Block one of the year is already over. We had a small team on Vascular, and we managed, but I think we all felt the strain from carrying extra work. I started out the year with one of the busiest services, but I guess prefer that than finishing with the busiest.
I've been the senior most resident on my service for the past year, and in that position, the acting chief resident of the service. So I was therefore not expecting this year to be so different. But there is an expectation, a responsibility, and in some cases a stereotype that comes along with the position of chief resident. And trying to live up to that expectation, fulfill that responsibility and if possible break the stereotype that if I'm honest, really has me struggling at times. If I were to give myself a grade on my "chiefing" thus far, it'd be a nice fat F for failure. I've got so much work to do the next 12 blocks.
One of my biggest failures is communication. I'm not a fan of unnecessary and/or futile communication, it's inefficient and waste of time, in my opinion. But I remember chief residents getting so angry with me as an intern when I would unintentionally leave them out of the loop on an event. It was always unintentional, but I would simply be taking care of a situation, perhaps communicating directly with the attending, or someone else involved, and forget to let any third, or forth or fifth parties know what was transpiring. I guess all their yelling really didn't impact me, because I still have found myself in similar situations, only difference is now its the Attendings getting angry with me rather than a chief resident. It's easier with our teams now because we have group chats that all updates and issues get sent to, so every resident on the service remains updated at all times. Not such a acceptable idea with Attendings, so if something happens I have to text/call/message not one but multiple, all who may be interested. And when I'm in a post call exhaustion, trying to keep it together to get plans for my team to carry out for the day, all while not missing a fever, or a drop in hematocrit, or forgetting a pulse exam, or antibiotic, or anticoagulation regimen.... superfluous communication is the last thing on my priority list. Maybe by confessing, I'm hoping that I'll be able to remember next time, and do better at my communication.
I also realized towards the end of this block that my poor communication is negatively affecting my interns as well. On Vascular, as I mentioned, it is super busy. In order to give my team as much time to get ready in the morning I request to meet with them at 06:30am, but in meeting at such a time it means we really have to fly through our rounds. It is not uncommon to see a vascular team member running down the hall or up/down the stairwell to catch up with the team as he or she was left at the last patient to finish the dressing change. Once again, I prefer to cut out superfluous communication in order to speed things up, and therefore let the patient know the plan for the day and then check over my shoulder to make sure the team understood the plan as well as we take a quick sprint to our next patient. I don't stop to make sure our intern understands what went into the decision making part of that plan. I realized I wasn't even asking my intern to analyze our patient's vital signs. I was doing it myself in order to speed things up on rounds. I caught what I was doing and tried to remedy it towards the end of the block, but was probably too little too late.
Going to be making a few changes approaching the upcoming block, starting tomorrow bright and early. If I can make small improvements here and there, perhaps I can pull my F up to a D... D- at least?!
Much Love and prayer!
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