Jun 29, 2006

Some Thoughts

Throughout medical school, we've always been warned to treat nurses well - 'nurses can make you or break you' - the saying generally goes. As I got closer to actually approaching residency, though, I heard some addendums to that saying. Most often, the addition of "some." As in "some" nurses really know what should be done. You should listen to "some" nurses. How to tell the "some" from the rest? "You'll know," they said ('they' being the amorphous symbol of a generic resident)

As a student, I never really knew which nurses were among the "some." Today, though, I realized that it didn't take me long to identify them. Mostly because I met an anti-"some" today. She really wasn't that bad. She was just driving me crazy. Mostly because, even though I called back right away when she paged me, she never answered the phone (someone would have to find her), and everything she said started with "I'm sorry, but..." It's my job to answer the pages, and my job to deal with annoying little patient issues. I believe that an intern is truly at the bottom of the totem/feeding pool in a hospital. Even med students - powerless as they may be - have the whole med school backing them up and, you know, giving them 'days off' and junk.

Anyway. The nurse wasn't really bugging me that much. She was just freaking out about very small issues.

The nurses at my hospital practice what is called 'primary nursing.' Well, maybe not exactly that. But that's kind of what it is. When a patient comes in to the hospital, a nurse on each shift takes them on as their patient, and if the patient ever gets re-admitted, they'll be the nurse again. Which is totally handy in a teaching hospital, where the doctors rotate on a regular basis. And totally handy when a chronically ill kid comes in - the nurse knows all about the patient's baseline and home meds. It is very helpful!

How boring my blog posts have become. But, I just ran some stats. Maybe this will explain... In the past five days, I have spent about:
48% of my time at work
4% of my time driving to/from work
6% of my time getting ready for work
2% of my time reading stuff for work
3% of my time talking/writing about work
22% of my time sleeping.

Leaving my 15% of my time free. Most of which I spend thinking about work.

Jun 27, 2006

Day Three and Counting

I've now officially worked for three days as a 'doctor.' I'm getting better. And worse. I feel more confident, and completely out of my league. I guess these are all good things...!

In the past three days, I've logged about 33 hours of work. Which really isn't saying that much - 12 hour shifts are common these days, especially in medicine. What is impressive, is that the week isn't even half over for me! I'm 'scheduled' to work 52 more hours before Sunday. I have Sunday off. Thank. Goodness.

A little about how our ward service works:
- There are two teams, each with one attending physician, one upper level resident (a second or third year) and two interns.
- There is also a Night Float team - one upper level and one intern.
- The physician work room is called the 'doc box.' I don't know why. Except, you know, we're doctors... and the room is kind of box-shaped. But most rooms are, aren't they?
- Every day one intern and one upper level are on 'late call.' Every one else is on 'short call.'
- At 4, the short call people 'check out' to the long call team. That means we tell them a bit about our patients and let them know if there are any active issues (like... if the patient gets a fever, give Tylenol, or order blood cultures, or what have you). The short call people are supposed to leave by 5.
- At 6:30 pm, the Night Float team comes on.
- When the Night team arrives, the late call people check out the whole service (all of the patients from both teams) to them. The late call people are supposed to leave by 8.
- The Night Float team stays through morning report the next morning - they leave between 8 and 9 am.

I was on late call last night - I got home around 8:30. I ate a small dinner, watched some Little House on the Prairie , read a little, then went to sleep at 9:45. I think I stayed up too late though! I was having a hard time with little things today - like writing my name. And walking...

There was a study done on medical interns not too long ago (I heard about it, I don't have the reference). They put EEG monitors on interns as they went about their daily activities. The results showed that the interns were walking around asleep. Literally.

I've only had three days!! I'm still running on adrenaline, so I'm good. But ask me again after three weeks.

I apologize for rambling. Be glad you don't have to read my patient notes!!

Jun 25, 2006

I'm No Superman

A journey into Brenna's head, first day of residency (a la JD in Scrubs, minus the theme music and the ability to wrap up a storyline in less than 30 minutes. And any actual coherence)

4:45 am - Alarm goes off. Oh no. I'm not ready. Today? Really? I'm supposed to start? What would happen if I just... didn't show up...?

