Raindrops on Kittens and Whiskers on Roses

a better last few days. i'm feeling healthier and maybe sorta kinda getting into the internal medicine groove.

i'm working 3pm-11pm right now and i love the hospital when it's all dark and quiet and there aren't so many people bustling around. it actually has kind of a tucked-in, safe feeling after dark. at least at this little hospital. i spend most of my time admitting patients to the floor (either to a regular medical/surgical floor or to the ICU) from the ER. at night the ER is pretty consistently busy, which is fun. i should have known better than to expect the ER to be like how it seems on TV. first of all, unless it's a trauma 1 center (which this is not), you're not getting much mayhem. most of the time i am ruling out heart attacks and strokes, treating pneumonias, anemia...that kind of thing. there are patients in the hallways on stretchers and there's a lot of activity, but there's no gore or screaming and panicking and such. it's actually got a great rhythm. also, i know the PA service takes 2nd place to the residents, so it's likely that the more dramatic trauma cases get snatched up by them. which is fine. i'm learning a lot in how to manage the common problems.

and i always feared that i'd be responsible for remembering every evidence-based recommendation for each condition, but there are a lot of protocols we follow.... standard diagnostic screening and treatment approaches used across the country for various complaints or suspected ailments (based on the interventions that have been shown to decrease morbidity and mortality). for example, if you felt chest pain, you would (should) be treated pretty much the same way in any hospital across the US.

(side note: you all know that the first thing you should do at home if you feel chest pain is to chew a full aspirin, right? or the equivalent= 4 baby aspirin).

so i'm getting more familiar with how things are done and with some of the routine patient problems. the PA i've been w/ the last few days is very sweet and generous. and that certainly helps. i'm trying to cut myself more slack and allow mistakes. and occasionally i'm even getting some things right.

and working this shift means i get to sleep in in the morning, get stuff done during the day, and stay up really stinkin' late "decompressing" (ie: watching south park reruns). speaking of late....i'm off to sleep.

goodnight, intarweb.