Rotation V, T-22

Having finished the Rotation K, somewhat successfully, not declining one or two or three late night outings to get some drinks after particularly intense days, I am finally done!!

But now I'm on to rotation V. Actually, I'm already a week into it.  This one is in the intensive care unit.  I will write in more details afterwards, but just to give a countdown, I have 22 days remaining in this rotation.

Of those, 3 are off and some odd number are post-call since I am doing 24 hr calls.  But now this becomes too confusing, so I'll just be using days remaining and calls remaining.
Anyways, the goals for this rotation are similar to the one prior, with some minor changes. I will be checking progress with each of the following categories.

1) Hopkins modules. ONE DAILY. No excuses.
2) Daily learning experience: attending teaching rounds/learning new things every day, ICU stuff. Write it in my notebook. Daily.
3) Over this rotation, get certified in procedures - central lines placement. Possibly arterial lines placement.
4) Keep organized: orders, sheets, notebook, paperboard on rounds.  
5) 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.  Do not get into arguments with people.    
6) Daily exercises - to get the bad energy out! :)  And also, spring/summer is coming!!

	#	#days
Daily hop modules	0	0/22
Daily learning	0	0/22
Daily exercises	0	0/22

Oh, and speaking of which, I was already assigned to research and to present a topic - so I guess here I start!!
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Other goals, during this rotation:
-Get vision rechecked and get new eyeglasses!
-мамография

-Organize my baby's photos to create photo-book

And so, the countdown:
Days remaining: 22
Calls remaining: 6

Rotation K T-9

OK, so I had not updated this in a while. So now we are more than half way through.  Many things have happened since then. First off, I fell off the wagon with updating the stuff. I think when I come back so late and many days so tired, I just don't have the energy to update this blog as much as I can.  Then I also got lazy about daily modules and learning new things everyday.  Basically, I come in and crash and pass out.  And then it's tomorrow. That's how it was.  There were many patients that we admitted and discharged all over the course.  I have to say that now that i am on rotation K for the 4th time this year, I am faaar more comfortable with it then before.  I think that I am able to see the larger picture better now then ever, and that I am able to manage things better.  Of course, it helps that I have a good team this time around, and everyone had been helpful.  I almost do not have to do notes every day, as we have 2 students and one intern doing them.  Of course, there are bumps along the way, and problems here and there. But...overall, I think that I should be able to pull through.  I think...I hope.

Then, an update about another obsession of mine.  We've gone to two drinking parties so far, and they had been a blast.  Especially the first one. There were lots of people and we talked (about work mostly, of course, what else do we have in our lives?) and so on. I think that this obsession of mine is (sadly or maybe for the better) going away.  I think that some things had definitely happened, with culminations being last week, but all-in-all, i think now we are drifting away.  I am afraid that I am becoming maybe a bit too obvious, and frankly, I am getting kinda tired.  So, like usual, I just  stopped communication all together. And I think he cut it too.  This guy is really smart, and I think is one of the few ones that inherently understands the situation, and probably owns it too.  I think that we are very similar in the way we view things and get easily infatuated and flirty, but at the end of the day, we know what's right.  I think that given a different situation, being in college or whatever, things probably would have definitely progressed; but at this point, there are boundaries.  I need to get back to planet earth and stop being selfish, and think more about others.  I know what's the right thing to do, but it's always so sad when things are coming to an end. I doubt that we will remain friends once the year is over (since there was always tension there), so those things are definitely hard to say good bye to. Damn it, I think I really was hooked up on this. Sigh. I know. It happens once every few years.

Anyways, I need to get back to a more structured lifestyle with things that I wanted to achieve this month that I wrote about.  And try to spend more time with my son and my family. 

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. :)

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

***
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. :)

***********
#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.