5:00 am - Shower. At least I'll be a clean doctor.

5:30 am - Getting ready to go. Stethescope! Doctors carry stethescopes! If I have a stethescope, no one will notice my glaring lack of doctoring ability. Where's my stethescope?!

5:50 am - Lost. Where the hell is the employee parking lot?

6:00 am - Wandering the bowels of the hospital. Davis Tower. Davis Tower. Where is Davis Tower?

6:05 am - "Doc Box" for checkout. Shoot. Wake up, wake up, wake up. You're actually supposed to pay attention to this now that you're a doctor. Listen! Stop talking to yourself!

6:15 am - Getting vitals from computer. I don't know where the weight is! Or what meds were given! What patient is this? Where am I? Why did I choose to do this? I don't want to be a doctor! I'll be a... teacher. Or a lifeguard. Or a morning radio show personality. I don't want to do this. I don't like this. That one girl quit in her first month of residency. Maybe she was smart.

6:15 - 8:00 am - More vitals, and pre-rounding. Yes, that's it. I'll quit. So what about loans. I'll pay them back eventually. No, wait. I like seeing the patients. No. I hate this. But some parts I like. Except for the things I don't. Do I hate it more than I like it? Yes. Yes, I do. I hate it. I could be a firefighter. They save people. Without stethescopes.

8:00 - 10:00 am - Rounds in the "Doc Box." Listen, listen. Maybe I could do the residency thing, and then quit. That way, I wouldn't be, you know, all embarassed about the quitting thing. I could move to Poland or something. And open a flower shop. Oh, shoot. Present patient now. Try to sound like you're not a third year med student on their first day. I'm smart, I'm confident, I have a stethescope. And a pen!

10:00 - 12:00 - Wandering around the floor, writing orders, seeing patients. Okay. Not so bad. I like talking to families. I like defusing potentially volatile situations. But I can still quit. If I want to.

12:00 - 12:30 - Lunch. How are the other interns doing? Am I worse than them? How much worse? I don't want to be worse. I want to be better. Or at least the same. The same. I like the same.

12:30 - 2:00 - More working on things on the floor. I am wandering around in circles. But at least I know when I'm in the wrong place now. I know how to write orders. That one guy actually called me doctor - and I don't think he even saw the stethescope. I discharged two patients. Go me! They actually left the hospital. I did that! I said they should go, and they did! I said, "Take Aspirin!" and they're going to! I write an order, and I don't need a co-signer. The power! I'm getting tired.

2:00 pm - Getting coffee. Wait a second... I LOVE this! Why would I quit?! It's great! Ha! So take that 'firefighter.'

2:05 - 2:35 - Closed in private room dictating a discharge summary. Hahahahaha! I have NO idea what I'm doing! But I like it! The transcriptionist is going to think I'm crazy. This is probably the worst discharge summary EVER. How wonderful!

2:35 - 4:00 - Accepting PICU transfer. I have a plan for the patient! I'm formulating clinical decisions. Granted, they're nothing earth-shattering, but it is my patient, and I'm formulating a clinical plan, and I'm right, and we're going to follow it!

4:00 - 5:00 pm - Check out in the "Doc Box." I'm listening! I care! I'm not forcing it! I sound like I know what I'm talking about!


So... the first day was extremely emotional (for my inner mind), but not very busy (for my body). I thanked my lucky stars that we started on a Sunday. Things are sure to be busier tomorrow. I know that I will have some bad experiences this month, and this year (and this life), but I'm glad that my first day as a "Doctor" was overall benign. And I'm so not going to quit.

Jun 19, 2006

Curriculum Vitae and Some Stats

Today was my first day! Not really a first day day - it was first orientation day.

