First three shifts - and Happy 4th of July

Finished what I expect to be the hardest shifts of my career. Sure, the first few shifts as an attending will be stressful and chaotic, but at least I'll know how to help patients.

These first three shifts were crazy because you know no one, the computer systems and hospital processes are foreign, and you really don't know that much medicine (especially since each institution does things a little different).

However, the three shifts couldn't have gone any better. The Attendings were great; helpful, respectful and proactive teachers. The staff is very nice, while I feel like I hardly had a chance to get to know them. And it's all electronic, so there's very little written charting.

The best part is that I'm gaining a reputation already as the procedure guy. The first night I did a nice I & D, then an external jugular central line, then a three layer closure on a lip laceration. The second night I intubated a patient, then did a foreign body removal from a cornea (metal shavings). The third night I did a lumbar puncture. The procedures all went smoothly and were very confidence building for me.

The only thing I haven't done, and that I need practice on putting in plain old IVs. I plan on getting some practice this week, along with getting better charting on the IBEX computer system. The last night I was managing up to five patients at once, or trying to. It's hard to make sure everything is progressing on each patient while keeping up on charting and everything else. I missed that one patient's CT was delayed and one patient's blood draw kept getting messed up. Each situation resulted in two hour delays.

My feedback from the Attendings after each shift was very positive. And I think I learned a lot. It also gave me incentive to read up on patients cases and study more. One case may end up being my case report for the year. An elderly lady came in with a supposed drug reaction, but ended up having encephalitis! Some permanent synaptic connections were definitely made working up that patient.

I have today, the 4th of July off. The family and I went for a long walk with the dogs at a nearby park. We're trying decie if we should go see any firework shows since the clouds are low and threatening to rain. The walk was good exercise, and let me recover a bit from the last week of running, weight lifting and swimming. I'm a bit sore but happy to feel the body getting back into shape.

I guess I still don't know what to expect for the first week. But I do feel my first week has gone very well. I'm getting a little confidence and feeling confident telling patients or consulting specialists I'm one of the Residents. I couldn't have asked for a better start to residency.