Posts tagged hospital

Death surrounds us. Recently, I have had many emotionally exhaustive shifts at the hospital. Some of my patients looked well; others did not. Regardless, many of them have died under my team’s care. We are all destined to that outcome one way or another. In that sense, perhaps it was meant to be - the diseases had progressed too far or the patient could not carry the burden any longer. But my mind lingers on the life that escaped with their last breath, on the last dying days where my life had become intertwined with theirs. My mind races and wanders to what could have been. Had we done enough? Did I do something wrong? If I had seen them a few hours earlier, could I have found a sign of the impending end? Could I have then given the patient and their family a few more precious moments together?  Despite my meticulous combing of the chart, I could never find the answers to these questions. We had done everything we could. In the hospital, death surrounds us, ever hovering in the air, lurking behind every chest pain, kidney failure, and fever. Though we make advances everyday, Death always gets the last word.  “I’m sorry we could not do more,” I once said to a rapidly deteriorating patient. “It’s alright. I know you guys tried. I’m grateful for everything. We gave it a hell of a run, didn’t we?” He mustered his fading energy to form a smile. “Yeah, you sure did.” We shook hands for one last time. “I’m ready.”

Death surrounds us.

Recently, I have had many emotionally exhaustive shifts at the hospital. Some of my patients looked well; others did not. Regardless, many of them have died under my team’s care.

We are all destined to that outcome one way or another. In that sense, perhaps it was meant to be - the diseases had progressed too far or the patient could not carry the burden any longer. But my mind lingers on the life that escaped with their last breath, on the last dying days where my life had become intertwined with theirs.

My mind races and wanders to what could have been. Had we done enough? Did I do something wrong? If I had seen them a few hours earlier, could I have found a sign of the impending end? Could I have then given the patient and their family a few more precious moments together? 

Despite my meticulous combing of the chart, I could never find the answers to these questions. We had done everything we could.

In the hospital, death surrounds us, ever hovering in the air, lurking behind every chest pain, kidney failure, and fever. Though we make advances everyday, Death always gets the last word. 

“I’m sorry we could not do more,” I once said to a rapidly deteriorating patient.

“It’s alright. I know you guys tried. I’m grateful for everything. We gave it a hell of a run, didn’t we?” He mustered his fading energy to form a smile.

“Yeah, you sure did.” We shook hands for one last time.

“I’m ready.”

$300.00
A medical ward’s monthly expense for stocking and supplying pens.

Doctor. Doctor. Doctor. Doctor…

During a patient encounter, there is an unspoken but established set of rules dictating how every interaction is perceived. Like a theatre, we all assume roles in this medical exposition. 

Nurses, technicians, and therapists generally have their first names on their name tag; I also address them as such in front of a patient and behind the scenes.

While physicians generally address each other on a first name basis, I have yet to earn that right. Some physicians prefer that I address them by their first name, others do not. Everyone however is addressed as doctor in front of the patient.

Now that I am a medical student on the ward, I am often bestowed interesting titles by patients and staff, many of which are misnomers: Medical student. Clerk. Resident. Doctor in training. Student doctor.

Doctor.

It is a strange feeling to hear that address before my name simply because i know I am not a full-fledged doctor yet. However, it is a theatre. For the patient, I have slipped into the role of a doctor in their eyes. I always ask myself if it is necessary to step out of character for them, to clarify my standing in this system. To me it always matters. To some patients it does not. So now, some days I correct them, other days I do not. 

Scanned and Legal

I saw a patient the other day for follow up after they were discharged from the hospital. I had a short note on my encounter sheet to go back and read the ER encounter summary. The patient had already struck me as familiar when I had introduced myself; I was quickly reminded when I loaded the scanned summary only to find my writing scribbled on the page.

My findings. My descriptions. My words. 

Helped along and countersigned by the attending physician of that day, it was now scanned into the hospital files, a legal document of an encounter for treatment and management in the face of acute symptoms.

It is a weird and funny thought to see my signature on a hospital form, mainly because it is the first of such instances. I am sure that over time, this surreal feeling of déjà vu and responsibility will fade into being just another part of the job.

Go with the Flow

I went to the wards to follow a doctor for a few hours. Who, I did not know; no name had been provided to me on my schedule. I would have to ask the nurses for whoever was available.