I am familiar with "First Work-Day" jitters, a subset of the larger heading of "Meeting New People" jitters. I was thinking this morning of all of the times I've started a new job. It has been a lot! I think this is a comprehensive list:

Olan Mills Telemarketer
Mailboxes, Etc.
Mervyns Associate
Cafeteria Worker
Intel pseudo-technician
Chem Lab Assistant
Assisted Living Assistant
Front Desk Receptionist/Supervisor
Arts & Crafts Summer School Teacher
Doctor's Office receptionist
Michael's Craft Store Associate
AmeriCorps Volunteer
Fruit Stand fruit-seller
Kaplan MCAT/LSAT teacher

Plus the jitters of many volunteer jobs, and, of course: new schools.

So. Jitters. Nothing new. But this morning, I realized that this is the first time that I am starting a job that is actually what I want to do!! This is huge! That feeling actually overwhelmed the jitters. But only for a little while.

There are twelve people in my intern class, including me. Two went to med school in New York (but are from California), one went to school in Denver (but was born in California), two went to UC Davis for med school, 6 went to other California schools (see a pattern here??). Only one other person is not from California - she is from Seattle.

Continuing with some stats:
2 guys, 10 girls
4 married
4 dating
4 single
1 with kids
None with dogs
1 with cat (me!)


Everyone seems very nice. But it is so hard to tell on the first day! We sat around having people talk to us, had a tour, a scavenger hunt, and tonight had a barbecue with all the peds residents.

It is hard to not look at everyone trying to figure out who will be my friends, and who will drive me crazy. No one stands out in either direction yet. But I'm sure there will be some of both!

Tomorrow looks like an extremely boring day of HR orientation stuff, but then on Wednesday, we get to go for a hike!

Wednesday is also the first day of summer.

And the first day they're predicting 100 degree weather.

Jun 18, 2006

With Family Like This...

...Who needs enemies...?

On Thursday afternoon, I realized that I was really, really bored. And I started worrying about Orientation, which is (finally!) starting on Monday. And then I worried more. And more. And I knew that way lay in front of me was a weekend of worrying. And boredom. Those two feelings are two of the top ones that cause me to do something that I really shouldn't do: shop.

I decided that a better use of my time and money would be to go home for the weekend! I was going to drive - I am an expert at long road trips now, after all - but 20-some hours of driving in one weekend seemed a tad excessive. Miraculously, I discovered that I still had miles on Alaska Airlines (from my year in Alaska - four years ago!), so I was able to get a half-price ticket! Thus, Friday morning found me in Portland - surprising both of my parents.

I do love surprises - an added benefit of going home last-minute. I also got to save a few bucks on shipping for my Father's Day present! Plus, who wouldn't want to spend time with people like this?!?:







My parents recently acquired a portable fire-pit thingy, so last night, we celebrated Father's Day by whipping up some S'mores and singing songs around the campfire. Okay, that's a lie. We didn't sing. We did tell some bad jokes, though.

Jun 16, 2006

Take Today, Subtract Ten Years

And you have me, graduating from high school...

Ten years ago today.

Man, I'm old.

Jun 15, 2006

4 + 4 + 4 + 4 + 4 + 4 + 4 =

Me!

Yes, I just turned 28. Which is funny, because I think I totally skipped 27. For the last 6 months or so, I've been thinking that I was 28. I guess that means this will be a big year! Or that this is the age that I'll think I am for the next few years - like 22. I thought I was 22 for about four years.

Thank goodness I didn't stay 13 for a lot of years (viewer discretion advised):


I went to San Francisco for the big occasion. I took the train there - Amtrak! I like the train. It adds a whole sense of romance to everything. Especially when you carry a carpet bag and wear your hair in pin curls with a cute hat and pencil skirt. I didn't, but it would have added to the whole experience. That and steam. There should have been some steam.

San Francisco itself was cool - quite literally. It was nice to get away from the heat of the "Valley." I apparently live in a valley now. A hot valley.

I love that I'm so close to San Francisco. I forget how much I enjoy visiting big cities - especially when I can hang with friends that have a familiarity with the city.

My 'vacation' time is winding down. Thank goodness! I am terribly entertaining, but I think Natty Gann is getting sick of me talking to myself. Orientation starts on Monday, and then next Sunday (the 25th), I start off on the inpatient service. Exciting!

Did I say exciting? I totally meant terrifying.

