I just got back from a week-long family vacation at Edisto Beach, SC. If you haven't been to Edisto, it's a great beach. The week was restful and enjoyable. Mostly it was fun to hang out with my family and spend long days in the hot summer sun. We had great weather all week--we didn't have much rain (if any), and it was consistently around 95º. I played a lot of hearts (our family game) and watched a lot of movies. We even got to go into Charleston for an evening (I saw HP7P2--i.e. Harry Potter 7 Pt. 2--on an IMAX). The vacation was just what you'd want from a week long trip to the beach--seafood, sun, and whole lot of doing nothing.
Today was a special day at the medical school as the new medical students had their first day of orientation. I was busy in the lab, so I didn't get to sit in on any of the events, but I did manage to see some of the new students (including my brother). I don't know that many of them, but the students that I do know are really cool people. I'm always impressed with Quillen's ability to attract such high quality students/faculty/staff. And of course, the family atmosphere of the place is hard to beat. I have to admit, as I watched the new students meeting and greeting, I was envious. All I could think about was how I wished I could be where they are. Hopefully, I will be soon enough.
We ran a couple of trauma and surgery scenarios today. The surgery rotations are always interesting and complicated cases, so I enjoy being there for surgery days.
Funniest moment of the day:
A professor was walking us (third year med students and the interns) through airway. We were talking about intubating and when it is appropriate/necessary to perform a cricothyrotomy. The professor performed a cricothyrotomy on the sim-dummy and set up the tube in the trachea. He asked, "Alright, what do we do next?" He was fishing for the answer, "We bag him." But instead one of the third years quickly responded without thinking, "We bag him and tag him."
There are some pretty exciting things coming up in the lab. I just found out that I'm going to be making my acting debut tomorrow. We are filming a demonstration video for ATLS purposes. Apparently, it is an important video as all of the interns are going to dress in full surgical gowns. Look out Hollywood, here I come!
Also, my boss is setting up a time for all of the interns to listen to a retired physician come and speak to us about cardiology. And we might have a doctor come and show us how to read and decipher X-rays as well. I'm looking forward to both talks. In particular, I have found X-rays to somewhat mystifying. When we run scenarios, some physician will look at an X-ray and immediately recognize that something is wrong with the patient. To me, the X-rays look pretty much the same as all of the other ones. . . Unless its something exceptionally obvious. So hopefully I can learn a lot from both talks!
There isn't too much else to report. I finished my book, The Brothers K, and would highly recommend it to anyone. I have been thinking about the book for over a week now, despite finishing it. It definitely makes my top ten of favorite books, although to be fair, I haven't read as many books as I probably should have.
I am also preparing myself to go back to Durham in less than two weeks! I've been told that I will be working on the BMT ward at the hospital, so I am very excited about that. I am so fortunate to have some of the opportunities that I do and I'm surrounded by wonderful people.
Much tanner than last week,
Peter
Monday, July 25, 2011
Wednesday, July 6, 2011
Halfway Done & On the Other Side of the Glass
It hadn't really occurred to me until very recently that I have only four more weeks of my summer internship left. I know it's terribly cliché―but I can't believe this summer has gone by so fast. And while I have loved working in the Sim Lab, I'm very eager to get back to Durham as well.
The past few weeks have been an amalgam of different activities and people coming through the simulation lab. Our most consistent visitors to the sim lab are the nurses in training (specifically LPNs). We typically have two or three groups come through the simulation lab to run different scenarios for the nurses about every week. Usually the scenarios are designed to improve the nurses assessment skills―so we emphasize that the nurses get good patient histories and pertinent information (such as allergies, medications, eating/sleeping habits, etc.).
We had a group come through this morning. The most remarkable thing about the simulation lab is that when you are sitting behind the glass (i.e. helping run the scenario), it is easy to become hypercritical. In fact, you start to notice every little mistake―down to the most trivial minutiae. Somehow, you convince yourself, "If I were in this simulation, I wouldn't make that mistake. . . " In short, it's difficult to appreciate the pressure of the simulations until you have participated in them (on the other side of the glass, so to speak!).
Fortunately, the newer interns were given just such an opportunity today. After the LPNs finished up, some of the older interns decided that they wanted to run some simulations for us. Naturally, we agreed―mentally preparing ourselves for our inevitable success diagnosing and treating a patient. And naturally, we looked like idiots shortly afterwards.
We ran at least four different scenarios (A patient with significant bradycardia, a trauma patient with tachycardia, hypotension, and a tibial fracture, a COPD patient, and a patient in anaphylactic shock). The first scenario, my team (the new interns) was completely disorganized―we didn't communicate well and nobody took charge of the situation. But as we did more, we learned to communicate better and discern our roles within the team. We bungled our way through most of the simulations, but we learned from our mistakes and gradually became less inept.
For me, it's easy to understand why the simulation lab is so valuable for nurses and medical students (even physicians!): You learn from your mistakes in the sim lab in a way that simply cannot be replicated. That is, when you make a mistake―or have some lapse in judgement, or accidentally forget something within the lab―and kill a patient, you tend to remember your mistake. I know, I know. . . this sounds obvious. But it's true.