Checking in at the desk early, the nurse pointed me to the head nurse, who quickly directed me to Dr. A who was sitting at his desk writing a note. He happily took me on but had to leave quickly to see a patient as I got ready for the shift to begin. As I sat waiting, I was spotted by Dr. B who, realizing why I was there, said that I would actually be following Dr. C, who had yet to arrive.

For the next few minutes, I found myself moving from one desk to the next as the nurses and doctors tried to figure out who I would be following: “Go there.” “Come back.” “You’re with me.” “Follow her.” “I’m free.”

In the end though, we figured out how I was going to work in the ward and with whom. And me? I just went with the flow. Hungry for an experience, I was happy to go with anyone.

“Here is your student, Dr. C.”

hey I was wondering, when you were in college, what was your job? Because I'm a freshman in college and I want a job at a hospital so i can familarize myself... Sorry if this is such a silly question... Thanks. :) — Asked by Anonymous

I did not work initially in college, but eventually I started working in a hospital research lab as a research assistant. I held a position at the lab for two years. I learned a lot about conducting experiments and gathering data but I would not say that I gained much in terms of clinical experience, which is what I think you are referring to. 

Before getting into medical school, my main experience with the hospital was participating as a volunteer and eventually a shift leader for the hospital’s volunteering program. These sorts of opportunities exist in almost every hospital but may require a bit of digging on your part. 

Good luck and take care. :)

“Scrub in.” Two surgeries and five hours later, I was done. The team was heading to the lounge for a much needed break as the second patient was wheeled out to the ward, still groggy from the anaesthetics and medicine. The surgeon was visibly tired but still quite upbeat. She said there would not be any more surgeries for a few hours so I was free to leave. After a few parting words, we went our separate ways. What a day. Would you like to hear more about this day? EDIT: I ask because the final piece of prose may be quite long to read.

“Scrub in.”

Two surgeries and five hours later, I was done. The team was heading to the lounge for a much needed break as the second patient was wheeled out to the ward, still groggy from the anaesthetics and medicine. The surgeon was visibly tired but still quite upbeat. She said there would not be any more surgeries for a few hours so I was free to leave. After a few parting words, we went our separate ways. What a day.

Would you like to hear more about this day?

EDIT: I ask because the final piece of prose may be quite long to read.

animalpetdoctor.homestead.com

The Conference

It would be my first case conference. The doctor I was working with suggested I go take a look. I had no idea what to expect. I arrived too early. It was ten to four and the conference room was quiet. Only a technologist and a doctor sat in a corner, huddled by the computer as they busied away with preparing files and scans. They looked up at me briefly and seeing my hospital tags, went back to working. Though I had already been given permission to participate, I still felt relieved.

The room lights buzzed in the background as I crept into a seat in the rear of the room. It was set up like a lecture hall. Chairs of different styles and sizes faced forward at the large projector screen. On it, files continued to populate the canvas, a miniature version of which reflected on the glasses of the doctor behind the computer.

Slowly, people began to trickle in. First one, then two, then a number of doctors shuffled in. Some looked bright and energetic as though it was the start of their shift; others looked tired and exhausted as though coming in after their shift was done; the rest fell somewhere in between. Though everyone was in different states of mind, it was clear from their conversations that they were all interested in seeing the cases that would be presented. Like the room’s arrangement had let on, this was a learning environment and the cases a learning opportunity.

“I think we’re about ready.” Said the doctor sitting behind the computer. With that, everyone got seated and the first case went up on screen. The doctor attending the patient got up to present the case to the rest of us. She gave a quick run down of the history and the developments thus far. CT scans and other test results were presented. Having learned some of the material, I was able to follow some of what she was saying but quickly got lost in the jargon and other diagnostic features. “For now I’ll just sit back and observe the process,” I thought.

Once she was done presenting the facts of the case, it was time to brainstorm. This was the purpose of these conferences: to bring to the attention of other physicians difficult or rare cases in order to discuss how to manage the patient’s care. One by one, the experts in the seats gave their recommendations, discussing what information was still missing that would be needed and what could be done now. I watched as some of the resident doctors madly scribbled notes into their notepads as the older, more experienced physicians gave their reasoning and their thought process; the presenting doctor did the same.

And so it went on for two more cases. The whole time, I just sat and watched as the doctors discussed and poured their knowledge together. It was teamwork at its best; it was learning at its best. For me to observe the process was definitely worth the visit.