Tuesday, October 22, 2013

Recall and Apply...

Today was another exhausting moment doing clinical rounds at the hospital.  I was assigned to geriatrics in the morning session and post- op in the afternoon.  So to my surprise, my experience at a local nursing home was epic.  We round with an attending physician at a nursing home that has be opened for over 50 years.  The facility was not the fanciest as you would find in the US, however, the up keep and dedications to the residents were impeccable.  The workers took great pride in the up keep of each resident.  "There was no smell of odors and facility was nice and clean."  As the attending would put it, "each worker here works above their pay grade unsupervised," meaning they work to a level that of excellence that's way above the amount of money they actually make.  Each resident was bathe and groomed each day.  All beds were made daily.  Each diet catered to the resident's dietary need.  Although funding and finances were not plentious, the caretakers took great pride in how they cared for the elderly.  Job well done I must say.

Now, coming from my perspective as a student learning to use all the information I've gained, being able to recall and apply it is imperative.  We first began with a 90+ female that had a history of high blood pressure and type 2 diabetes.  So, we were methodically drilled on how would we care for this resident.  What line of medications would be administered and why.  what are some contraindications of these medicines in the elderly, etc.  To my surprise I was able to recall more pertinent facts than I thought I would.  When put on the spot my mind began to race, trying to quickly recall the answer.  I tried to visualize and recall my notes, or things I had written on my whiteboard as if they were right in front of me...Now, somethings were fuzzy, but, for the most part visualization helped me today.  For instance, I was asked what was a side affect of an Ace Inhibitor that I should look out for in our patients.  I recalled my drawing on my white board and was able to locate that side effect: coughing... I'm growing everyday..taking baby steps..but, I'm moving forward.

Then our next case was a spinal injury patient that also suffered from diabetes and had to have his right leg amputated due to diabetic neuropathy, a complication of diabetes.  We had to recall the signs and symptoms of a T12 spinal cord injury, as well as brachial plexus injury that has damaged the radial, ulnar and median nerves in his right hand.  WoW...over the past two years we've learned all this stuff and now right before our eyes..it was time to apply what we've learned.

Another plus for the day, was I was rounding with a top notch group of students which made my day even more enjoyable. Everyone was eager to learn, to help each other gain the knowledge we needed...Team work is so important...

At the end of our rounds, we saw many different textbook ailments.  I was impressed with our agenda for the day.  I thought the attending was just shooting off the cuff...but in the end she actually had a type written agenda of all the cases we saw today..I was really impressed with that. That allow us to really seal in our subconscious mind the learning points of the day.

It feels really good when you are able to see the transition of life right before your eyes, however, big or small the progress, be excited about the progress.  Because as you continue moving forward you will see you labor is not in vain.


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