Jun 8, 2006

License to Drive

Since I graduated from high school (ten years ago, for those keeping track), I have only lived in Oregon for about one year. I've lived in Minnesota, Alaska, North Carolina and now California. But, until today, I always maintained my Oregon residency, including my Oregon driver's license.

I was going to get an NC license (long story), but I failed the written test. Computer test, actually. I missed one question, and it tells you right away - that threw off my stride. Plus the NC test had lots of violation-specific questions (i.e. what is the fine for driving under the influence) and, well, I tend to stay away from the violations, preferring, instead, to just be a good driver. Ultimately, I decided taht I didn't need an NC license, so I just kept the Oregon one.

But now that I'm a 'doctor' and an 'adult' with a 'real job,' I have to get a new driver's license.

So, I made an appointment online for the Sacramento DMV, and this morning went in to Take the Test. Based on my past failure, I was a tad nervous. (Incidentally, a recent study showed that 1 in 11 drivers would fail a state driving test. how would you do?)

Surprisingly, California still has a paper test, which is hand-graded. I do better with paper tests.
I even got a smile-y face.

So, yay! I passed! They took my picture for a license, but (unlike Oregon) they didn't give it to me today. They apparently mail it to me in a couple of weeks. I don't know if the picture was any good, but it has to be better than this:



After the DMV, which was right by the hospital, I stumbled upon a Trader Joe's. Thrilling! A great grocery store just a few minutes away from my place of employ - on the way home, even. That is exactly what I was looking for.

Natty Gann update: Overnight she figured out how to get into my bed. Which explains why I woke up hanging over the edge of my (queen-sized) bed.


She also found a new place to sleep.

Jun 7, 2006

Expando Ray!

The Costco here sells sushi. It's not very good.

Guess what?! I have a satellite dish now! After my TV panic the other day, I realized that Dish Network was not the only satellite TV provider. Unlike Comcast. Grr. Comcast. So, I called DirecTV. And today, the DirecTV guy came, and basically said the same thing that the Dish Network guy did. BUT DirecTV guy was much more willing to stand and listen to me debate with myself the pluses and minuses of mounting the dish. Ultimately, I decided to test it out. The mounting was really easy, actually - just a few screws into a wood post - no real structural damage. I've made bigger holes in my apartment to stabilize a bookshelf.

And now I have TV!!

I signed up for the Total Choice Family Package. Partially because it was the cheapest option, but also because, well... it has the channel I watch the most lately: Disney. I don't get VH1 or MTV, (which I know horrifies Melissa), but I don't care all that much. I may upgrade in the fall so that I can get Bravo - I wouldn't want to miss Project Runway!

I do get tons of religious channels.

AND the NASA channel. I watched it for a few minutes. They had a cartoon on teaching about similar triangles. There was an Expando Ray to make a triangle bigger! Expando Ray!!! Do you think NASA really has an Expando Ray?? I want one.

Natty Gann is settling in well. I have determined that she can't jump (like a white man, I guess...) She gets into my lap by digging her claws into my thigh and climbing. Kinda hurts.


I've given this chair to Natty Gann. She can climb up on it pretty easily, and it isn't my couch. I covered the couch with tin foil so she won't climb on it... Problem is... I can't either. I think she's already got an aversion to the couch by now, though, so I'll remove the foil.

Did you know that 62% of pet owners say they would ignore Disaster Relief orders to evacuate if they were not allowed to bring their pets with them? Here is my PSA of the day: if you're one of those people (I would be...), make sure you have a plan, including a list of hotels outside the evacuation area that will accept pets. Thank you for your time. And attention.

Continuing with a random smattering of topics: I met my chief residents today! I had to go in to the Peds office to do a pre-child-advocacy-rotation interview. The cheifs were there finalizing our rotation schedules. I'm starting on the Wards. Which is totally what I wanted - jumping right on in. It is terrifying, but better for me than putting off the hard stuff. After my first hard month, I have Child Advocacy, then vacation, then I do NICU.

It was fun to start meeting people. They all knew who I was when I walked in. Strange that they know so much about me, and I know nothing about them. The out-going chief was there as well. She told me that she was sending a bunch of her clinic patients to me... Scary! She did it because she remembered my name. The good thing about having a unique, but easy to remember name, I guess.

