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Went grocery shopping at CVS again. Tomorrow I'll make the trek to Trader Joe's, today I just didn't have it in me. I had hoped to do a lot of decorating today, but I just can't seem to commit on where I want to hang everything. The things I do know where I want to hang are heavier than I want to deal with all by myself. Again, will need to recruit one of my local XY chromosomer friends to help out.
I've had time to reflect on my recent residency experiences and I gotta say, I've come a long way in just one month! I'm a bit sad that I've had to spend so much time away from L&D managing post partum patients and circumsizing wee wees that I didn't get as much baby-delivering in as I would have liked. I also didn't get as much O.R. time or training as I had hoped for. I am feeling more and more comfortable in my own "doctor" skin though, which is nice.
This past week I ran into a bit of a snaffoo with one of the nurses on the post partum floor and I had cause to notify the head honcho attending Dr. Beckmann (author of the main textbook for medical students doing their OB/Gyn rotation, I might add.) One of the patients had been prescribed a Depo Provera shot for birth control before she was to be discharged home and the nurse did not fulfill the order. In fact, she talked the patient OUT of having the shot entirely, then told me the patient refused the shot and therefore she wasn't going to administer it. OK, fine, but there's a few problems here... First, the order was never D/C'd ("discontinued") and the nurse never documented that the patient refused the shot. Second, she decided that since she had been doing this work for >20 years that she knew what was best for the patient, which I don't disagree with. I DO, however, disagree with basing your treatment of patients on anything less than scientific evidence. You see, she is under the impression from lactation consultants that Depo Provera reduces a woman's ability to breast feed her newborn. This, in fact, is not the case. She has it so stuck in her head, however, that no matter what evidence I bring forward, she's convinced she's right and she knows best. Let's keep one thing in mind that's very important: I do not for one second, at least not at this juncture in my career, presume to know more than the RN's who have been doing this for decades. But if I have research-based information that conflicts with an older way of thinking, I would appreciate an open-mind and for someone to hear me out. In the end, a written order was not executed by the nurse and my patient went home without birth control. This is unacceptable. Dr. Beckmann is going to have a chat with her, I suppose, but not in an administrative manner but rather in a "we're on the same team, let's do what's best for our patients" manner. I couldn't agree more and that is indeed how I tried to communicate with her, but she sees me as young, naive, and inexperienced. So I'm anxious to see where this goes and what comes of this. (As an aside, there are really only two forms of birth control we can give to women who have just had a baby, whether or not they're breast feeding: the Depo shot or the progesterone-only Mini Pill, which is a pill you have to take at exactly the same time every day. You can imagine this is not my preferred method of birth control to send young women with busy lives and a newborn home with.)
Things I have learned so far: If you screw up, don't make excuses but rather admit being wrong and put forth suggestions for how you will act differently in the future; don't piss off your chief; don't piss off your attendings; don't piss off the nursing staff (been able to avoid that so far); don't eat too much of the cafeteria food; DO thank your colleagues (that includes medical students); DO ask for help without reservation; have confidence in yourself -- you're probably on the right track.
My goals for this next month are: to read more, to practice surgery techniques more, to read more, to exercise more, to go out and have fun more. I think I will accomplish all of the above and more. *grin* Indeed, I will be treating myself to a full body massage at some point this week, as well as a mani-pedi sometime next week!
I'm off to take a bath now.... ah.....
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