. It's not just going to be cram for the test systematically eliminate answers from a multiple choice test anymore. Now I have to create the answers and then systematically eliminate them from my list. It's not just trying to pass with a satisfactory 70% anymore. I'm more excited than I am nervous for this next year but those doubts and fears are still ever present.
I have many friends starting med school and dental school this year. For those that read this let me give you some advice that I'm gained from this year.
Try to organize a schedule that will allow for study and personal time. The schedule is by no means will remain static but try to stick with something. At the beginning of the year I started out strong studying most nights of the week even when a test wasn't present. I understood the information and was able to participate in class with answers. Throughout the year though that studying steadily decreased and I started to not prioritize it enough. By the end I was only studying for upcoming tests and just doing the bare minimum. It's easy to get distracted and burnt out with classes and school work but try to do more than the minimum. I feel that's the main reason why I feel so inadequate for the next year.
You will get bored in class and become easily distracted, especially if there is a computer with internet access in front of you all day long. It's hard to just sit there and pay attention. If your programs are anything like mine the lectures will be taught off of power points and you will have access to them anytime you want. This makes it even more difficult to pay attention. If you get in the mentality that you can go over the lectures later on your own time you will miss a lot of information that doesn't come in the ppt's. Unfortunately there will be many times the lecturer will read straight from the ppt and that will get annoying. I was the one who got bored and started playing on the internet. One thing though that I saw other classmates doing was taking notes on paper instead of on the ppt. This facilitated their paying attention and participating. If you're like me don't think that you can just pay attention and get everything then go over the lecture later without taking notes. It just won't work.
Another thing where I screwed up was letting someone else compile a study guide. The person who did them compiled them very well and they were very thorough. They helped me study for the test but not for retention. Make your own study guides. It will take a lot more time and you might not be as thorough as someone else, but you will learn and retain more.
One thing that I have done that has been beneficial is my internship in psychology. It has given me so much patient experience that otherwise I would have had to wait for. It hasn't helped me out a lot in a medical setting but I have learned skills for interviewing patients that I know will be beneficial. It's also given me added experience in assessing patient progression and also adjusting therapies where needed. In your studies if you get an opportunity, and have time for, any outside experience like that I suggest you take that opportunity.
One final thing, don't expect to know everything about everything. Going in and coming out you will feel inadequate and unprepared. That's just the nature of the beast. The best providers are the way they are not just because they were the smartest in their class but because they worked hard through school and afterwards. They continue to learn and gain experience in the field. Do all you can while in school, but just know that you still will far short. Accept that fact and you'll find that you'll be more excited than scared going into your clinical years.


P.S. don't blog while in class...that also makes it difficult to pay attention.

3 comments:

Daddy Jones said...

Oh you know it. My campus blocks a bunch of sites to keep us on track. (Course, we all find ways around it on Test days as we wait for the professor to rejoin the class).
On the note of TV and the real world.. (wow, I just got that)... what I mean is how things really happen and how TV shows it. If you ever see someone putting an ET Tube in with their right hand you can start laughing. I can't wait till we get into doing those labs... mmmmm ET. Next month we get to do Med Gas Therapy on each other.

HDVB said...

Hey, love the stories, but whats will the picture of you in the backyard with your shoes on your hands?

Tyler said...

It was Halloween and my costume was shoe hand man.