Rotation K, T-21

Day #4: Now that there is only 21 days of work left after today is done.  On this rotation. Today was ok, when we actually had full team, we got all the work done fast. Finished by 4 pm despite three meetings and different tests.  Couple of discharges.  There was an interesting lecture today by the chiefs.  I realized that I know absolutely nothing about ulcerative colitis/Crohn's disease - need to seriously review. As for other things, not really well.  Still eat like crap. Need to work on the exercise routine and do daily modules.

Countdown: days done.days to go  4.21

Rotation K, T-22

So here is an update about my ongoing rotation.  I tried to follow all the plans that I had outlined. First of all, positive results. People tend to respond much better to positive attitude and "niceness" although I had one or two episodes when I was not so nice.  Justified, most likely, but still.  Maybe in a more mature way, I could have handled it differently.
Day#1 - surprised me about my calmness...or maybe I was ready.  I was impressed that I was able to put in IV from the first try in a morbidly obese patient.  Maybe I am better than I give myself credit. Finished things mostly on-time.  Was able to handle my tasks.
Day#2 - was on-call, most of the day without my intern.  Interestingly appeared to have handled it well.  Would have even left on-time if it was not for last minute code.  But it was interesting code, at least.  Wish I was faster on the notes.
Day #3 - was actually worse than on-call because we got random admissions throughout the day. Rounded for a while.  Lost my cool a bit when working with cardio - should have known that he was difficult.  But started to get agitated and did not handle it as well as I should have.  Overall, it turned out well though.  No issues.  It is amazing how one sick patient can turn everything sour.  I was not even able to do much for other patients as I had to deal with this critically ill patient.

Things I still need to do:
-Get up earlier
-Read up on at least one thing a day from the patients in order to learn
-Daily exercise - only did it on day #3
-Cut down on sugars - why do I always eat like crap during this rotation
-Also, I have to cut down on this mild obsession of mine - i'm afraid it's becoming obvious.

Rotation K, T-25

I decided that instead of approaching this upcoming rotation with fear, anxiety/anger, I will try a new positive and organized approach so that it is more manageable.  I will try to learn as much as possible from this rotation and ignore all the negative parts. As my good friend says, "sometimes, just say ok and be quiet." That will be my motto for the upcoming month.  So here are some of the things I will try to do:
1) Come earlier than prior (7 am)
2) Keep organized using sheets; use paperboard to keep everything together.
3) Orders after we finish the unit.
4) Accept that there will be unfairness daily/hourly (including unfair load, screaming, ancillary issues, long work hours, instant changes) but just accept it and say nothing.
5) Learn one new medical thing every day. :)

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-Will also do hop modules daily.  religiously.
-Daily exercises (and/or do some sports) to get my "bad" energy out.

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Anyways, after counting the days and days off, I have exactly 25 working days remaining in this rotation.  Starting on a Sunday and with daylight hours taking my day off seems a bit depressing, but I'll try to keep it on a positive... hehe:) though it's hard.

Мой маленький сын

Решила что про сына буду писать по-русски.  Хотя бы все-таки потренируюсь.  Мой сын родился в середине июля после 41 недели ожидания.  Все-таки все прошло хорошо и я родила без всяких вмешательств и хирургий, но с анастезией.  Так что вот.

Первый меся был не таким сложным, хотя сейчас все-таки усложняется посколько он все больше и больше часов не спит и пытается исследовать мир вокруг него.

Anger management - Lessons 2 & 3

Understanding anger episodes.  
Once my anger is triggered by some event, usually work-related, I fall into the same patterns:
1) Awfulizing (I thought it was the most awful thing that could be happening, but it wasn't...)
2) Low frustration tolerance ("I just can't fucking deal with it..." even though I probably can)
3) Demandingness ("I thought the other person totally should have thought about me...acted differently...")
4) Negative rating of others ("what an asshole....")
5) Negative ratings of self ("I'm so worthless...")
6) Distortion - not seeing things clearly because I'm so mad

As for expressive patterns, some of the common ones are:
1) indirect anger expression
2) Outward expression - verbal and gesture

Interestingly, I make no efforts to resolve or correct the situation with the direct person/event that caused my anger, but mostly  bitch to others.  Hmmm...unproductive. :)

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#The "big mistake" is focusing exclusively on the bad behavior of others while ignoring the more important issue of whether anger is working to make my life better...--> definitely may apply to me at some moments

#The energy required to manage my life with this problem is far greater than the energy required to make a change.

Anger management - Lesson 1

So I had decided to take a look at my behavior and to change certain patterns.  I think that I do get angry way too often than necessary and it may even become a detriment to my health/social relations.  So I decided to get a DIY book about anger and sadness and see how I can correct it. And so, lesson #1.
Anger consists of the following elements:
1)self-talk
2)images
3)sensation in your body
4)pattern of expression
I think that I definitely have #1 an #4.  #1 would include things like exaggerated description of the problem, blame, a belief in inability to cope with problem, morally (blaming) thoughts of others, condemnation of others and thoughts about revenge. Images is when you keep replaying in your head the negative experience that just feeds into your anger.  And, as for patterns of expression - I am definitely an "outie" as I like to show my emotions. 
*Also interesting that anger and aggression are not likely that closely related.  Aggression actually follows anger only in 10% of the time.  Interestingly, most people suffer from anger itself.

It's not too late to turn it around...

Lately, I've been moody and depressed about a lot of things.  And angry.  About the fact that I got my chosen rotation so late in the year that will compromise my fellowship applications; about some of the evaluations that I've (i think quite unfairly) received from my my attendings.  About unfair treatment that I've received from my chiefs/bosses.  About life in general.  Things that in general were making angry and upset.  And then realized that they are all not worth it.  Working at the place where I work now (a big cancer) makes me ponder about bigger and deeper things.  Young people unlucky enough to have cancer have such a limited time to live and to enjoy their time with children and their close ones, and it is so saddening and sobering experience. What are my problems compared to theirs?  Things that I'm worried about are simply not worth worrying about.  They are not worth even feeling down about.

The evaluation grades that I get from my preceptors/bosses don't make any sense.  For example, one of the preceptor raves how I am so professional and hard-working individual and the best in everything and then proceeds to give me all 7 out of 9 on everything.  If everything was so good, why not 8 or 9 out of 9 then?  Another one who always praises me about my notes gives me a 5/9 on my notes but praises my attendance in clinic (9/9) when I have missed my sessions several times.  Another one gives me 6/9 for communication when I translated and worked with foreign-language patients all month long.  None of it makes any sense.  I'm just not even gonna give a damn about it.  Clearly there is no pattern, so i'm just gonna be myself, and not care about those things.