Tuesday, September 9, 2008

Data Collector

I've been working my butt off in Peds Infectious Disease. We cover two hospitals, plus there is clinic so basically we're constantly picking up new cases and finishing up others. We've got some sick kiddos recently: a Rocky Mountain Spotted Fever, lots of osteomyelitis, Leptospirosis, bacteremia sepsis, and today I diagnosed malaria!



But part of the hardest part of this rotation is getting my thoughts together in order to get the assessment and plan ready to present. I am good at getting the information--I can ask the important questions, and I can pick up abnormal findings on the physical exam. I can also get the vital signs and the lab values off the computer. After that I am supposed wrap it up with a simple one line sentence and explain my thought process for what I think it is. This is where I falter. While I was on ED I could get it together, but on Peds ID, I am usually so confused and have a billion things running in my mind that it sounds like blllllaaahhh.



Lucky, my attending sort of expects this. He believes our teaching was geared at making us great Data Collectors and looking back over 3rd year I actually completely agree. For example, on surgery I would wake up early to "round" which really just means I would make sure to find out if anything bad happened to my patient while I slept. If that was a no---did they eat? did they have a temperature? did they get out of bed? how was the pain? after I collected that info and their vitals and labs (which we rarely ordered anyway) I would just recommend that they eat, get out of bed and make sure their pain was controlled. Done and done. On OB it very similar only I'd mention something if they wanted any form of birth control. On psych I never rounded. On medicine we were told by the ED what they had, and we just consulted various services so I'd make recommendations on that and I'd look up journal articles to learn.

So it seems like I really didn't have any creative thought of my own when it came to summing up the patients---I was medical student, the Data Collector.

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