For the past year and a half, when I am home, the best day of the week has been Monday. Monday mornings consist of outpatient orthopedic surgery that I get to observe. Because I do not want to forget how utterly grateful I am to have this experience, I have decided to record my thoughts on each Monday’s surgeries. This experience alone was the first to shape my future aspirations as an orthopedic surgeon… My senior year in high school.
– Second encounter with removing sutures today, Wednesday, these were a lot tighter than my first case. Patient was in tears… I was called upon to remove sutures from an arthroscopic wound. I got out all but one stitch out… had to get doctor to use loops to see where to cut for the final one though. This occasionally happens according to the nurse, but usually only on toes and fingers…
– I recieved FRESH SCRUBS today as well! 😀 There is something about a fresh new pair of scrubs…
Lots of conflict and bad character in the office. Computer software “Office PACS” system keeps crashing and x-rays aren’t available…. It was a real problem because everyone is on a fixed schedule, patients have been waiting a while already because of the usual delay. I finally successfully put 6 total patients in the computer, which means the doctor can come in now. I was moving pretty efficiently and I felt as if I actually did help in the clinic today.
All was going spectacular, until I was observing in on a case where the doctor had to pull out some fluid from the knee joint, an aspiration. What happened was he completely filled up one needle and then need to switch to another one. He asked me to grab a hemostat.. I DIDN’T KNOW WHAT THAT WAS…. I just froze and didn’t say anything.. thankfully I called the nurse right outside the door and she helped. I love learning lessons.
Also, I learned how to correctly set up a cortisone injection today from a
guy doctor named Dan. Let me speak a little bit about Dan:
Dan is a respectable 40 year old man who starting working in the clinic over the Christmas break I was home from school this past year. I had heard a few sarcastic rumors about him and his personality, but I quickly threw those aside. I figured out Dan was a recent graduate from a Caribbean medical school that did not match to a residency program. Now I heard of this kind of problem happening before, through my vast amount of podcast listening, but never thought I’d meet a constituent. I learned about his past as a biomedical engineer who graduated from Florida State and became a chiropractor. He was a chiropractic for 10 years and decided “it was a joke”. He said the patient is not getting able to experience the full scope of clinical healing. I wish he elaborated more on this subject but he did not.
I learned most of my training through Dan this summer when I came to work at the clinic. It turns out he had matched to a family medicine residency program in South Caroline and would be leaving at the end of the week! I know how down he must have been after graduating from a Caribbean medical school and not matching. He gave invaluable advice for my medical education journey… how to think about cases, how to study, and, most importantly, how to form my own world views. Dan was the most extreme libertarian I have ever spoke to and I will not forget rigorous lunch debate on climate change, among other things.
Good luck Dan!
Having the job title “Nurse Aid” does not qualify one to perform many roles in a clinic. I discovered this last week during my first week on the job. My main tasks consist of filling out patient charts with their vitals, past medical history, etc. (everything patients fill out in the waiting room). A harder and more difficult task is actually going out to the waiting room, calling the patient back, and setting up their file in the computer so when the doctor comes in he or she can directly input feedback and diagnoses. Thinking about doing this, it does not seem to be difficult task at all. Quite the contrary, no patient has the same history and physical. Every patient has a different template on this computer software (the digitization of medicine can be saved for a whole separate post!). Unexpectedly, I have had to take notes to go home and study them that night. If any other health care employees are reading this they know there is no time for inefficiency in the workplace. Doctors are constantly multitasking; there is an art to it, really.
I wanted to specifically write about my experience taking out sutures yesterday. The clinic was running behind (unfortunately, very commonplace) and there was patient in a room who needed his sutures out. All nurse and MAs were busy so the nurse asked me if I felt comfortable doing it. With an immediate yes I grabbed a suture removal kit and got down to business.
No I have never had any physical contact with a patient before. The closest I have gotten was holding a fresh cast in place for five minutes while waiting for it to harden and mold. However, I dived into a pair of gloves and took out the sutures on this man’s post op. knee arthroscope surgery. Eight sutures total from the two puncture holes all came out flawlessly. The nurses now have confidence in calling me to assist with suture removals.
As the first week of my new job comes to a close, I just wanted to share quickly my experiences. I wrote previously about Monday and Tuesday in the previous post. Wednesday and today have felt like a whole, brand new experience though. Yesterday, the manager of the clinic had me fulfill a role that was needed for efficiency. I had to direct patients to the X-Ray waiting room because the set up of the clinic is a maze. I also made facesheets for the new patients of all the doctors working. Needless to say I felt very productive and needed. I tried to construct the patient’s charts as thorough as possible when entering in their information for safety purposes. EVERY LIFE ASPECT IS CONSIDERED WHEN THE DOCTOR MAKES A DIAGNOSIS! I made sure I did not forget anything.
