Saturday, January 8, 2011

Closing The Gap

Yes, yes, I know, I have been inconsistent yet again.  But I'm baaaaaaaaaaaaack!!  (Hmm.  Creepy.)

I've spent the past month at Medium Class Shmanhattan Hospital, which is an outside rotation that my program arranges for us to attend a few months each year.  I state that it is Medium Class so as to avoid confusion with those Super Duper Fancy Shmancy Manhattan hospitals, which of course, I will not get to go through.  But for me, it is in fact SUPER DUPER because nearly anything looks brand spanking new next to my home base hospital.  (But I love oldies!  OLDY BUT GOODY!!)

It's a place that many of my senior residents wax poetic about, because it has things like an EMR and several operating rooms and lots of cases.  And overall, I had a pretty good time rotating there, from a surgical standpoint.  But it wasn't quite what I expected.  For starters, at my base hospital, being on call is busy, sometimes overwhelmingly so.   But the other interns don't chill out while you're working your ass off - they help, because we're The Team.  In contrast, I was only on call a few times for the month at MCSH, but each call was more or less torture.  The pager just explodes with consults and clarifications and so on, and you are fielding all of them while also running the patient list and trying to discharge people.  You hope that the many other surgical residents milling around will help you, but unfortunately, they don't always.  You have an army of students to help you, but not all of them are motivated to stick around in case you need a spare hand to grab paperwork or help patients walk after a procedure.  The nurses were shockingly worse than at my home base hospital - I actually got called several times because I had ordered a medication or a blood test, and the nurse wanted to know if I wanted it.  One could make the argument that this is just an example of a nurse wanting to be thorough, but when it happens 18 times in a day (literally), it gets a little old.  Read the fine print, lady, I want what I want.

I also drew the short straw and rotated during the holidays, during which there were noticeably less patients and cases to see.  The 40-50 cases my co-interns were seeing wound up being more like 20 for me.  Of course, being an intern, it doesn't really matter as much, but it still would have been nice to Do A Fricking Appendectomy like my co-intern did, or scrub on any case bigger than an elective hernia procedure (like an exploratory laparotomy), like others did while on call.  Of course, getting to assist in small cases is good for an intern, it's how you get your feet wet.  But there were days where I didn't get a single case at all, and other interns got 3.  By the end of the rotation, I started getting a little grumbly about a lack of equity when it came to case division, and finally got fed up when I had a bad night on call during which some residents refused to help me divy up the work.

So, I'm done now.  Because of a complicated issue involving intern supply at another outside rotation hospital, I have been switched off of my upcoming rotation with surgery at the home base to do two weeks of surgery at a large Queens hospital, a place that no intern from my year is assigned to.  Onwards and upwards to the next new thing, I suppose.

Hmm.  Now I need a name for the Queens hospital.  Maybe it'll be Shmeens.

1 comment:

  1. I was thinking of you recently, when I had my first surgical experiences. I got to help with a lap appy (not bad for a first year student!) and debridement of necrotising fasciitis! I had a great time, and surgery is definitely on the table now for my future career!

    I'm sorry that this rotation didn't go so well, but hopefully Shmeens will be a vast improvement!