Natty Gann seemed to do fine during my absence this morning, which is good, because I think I'm going to San Francisco this weekend. And she's not coming...

I'm sure she'll be fine on her chair.

Jun 6, 2006

Introducing....


Natty Gann!

Lindsay guessed the name right! That means she gets to be the cat's honorary godmother. Woo-hoo, Lindsay!

Natty Gann is so sweet! I brought her home, showed her the litter box, and gave her some food. The pic above is of her first few minutes in the apartment - she wolfed down the food. She is such a scrawny little thing, she definitely needs it.

After eating, she came over to me and just wanted me to pet her and pet her and pet her. No scratching or biting at all. Thank goodness - that is my biggest cat issue.

She does have this crazy walk, that for some reason makes me think of Voldemort.

I think the poor thing lived in a house once upon a time - she certainly is well-mannered - but was either abandoned or ran away. I don't know when she was injured, but it definitely affected her ability to get food. I don't know if she can really jump much yet. She's tended to stay at her lowest electric state (grounded... that's a really bad chemistry joke...). But she was also sedated today in preparation to get spayed. Turned out she had already been 'altered,' so she didn't need surgery.

So... Realizing I'm turning into Scary Cat Lady by describing every little detail about Natty Gann.

Instead, let me tell you: 1. That I got a new cell phone! If I had more attachments to NC, I could have saved that number like so many people do when they move, but... Well. I don't really want a NC number. So now I have a California number. And a tiny little phone (click on that link to see it, Mom) and 2. That my home phone number spells a word! I've always wanted a number that spells a word!!!

Natty Gann is sitting on the floor in my dark bedroom.

Cats are weird...

(but not as weird as Crazy Cat Ladies)

Coming Soon...

Eek! I'm off to run a few errands, one of which is: getting my cat!

The vet actually called this morning to 'make sure I knew' (I didn't) that the cat has a limp. She thinks that at some point the cat's pelvis was broken, and healed on its own. It shouldn't cause any major problems, but she (the cat, not the vet) will probably have arthritis in later life.

I don't know what to do with that information...

ANYway.

I realized as I showered this morning, that I still didn't have a cat name. I thought and thought and then, suddenly - as happens so often in the shower - inspiration!

I will be naming my cat after a character in one of my favorite childhood movies!

It is a movie I own.
About a scrappy young girl.
Who was abandoned.
And finds her way home...

Any guesses?

Jun 5, 2006

Cool!


Here is my new refrigerator! Yippee! I was not at all sad to see the other one go. It was really loud. It's kinda neat to be the very first person to get to use a new appliance in an apartment. No other people's random germs all over it.

Jun 3, 2006

Setbacks

This morning, when I got up, I was very excited to post a blog this evening to introduce everyone to two newcomers into my home: a cat and a satellite dish.

Turns out, I get neither.

I spent last night cat-proofing the apartment. And this morning, I put out fresh litter and fresh water in two bowls for the new cat. I went to the animal shelter, got to meet the cat out of the cage, hold her for a while, then give her back. Now, don't worry - I still get the cat. Just not until Tuesday. They have to give her her vaccines, spay her and insert a handy-dandy microchip. So, I guess it isn't that bad that I didn't get her today. But sad. Though, I do still need to think up a good girl cat name...

The cat issue was not all that traumatizing. Though I do need to remember to change the water in the bowls next Tuesday.

What was traumatizing, however, was when the Dish guy came in already shaking his head. Turns out there is a tree and a wall (my wall) in the way of the two available satellites. The only way I can get Dish is if I a)convince my neighbors to get it, and run a wire off of theirs or b)convince the apartment people to cut down the tree. Neither is going to happen.

So, I had to resort to Comcast, even though I was trying to avoid them. I logged on and ordered the Standard Package plus digital video recording for twice the price that it would have been with Dish. TWICE. PLUS an installation feel. PLUS the fact that the cable jack is on the total opposite wall of where I situated my TV, after two hours of furniture re-arranging yesterday.

