Wednesday, April 17, 2013

What broke me?

I was actually doing really well in independent practice and what has broken me and continues to break down my self confidence little by little is hospital patient care. My family medicine group does "hospital rounds" where basically one of the 7 of us looks after the practice's hospitalized patients each week. I hate it. I have been on hospital rounds for the last 3 weeks. 2 weeks of "mentored" time and this week on my own. I find it so stressful I really want to quit my job to not have to go back. Seriously. The worst thing is getting the 7-8am phonecall that someone has been admitted to your service. Now you have to go in and try to see all the patients PLUS do an admission in the 3-4 hours you have before having to go back to the office to see afternoon patients. Today my admission was a shit show. Not what was handed over, way more complex, a story that didn't add up, way outside my scope. I spent all day struggling with this patient and finally asked for an internal medicine consult from the run of his feet internist because it all just didn't add up. HOpefully he sees him this evening in the midst of his 100 other things he had to do. I am not an internist. I wasn't trained to be one. My internal medicine rotations were mostly spent trying to discharge patient who were admitted for failure to cope. I'm not sure how much I actually learned. I hate this.


XE said...

That's what internal medicine consults are for! We like this stuff! It's not your fault you were given a patient who needed specialist care. Hugs.

Milk and Two Sugars said...

"I am not coping." I've had to say it once and thankfully the person I said it to was equipped and willing to help me. I really feel for you, this is such an unpleasant situation.

My only suggestion is to develop your threshold for when you make referrals, and then be happy to refer whenever you reach it. Presumably your threshold would increase with time and experience, but it's not wrong to decide that you have reached the limitations of your ability to care for this patient at this time. Your patients would be better off, you would benefit from seeing how someone else manages them, and all the other patients you need to see that day will benefit from having a doctor who isn't stressed because they're running so behind.

Oh, and swear a lot, it's therapeutic ;). Much love.