I was very nervous Wednesday night. My stomach was growling and I was nauseous. Thursday was the first day of my internship year. What if I wasn't ready? What if I was under prepared? I had this vision of being paged and bothered all day long with lots of questions, most of which I didn't know the answer to. I took some tums before I went to bed and tossed and turned all night long.
When I woke up Thursday morning, I was still quite nervous. I did my normal morning stuff, got dressed, and drove to the hospital at 6:30 AM. Once I arrived I put on my long white coat for the first time, signifying that I was now a doctor (medical students wear short white coats). However, what happened Thursday was quite a bit different from what I had imagined. I basically followed my attending around just like I was in medical school still. The hospital is quite slow right now so we didn't even have too many patients. And the few patients we did have were pretty stable, so once we did morning rounds there wasn't much else to do (this not counting the one patient we had in ICU who had an overnight blood gas pH of 7.1!). After noon on Thursday there really wasn't much to do. I mostly sat around and talked to the other interns.
Friday at the hospital was pretty similar to Thursday. We rounded on our patients and even discharged one, giving us one less patient total. I then sat around the hospital and shot the breeze for a few hours before leaving around 3:30. My attending was taking a weekend vacation to his farm in Missouri, so he told me I could take off early.
So far internship has been nothing like I imagined it would be. I've basically just followed around my attending like I was still in medical school doing rotations. We've been really slow the past few days too which is a bit surprising. I am somewhat grateful that we have been slow and that everything wasn't dumped on me all at once, but I hope I gradually start getting more responsibility and we get busier for the next week.
Until then I have a three day weekend. I am not on call this weekend and I have Monday off as it is an official hospital holiday and my attending will still be in Missouri. So I hope everyone has a nice 4th of July weekend.
Glad to hear that your first few days were good. What is blood gas pH and what is a good reading? 7.1 sound fairly neutral to me.
ReplyDeleteBlood gas measures the amount of oxygen and carbon dioxide in the blood. The body needs a fairly narrow range of pH to function properly. Normal value is between 7.35 and 7.45. Respiratory disease (which this patient has - COPD) and metabolic disorders, including kidney disease, can cause pH to go out of whack. Your body will compensate as much as possible to try to correct an irregular pH with changes in respiration and changes in metabolism, depending on if you are acidic or basic. The major blood buffer system in the body uses this equation:
ReplyDeleteH+ + HCO3- <-> H2CO3 <-> H2O + CO2
COPD patients retain CO2, shifting the above equation to the left, producing lots of H+, an acid.
The above is a simplified example. It all involves pretty complex acid-base chemistry and human physiology.
So how was day two? Too busy to post? Hope you get a break soon.
ReplyDeleteJoe