And then it turns out that I can't get DVR unless I get some fancy digital cable package that costs $60/month. Plus the $10/month for DVR. WHO ARE THESE PEOPLE???? What? They think I'm made of money??? Yes, I will finally be making money. But... I can't afford that. Me and my cat have to eat.

So.

Rabbit ears.

And, I guess I need to go buy a VCR again.

I feel silly making such a huge stink about TV. But... it's all that I have right now.

Until I get the cat, at least.

Jun 1, 2006

MeetIn'

A few months ago, I came across this website called MeetIn - the 'largest' friends social group in the world. They didn't have a chapter in Winston-Salem (*gasp*), but they did in Sacramento. So I joined.

And tonight... I actually went to an event!! Are you not SO proud of me? I am! I found myself at Sammy's Astro Club tonight, at "Dive Bar Night." I had so much fun! There were several new people, and lots of regulars. I think tonight was a blow-out attendance night - there were probably 30+ people there. I had no idea what or who to expect, but it turned out that most people were like me - young professionals. Some single, some engaged, and one guy who just broke up with his girlfriend of seven years, but still lives with her... he was depressing.

Who knows if I'll ever be able to go to anything else - Dive Bar Night is only every other week and I don't really know what my schedule will be like. But I'm just glad I went out this one time. Sacramento is like the big city to me now, so I need to take advantage.

And now, as promised: pictures! I can't promise good quality - I had to shrink the file sizes down to get it to actually load...


Here is my bed! I love it. The mattress set is from Costco, the frame from Ikea and the bedding from Overstock.com. Isn't it beautiful? I don't really have any other bedroom furniture yet. Someday I will. Maybe Saturday! (aka Yard Sale Day)


And my couch. I love it, too. Like the curtains? I hung those last night. In the background you can see the dining room and kind of the back of my new monitor... Once that is more organized, I'll put up pictures of that area, too.

Hot Time in the City

I finally got motivated to unpack some boxes today. Helped largely by another trip to Ikea yesterday, where I bought some under-the-bed storage boxes ($12 each!!) and a cheap drawer set for my closet. So! My clothing is 'put away.' Kind of. It is put in the general area of 'away' at least.

As I was unpacking clothes, and hanging up my pictures, I realized that I was getting warm. Hot, even. Really hot. Super freaking HOT. A glance at the thermostat showed that I did, indeed, have it set to 80. The air conditioning was on. And the temperature was reading ninety. Ninety. So... apparently there is something wrong with my air conditioner.

Actually, after a call to the front office, I realized that the breaker for the AC was off, so I remedied that. It is still freaking hot in here, though... But it is down to 87.

Speaking of difficulties cooling things down: my refrigerator is a tad loud. And by a 'tad' I mean 'conversation-interrupting' or 'wake-up-from-sleep-causing' loud. It sounds like a spaceship trying to take off. I informed the management about that when I turned in my little "Is the Apartment in Good Shape"-type checklist. The next day (yesterday), the repair people came, took one look at it and said, "Oh. This is an original. It must be the compressor." Then they asked me how loud it was (real loud), and wrote down that I need a new refrigerator! Yay!! New refrigerator!!

To go with all my lovely new furniture! Speaking of, here are some pics to tide you over (Ari!). I'm only posting two pictures, because, well... everything else is still in major chaos.

Never mind. I lied. I think I'm trying to post at a busy dial up time, so it is being slow. I'll try again later!

In completely other news... I did something very different yesterday. Something I really thought I'd never do. I went to the public animal shelter... and I picked out a cat. A cat! I decided a while ago that I'd like a pet. What I really want is a dog (I looked at the dogs at the shelter too - I wanted all of them), but I am really not in the position to take care of a dog. After a dog, I'd like a kitten. But I don't really think I can take good care of a kitten, either. So, I'm going to get a full grown cat.

I picked one out yesterday, but it was a new arrival, and they need time to let any possible owners come claim it. But on Saturday, if he is still there, he's mine. Or she. I can't remember if it was male or female...

Any ideas for names??? Top of my list right now is "Linus"