NICU redux

I spent a month in the NICU as an intern, and it was probably the best month of the year. I'm back in the NICU and while it's mostly enjoyable (dealing with the ill neonate, preterm births, adjusting ventilators) the hours are grueling. Now I'm in the step-down unit, which is a bit like the nursery, my least favorite rotation of the intern year. I'm in the process of attempting to switch to anesthesia again.

Exhausted

The month in numbers:
Average hours worked per week: 79.5
Longest shift worked this month: 27.5 hours
Days off as of now that aren't post-24 hour call: 1
Hence, the time on the sofa with the tv remote and the cat...

Finally going to Haiti

Ever since I read Mountains Beyond Mountains, which was before I even went to medical school (and may have been an inspiration to do so), I've wanted to follow in Paul Farmer's footsteps and do medical work in Haiti. I've been learning a bit of Creole with a book and Pimsleur in preparation for the trip which begins tonight. I fly to Miami, and I'll spend the night in a nearby hotel, then fly out pre-dawn to Port-au-Prince, where I'll spend the week in a very busy hospital. Lopital Bernard Mevs is part of the ongoing rebuilding efforts, and I'm going with a team from Project Medishare, coordinated by the University of Miami.

Last ward month as an intern

I can celebrate the end of the year of the intern. Now instead of asking for all the patient education, running around getting pieces together for followup, and doing all of the paperwork necessary for discharge, I can focus on the overall care of the patient, making more decisions, and teaching the new batch of interns. I had two months of inpatient service in a row, and it's pretty exhausting and grueling, but actually rather fun when you have the right bunch of people to work with.

Now the studying begins

As I approach the end of my intern year, and found out that I passed Step 3 of the USMLE, I can focus solely on pediatrics. The standard reference text is Nelson's, which is several thousand pages packed with essential information. I have two more years to study at the end of each day, and need to master this and pass the Pediatrics Boards.

European holiday!

Dr Bones is off for a couple of weeks R&R in sunny Europe during the springtime. Hopefully when he comes back, he'll be refreshed and once again full of enthusiasm for doctoring.

Conference in the Big Apple

I attended the ACEP/AAP conference "Advances in Pediatric Emergency Medicine Assembly" at the Hilton in Midtown Manhattan. It was great to first of all get away from the hospital for a few days, but also to hear some inspiring talks, meet people who are living life post-residency, and get ideas about future research projects. It got me working toward a QI project, using Twitter more effectively, and also thinking about my life post-residency. I used a video laryngoscope, which brought back memories of enjoying going to work as an anaesthetist. So I thought again about applying for anesthesia residency next fall. But the idea of doing another residency sounds too daunting, so fellowship might be better. Peds Emergency Medicine would be great in many ways. I also found out there's a 1 year unaccredited "fellowship" in Urgent Care for peds, which grooms the candidate for work in their clinic.

It's a madhouse!

I'm on a child psych inpatient unit for the month, and there are times when the kids are shouting, banging, fighting, cursing, throwing things, and I think to myself "It's like a madhouse" and then it dawns on me the veracity of that flippant comment. There are these buttons in each room, which call different sets of very large men to help control situations that are totally out of control. So far, I haven't been injured, but I have another week yet...

And the voice said...

And the voice said: Neither snow nor rain nor gloom
of night shall stay these couriers from the swift
completion of their appointed rounds. --Laurie Anderson, O Superman (for Massenet)

A second snowstorm has hit NYC this winter, first Hercules then Janus. Both times a state of emergency was declared, and work hours restrictions were suspended. This however had no effect on us, as everyone made it to work and home and back again without issue. I was on night float during Hercules, and worked 14-15 hours a night, and that was for 6 nights a week, so I can't imagine how working longer hours would have felt. Good thing night float only lasted 2 weeks, otherwise it would be easy to enter burnout territory. 

Night float

Night shift starts at 5pm and finishes after morning sign out. Sign out starts at 7am and the longest it went on for was til 8:10am, though usually we'd get through it by 7:30. Either way, it makes for a very long night, and doing that Sun-Fri night makes for a very long week and very tired Bones. Coke, Pepsi, Emergen-C, junk food, and hospital food kept me going, and Seamless deliveries helped a lot too.