going from student to doctor

I haven't been writing nearly as much.  I'd like to breathe new life into my blog and have it reach more people, so feel free to share it.

Anyway, the transition from student to physician is all too real.  You're always thinking about what's right for the patient, but there's a lot of playing it safe and being overly cautious because of the potential for unintentional harm to a patient.

You often get pressured by nursing staff and ancillary people to "put this order in" or "write for this" and you can get burned by doing that without thinking it through.  You get so busy that you don't always get to write orders in a timely fashion and you start feeling a little bit of friction.

I'm a little frustrated with nursing at this one hospital, because I want to know how much of X medicine someone got or how many fluids they got and I keep hearing "this is my first time with the patient," like it's somehow okay.  I get that nurses are busy doing tons of stuff, but you can jot things down here and there.  I wish nursing was more assertive about urine output and that they include us in their sign-out to each other instead of ignoring me when I'm right there.  I end up pushing myself into their report because it's my patient and I'm writing orders.

There has also been a lot of great nursing.  I wouldn't be happy having to move 300+ pound patients around, doing all the cleaning of urine and fecal matter and vomit for 12 hours a day, day in, day out.  A lot of the nurses around keep a good attitude and I have a few favourites I hope I get to work with the next day.  The hospital usually has the same nurse continue to follow the same patients over and over so there's some continuity, which is really helpful when you're tracking a patient's clinical status over time.

There are a lot of brave nurses who stick around a combative, agitated patient and who give great care to people coming off from cocaine and meth despite being in danger sometimes.

I'm going to miss a couple of the nurses in the unit once I leave, they've been there to talk me through orders or know what to call me for so we avoid crises.

Being a doctor is a great feeling (most of the time) but you're always under the microscope for everything you do and every word you write in your patient notes.

Then you get sucked into a lot of family drama and potential legal drama with families who make their frail actively dying loved one with say, several significant strokes, heart attack, metastatic cancer, renal and liver failure, maxed out on pressors and mechanical ventilation be full code and continue aggressive medical measures even though you explain to them over and over that their loved one is sick and will not recover.

It's hard.  It's rough being a doctor.  I wish I could be a student again sometimes, you know.