Friday, September 07, 2007

Wasting time

This is a very light service--we have an attending, a medicine resident, and 2-3 PAs/NPs depending on the day to monitor about 12 patients. My duties consist of visiting my two very straightforward patients in the morning and writing a note. So far I have also done one H&P on a new patient. The rest of the day we round, then I go home (5:30 yesterday, 1:00 today:). The attending is constantly teaching me and the resident though, which is a rather unique experience for me--since the teaching occurs in between patients on rounds, the PAs find it a little frustrating though. Since this is an elective, I also get weekends off.

Yesterday I went to a medicine M&M for the first time (when I was on medicine last year, M&M and grand rounds were cancelled for the summer)--it was the total opposite of surgical M&M which consists of residents' presenting their patients who either died or had something bad happen to them, followed by the residents' being grilled and yelled at by the attendings (despite the fact that the attending is the one who actually made the poor decision). The medicine M&M however did not pick on the residents at all--one of the chief residents presented a patient and the chairman called on attendings to ask what their thought processes were. I tend to favor the medicine method, though I have to admit I don't think they needed to spend an hour on the one patient (surgical M&M goes over at least 5 patients in an hour). I went to medicine grand rounds this morning which was exactly like surgical grand rounds: 5 minutes of useful information embedded in 55 minutes of sleep-inducing information that is useless to everyone except for the person in charge of the research.

One of my two patients is an 81 year old woman who has been on peritoneal dialysis for the last year (peritoneal dialysis is dialysis that consists of injecting the dialysate directly into the abdominal cavity--the abdominal wall acts kind of like a filter, then the dialysate is drained back out). She came into the hospital over the weekend with an umbilical hernia which she had repaired--she now needs to be on hemodialysis (the patient's blood is sent through a filter and put back into the patient) for a month. I find that I am much more interested in her from a surgical standpoint than a medical.


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