Back in GDL, UAG has resumed. This means that many of my classmates yesterday were posting as their Facebook status something to the excitatory effect of a “new semester”. And although technically I am two weeks ahead of them (having started my 7th semester two weeks ago), I now feel two weeks behind. Or to be more exact, two weeks and one day behind all of them. I’m scheduled to start in my assigned hospital on the 25th in GDL, however, because of the inefficiency we all know and love as Mexico’s own system of organized chaos, the 25th I will instead be running all over the city in between offices and hospitals just trying to get documents where they need to be. I roll my eyes at this, because I already know what is most likely to happen. I will return to GDL on the 24th, spend hours trying to get myself organized and my plan of attack all laid out for Monday, all to find out come Monday that everything they told me in June (right before I left) has now changed and I actually need to do this, this and that instead. I may have to plan on going to the gym for a boxing class that night....
Anyways, back to the here and now, I’ve finally come to a point in my learning here in Boston where I’ve come upon some down time. If I had the choice, I’d rather not have the down time, but at the same time, I can actually take it as a good sign. I’m getting my work done in much, much, much less time and much more independently than before. I did learn a lesson yesterday though, that I shouldn’t let myself be too independent:
- One of my patients is an adorable baby boy, unfortunately he has a messed-up heart (technical term ;). But because having a messed-up heart isn’t enough, they saw signs of an intestinal infection so took precautions to avoid it, one such precaution is not letting the baby eat. So I started him on a PN prescription. Many problems later and a long story made short, he ended up being way behind on his PN. Monday I came in, assessed his status and then put in the order for an advance in his PN. One of the dieticians then reviews the case, notices the patient has a high blood sugar that morning and freaks out because I had increased the dextrose of his PN. I called the nurse to confirm that the reading had been contaminated, and she agrees to get a heel stick reading as soon as possible. In the meantime, this dietician continues to freak out. She tries talking to the attending team in charge of the baby to get them to just flat out change the PN order, but they refused her saying he needs the increased calories. (They’d already told me that when I’d asked them about the situation.) This now had succeeded in making her mad. She calls our attending and vents to him, but he just told her to wait until the heel stick results. In the end, her rampage was all for nothing. The heel stick proved that the high reading had been a contaminant, and the PN was advanced just as I had originally recommended. If we had been in Mexico I would have told her to “toma una pastilla de CHILL!” Either way, lesson learned, and now I make sure I go to or at least call the particular dietician I’m in consult with to get their stamp of approval before I actually put in recommendations.
This morning I attended a breakfast conference with the fellows. The topic was constipation. (Constipation for breakfast!! Yum!!) The doctor giving the topic was not shy to admit that she LOVES constipation. I actually appreciated that she said that because it made me excited to hear her talk. Whenever someone loves what they are talking about, it shows, and almost always makes for an interesting talk no matter what the subject is. And of course, it ended up being an excellent conference. At one point she was talking about a certain study and made a joke about how they do the study in Mexico, which everybody laughed at. I, on the other hand, got defensive. Just because Mexico does not have all the nifty resources available CHB does, doesn’t mean they should get made fun of. Instead they should be recognized for their creativity in developing a method of completing the exact same study with the few resources they do have. But all jokes or nonjokes aside, I learned a lot about constipation from her..…who knew?!?!
Hasta!
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