The last day of ICU

Today was my last day of the ICU rotation. I have to say that I actually learned very little on my rotation. I learned how to write an ICU note. That was something. I learned that despite what everyone says, common things occur commonly.

Today was a very... stupid day. I caught five or six things today that were just silly. One patient had two H2 blockers. Another patient was on heparin and actively bleeding. Another patient had meds that the pharmacy didn't send up. One patient was NPO and getting scheduled insulin. It was just a string of stupidity today.

I greatly confused a nurse today. She needed a boost, but she walked right past me. If you've never met me, I'm a pretty big guy. So I stopped her and we boosted her patient, and that was that, but I think it's sort of... a sign of the times, y'know? I think that a lot of docs and students think they're too good for this sort of stuff.

It's like we were putting in a Cordis, and I can assist someone in a sterile field just as well as a nurse. It takes all of one hour to learn how to maintain a sterile field. And the nurse was surprised at me.

Maybe it's because my mom is a nurse, but whenever I work with nurses, I'm always on my best behavior. I realized one day that nursing is a really tough job, and I should try to be helpful if I can. I mean, why does some nurse need to waste time helping another nurse boost a patient when I can help? Why does a nurse need to stand around at a simple procedure when I can do the same thing?

I thought I was the only person that did this, but I discovered that M was also guilty of doing this stuff, and in fact did much more of it than I did. I think that's why I liked working on rotations with M. We both were eager to do things that had absolutely no teaching value, but were things that were... good-natured.

I thought about it a long time, and I used to think that a lot of my attendings liked me because I was a hard worker, but I discovered that this is not really the case. It's the willingness to do something that really has no value to me whatsoever. It's that I would talk to families of patients on my own. It's that I would stick around late and help out. It's that I wouldn't leave until I'd done what I said I would do. It's that I actually cared. It's that I'm still sad for the wife of a patient I saw who blamed herself for her husband's death. It's that I'm still angry about an aggressive workup on a brain dead patient.

I was thinking today about how devastating oncology was for my mental wellbeing. I was thinking that I'd said that I could never do it. I was thinking today that it's not only a field I could do, but one that I should consider. It's got a healthy amount of intellectual stimulation, but moreover, it and general medicine are two fields where your relationship with your patient can be more valuable than any treatment you have to offer. Y'know the truth of the matter is that I think I could be a decent oncologist. It's simply a matter of whether my heart could stand it.

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