Well, I finally took my $1,000 dreaded clinical skills exam Friday. It took 8 hours and then right after, a classmate and I drove the 8 hours back home. It was a long day. The test was really pretty dumb, looking back on it. I mean, these people are actors paid to fake an illness. I have 15 minutes to go in, ask questions, do a fake exam, and then 10 minutes to write a patient note explaining what I think is wrong and what labs should be done. I had to do that with 12 different patients. The funny thing is, I'm not really graded on if my diagnosis is right. I'm graded on whether or not I was "nice" to the patient. To pass this exam, you have to do extra "politically correct" stuff that you read in a review book. For instance, instead of just listening to a patient's heart, you have to say, "Now I'm going to listen to your heart. Is that okay with you?" Now, since when does a patient NOT want you to put your hands on them? Isn't that why they go to the doctor? Of course it's okay if you listen to their heart, lungs, abdomen, or whatever. They expect you to. To prepare for this test required reading about these sorts of "tricks" in a review book. I didn't study so I could improve my clinical skills (which in my opinion are already quite good). I studied so I could pass the test. Is that really what medicine is supposed to be about?
In other news, I started a new rotation in a private emergency department. I'm working 7am-5pm this week, 3pm-12am next week, and 11pm-8am the week after. I emphasized "private" because I can already tell a huge difference in how things are done. For one, the nurses are better. They are nice, helpful, and they get their job done quickly. The scary thing is I have to be careful what orders I write because they will actually get done. I'm not used to that. Today I was seeing this 12 month old with a fever and I was figuring out the dosing for motrin. Kids are a bit confusing because you have to adjust the dose according to how much they weigh. I'm so paranoid I'll make a mistake on this and mess the kid up, so I had to reassure myself that yes, 9kg X 10mg does in fact equal 90mg. Funny how all of a sudden you doubt your 2nd grade math skills when it comes to something important. ~sigh~ I guess I'll get more confident when I get used to it. It scares me that graduation is 3 months away and there's so much I don't know.
posted by Kate @ 11:02 PM
4 Comments:
There is a nursing shortage, and your comments influence others. I'm accustomed to physicians talking down to nurses. The condescending tone does nothing to promote a field full of compassion, integrity, and intelligence. All health care professionals have an obligation to respect and protect the members of the healing arts. Please drop the arrogance. Everyone makes mistakes, and you are too new to begin a fulfilling career with such loftiness.
Oh, for heaven’s sake. Get over it. How many nurse blogs have I read where they rag on docs? And, in any case, I’m not sure what it was she said that was condescending. She noted a fact: nurses in the private world, working with experienced, completely trained docs, tend to be more responsive and respectful than nurses in training centers working with docs-to-be (med students) and baby docs (residents); they often become cynical and turf-obsessed (the nurses, that is). Not surprising, I guess, with a new crop of not-yet-very-well-trained potential screwups coming in the door every 4 or 6 weeks, but not much fun if you're the new student/resident.
A smart doc knows he can’t function without smart nurses, and is polite, pleasant, and respectful to them. It’s nice to be in a situation where they return the favor. I thiink that’s the point she was making.
If there are nurses out there blogging against their physician colleagues then they aren't meeting their professional standards either. The botttom line is that healthcare is suffering from a remarkable lack of respect in all areas, from all members of the team. We don't exact revenge on our colleagues by engaging in such behavior. We ultimately hurt our patients. Interdisciplinary peace is an excellent goal for everyone practicing. The patient outcomes are much better. :)
Good thing this blog is for friends as well as medical professionals! Me, I don't mind sweeping generalizations of doctors or nurses. Heck, I can even sympathize with the more recent mention of ducking away from reporters, and I am one!!! EAQ
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