It's ok to make mistakes in the simulation lab, because you are only "killing" a dummy. But in the back of your head, you can't help but think, "What if that had been a real person?" Thus, there's more poignancy in these sorts of learning situations.
That's not to say that we didn't have any fun with the simulations. Two of the most memorable/funny moments from the simulations:
1) On the trauma scenario, the patient was (understandably) freaking out and complaining of terrible pain. Well, we (the interns) knew that the patient's SpO2 (oxygen saturation) was very low and that we were going to have to secure his airway (i.e. intubate) the patient. Typically, in situations like this, the patient will receive a drug called Versed which simply calms the patient down and ensures that they will not remember the intubation process. As we were discussing whether or not to intubate the patient, one of the interns said, "Let's just knock him out and intubate." As you can imagine the patient did not respond lightly to this comment. Haha. We learned a valuable lesson there.
2) On the anaphylaxis scenario, we were trying to decide whether we should give epinephrine to the patient or not. This time, one of our interns simply suggested, "Let's just give the epinephrine. If it kills him, it's a lesson for us. . . " The intern was kidding, of course. But I'd hate to run into a doctor that was really that cavalier about administering treatments.
Besides the simulations today, the lab has been pretty relaxed the past couple of days.
I've finally got some pictures from the internship that I've posted here (mostly from our camping/outdoors excursions):
The past few weeks have been an amalgam of different activities and people coming through the simulation lab. Our most consistent visitors to the sim lab are the nurses in training (specifically LPNs). We typically have two or three groups come through the simulation lab to run different scenarios for the nurses about every week. Usually the scenarios are designed to improve the nurses assessment skills―so we emphasize that the nurses get good patient histories and pertinent information (such as allergies, medications, eating/sleeping habits, etc.).
We had a group come through this morning. The most remarkable thing about the simulation lab is that when you are sitting behind the glass (i.e. helping run the scenario), it is easy to become hypercritical. In fact, you start to notice every little mistake―down to the most trivial minutiae. Somehow, you convince yourself, "If I were in this simulation, I wouldn't make that mistake. . . " In short, it's difficult to appreciate the pressure of the simulations until you have participated in them (on the other side of the glass, so to speak!).
Fortunately, the newer interns were given just such an opportunity today. After the LPNs finished up, some of the older interns decided that they wanted to run some simulations for us. Naturally, we agreed―mentally preparing ourselves for our inevitable success diagnosing and treating a patient. And naturally, we looked like idiots shortly afterwards.
We ran at least four different scenarios (A patient with significant bradycardia, a trauma patient with tachycardia, hypotension, and a tibial fracture, a COPD patient, and a patient in anaphylactic shock). The first scenario, my team (the new interns) was completely disorganized―we didn't communicate well and nobody took charge of the situation. But as we did more, we learned to communicate better and discern our roles within the team. We bungled our way through most of the simulations, but we learned from our mistakes and gradually became less inept.
For me, it's easy to understand why the simulation lab is so valuable for nurses and medical students (even physicians!): You learn from your mistakes in the sim lab in a way that simply cannot be replicated. That is, when you make a mistake―or have some lapse in judgement, or accidentally forget something within the lab―and kill a patient, you tend to remember your mistake. I know, I know. . . this sounds obvious. But it's true.
It's ok to make mistakes in the simulation lab, because you are only "killing" a dummy. But in the back of your head, you can't help but think, "What if that had been a real person?" Thus, there's more poignancy in these sorts of learning situations.
That's not to say that we didn't have any fun with the simulations. Two of the most memorable/funny moments from the simulations:
1) On the trauma scenario, the patient was (understandably) freaking out and complaining of terrible pain. Well, we (the interns) knew that the patient's SpO2 (oxygen saturation) was very low and that we were going to have to secure his airway (i.e. intubate) the patient. Typically, in situations like this, the patient will receive a drug called Versed which simply calms the patient down and ensures that they will not remember the intubation process. As we were discussing whether or not to intubate the patient, one of the interns said, "Let's just knock him out and intubate." As you can imagine the patient did not respond lightly to this comment. Haha. We learned a valuable lesson there.
2) On the anaphylaxis scenario, we were trying to decide whether we should give epinephrine to the patient or not. This time, one of our interns simply suggested, "Let's just give the epinephrine. If it kills him, it's a lesson for us. . . " The intern was kidding, of course. But I'd hate to run into a doctor that was really that cavalier about administering treatments.
Besides the simulations today, the lab has been pretty relaxed the past couple of days.
I've finally got some pictures from the internship that I've posted here (mostly from our camping/outdoors excursions):
Me getting ready to make smores on our last camping trip.
Me and A
At the Beauty Spot
At the Firetower
Intern Love
Suturing up NOELLE the simulation dummy.
In brief non-internship news:
I went to Charlotte this last weekend to visit two of my best friends from college. I had a great time. Charlotte is a fun place to be, for anybody considering the option of living/working there.
I am currently reading this book:
It was given to me by a friend. I thought I'd share the wealth by telling you all about it. Admittedly, I am only a little more than halfway through the book, but already it is the most enjoyable read that I can remember in the past couple of years. The book is both funny and poignant. Check it out.
Alright, I have had enough rambling for one night.
Still happy,
Peter
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