Clerk's Notes 1
>SUBJECTIVE<
On Week 4 of Clerkship. Haven't been posting online much to maintain the privacy of patients, doctors, and batchmates alike. But here's what I can safely say:
In [hospital name redacted], clerks are generally not allowed to do much. On occasion, we run to Radiology to get initial reads on X-rays, do paperwork during emergencies (known as "codes"), and, if we're lucky, admit patients. Right now, because we haven't rotated yet in [name of public hospital redacted], we aren't skilled enough to be able to confidently perform procedures like blood extraction. But sometimes a nice intern or nurse will let us do these things under their supervision. Other than that, we mostly spend our days reading our patients' charts, learning their stories.
I was telling all this to one of my batchmates and he gave me a funny look and asked "If that's all you do, why do you guys always complain about being tired?"
I can't speak for everyone else rotating in Internal Medicine, but for me, what's tiring about clerkship is adjusting to clerkship. There are so many things about being a doctor that you don't learn in school, the most striking of which being the unspoken intricacies of hospital politics.
The hierarchy goes like this. Consultants are the kings and queens. The fellows are the knights. The residents are the squires. The interns are the handmaids. The clerks are the bacteria that live in the feces excreted by the swine that are slaughtered by the handmaids to feed to the squires who serve the kings and queens.
Actually, come to think of it, that is an inaccurate analogy. Bacteria don't occupy (much) space. Clerks do. Bacteria don't get in the way of doctors doing their job. Clerks do. Bacteria don't sleep on the wrong side of the quarters and end up displeasing the interns. Clerks do.
What organisms are lower than bacteria in the hierarchy of life? Clerks are.
>OBJECTIVE (As of 3:21 pm)<
- Vital signs stable.
- GCS 15. Drowsy, but coherent and follows commands.
- With 1x1 cm mouth ulcer on right upper lip (probably secondary to nervous tick of lip chewing)
- Occasional tachycardia (probably secondary to recent intake of caffeine)
- Clear breath sounds. Occasional sighing (probably secondary to chronic hospital duties)
- Soft flabby abdomen (probably secondary to lack of exercise and prolonged intake of cafeteria food)
- No pedal edema (although with subjective complaints of feet pain)
- Malodorous feet (probably secondary to chronic shoe and sock use)
>ASSESSMENT<
Week 4 of Internal Medicine rotation
>PLAN<
- Continue hospital duties as scheduled
- Encourage frequent journaling
- Continue oral caffeine for episodes of drowsiness
- Administer chocolate bolus 1g per orem as needed for episodes of depressed mood
- Watch out for episodes of hypotension and nervous breakdowns
posted from Bloggeroid
The first few weeks are always hard, since you're still adjusting to life in hospital. After that, it'll only get worse. Hihihi.
ReplyDeleteHihihihihuhuhuhuhu
DeleteSo you barely have any patient interaction???
ReplyDeleteWell usually if you ask, the residents will allow you to interview patients on your own. But you don't have any academic obligation to interact with them talaga. Any interaction you may have is of your own initiative to learn.
DeleteSo essentially, if you *request* for more patient interaction, you usually get it. But if you don't go out of your way to seek it, then yes you barely have any patient interaction.
DeleteAs of now ah, while we're rotating in a *private* hospital. :)
DeleteHello po miss Aimee, I'm choosing between ASMPH and 2 other med schools that are also in the top 10 and I have spoken to friends from the other schools and they say that when they were on rotations with clerks from ASMPH that they were very lacking in skills. I didn't really believe them until I read your post.
ReplyDeleteYou really get only minimal patient exposure there po? even though its school of public health? yung mga kwento po ng mga kakilala ko from the other med schools are so different from what you describe. what is the extent of the public health aspect of asmph?
Thank you, in advance! :)
Hello! Actually I probably should have clarified in my blog to say that patient interaction was minimal during my time in Internal Medicine floors. Because once I got to my other rotations in IM of a public hospital, as well as the emergency room of a private hospital, you're SUPER hands on with your patients! Magsawa ka sa patients as in hahaha.
DeleteThis post was written at a time when my only rotation was the Internal Medicine floors of a private hospital, so it doesn't reflect my entire experience as a clerk. :) Marami pang ibang rotations where you get loooots of patient interaction, believe me :)
Delete