Today I worked a full 8:00-5:00 shift. Today was unique in that I finally got to experience some more patient interactions while periodically following the doctor into the rooms with the patients. At the beginning of this week I realized how much more interesting medicine is when you are solving the patient’s problems; not entering the patient’s problems into a computer. The patient’s cases were very fascinating today too. I saw a variety orthopedic problems ranging from a severely infected ingrown toe nail to the oh so common lubricating and cortisone injections.
This is where the ultrasound picture comes into play. I was setting up the ultrasound for the guided injection and forgot the gel that needs to be applied to the head of the ultrasound for reading. The doctor said, “Austin, where is my Goop?” I had the biggest smirk on my face and barely contained my laughter. Among all words he chose “goop” to describe the gel. I bet he is picturing this in his head..
I do not know why this was so funny to me. He also calls it “Juice” occasionally, which also cracks me up. The smallest things throughout the day make all the difference.
My first year of college flew by. I could not have asked to end with better marks in all of my classes. The social aspects of my first year, however, area different story and I will write about them in another post.
I finished spring finals about two weeks ago and have really just been lounging around the house. One of the best parts about this was being able to catch up on my leisurely reading that I do not like to do during the school year. For example, I have already read half of the 600 page biography written by Michael Bliss- Harvey Cushing: A Life in Surgery. Among other readings, I have also been trickling some MCAT studying, reviewing topics I have now learned from my General Chemistry and Biology courses.
Today though I start my SUMMER JOB. I do not want to call it a job though because I have aspired to work here for the past two years and do not want to think of it as an obligation. I will be an MA at a local orthopedic clinic that I have been volunteering and shadowing with for the past two years. I am anxious to see how I can contribute to the team today. I will report back tonight with the day’s training and work!
Worked from 8:30-5:25 in the clinic today. I am so thankful for getting paid to do a job that I love! Of course, with work comes responsibilities, and these responsibilities took away the time I usually got when I shadowed the orthopedic surgeon there. I much like the problem solving and diagnosing a doctor does compared to clerical work. The paperwork and charts make for a confusing system. I don’t know how great the outcomes would be but I for one would definitely strive to make the office completely paper-less. It is much harder to put into action than it seems I suppose.
Overall, a GREAT first day and I look forward to becoming more efficient.
The past two weeks have contributed to a solid start of my second semester in college.
The first success I want to report on though was a change in my diet. Actually, this new “diet” I adapted is more of a lifestyle change. I started up on the Bulletproof Diet a week prior to going back to school. I wanted to make sure my body LOVED it; without a doubt it DOES!. The main focus of the diet is to eliminate the toxins and molds (mycotoxins) that are everywhere in our food. It is a high fat, medium protein, low carb diet. The science behind it is phenomenal and I would recommend it to anybody trying to enhance their vitality beyond the norm.
After three solid weeks of eating “clean” I have found a considerable amount of energy while going throughout my day studying and engaging in class. I will write a whole separate post about my experience with the Bulletproof Diet on another post.
The second success I want to report on is my study habits. Beginning this semester with 17 hours: Chem 1212, Biol 2107, US Hist, Eng 1102, Precalc, I have kept my focus on my academics and leadership, forming study groups and being on the committee board of my school’s Relay for Life team. Also, I have started volunteering at my local hospital in the Ortho Clinic. I absolutely love the diversity I see here in Atlanta.
As I was shadowing in my local orthopedic clinic today I heard a pretty respectable remark from a patient. Actually, it was a patient’s dad. The patient happened to be a high school boy who was extremely athletic, particularly with basketball and football. We ended up treating him for shoulder tendonitis. Shoulder tendonitis can be treated conservatively and is pretty easy to recover from, HOWEVER, the parents deemed it career threatening. They insisted on any kind of surgery to make sure his shoulder was normal and he would be able to continue sports. I love concerned patients who want to know every aspect about their diagnosis and I respected this boy and his parents.
In disregard from clinical work, I took away a meaningful paradigm the patient’s dad told as they were leaving. During the clinical examination the boy exclaimed the pain originated after doing a “hitting” drill in football. The P.A. said she was unfamiliar with football alongside with most other sports. The only sport she’d ever done was diving in college. The boy’s dad remarked, “You can’t make a cake without the ingredients you know.”
I knew exactly where he was going. We are supposed to be orthopedic specialists, specializing in the musculoskelatal system and sport’s injuries, and most likely having first-hand experience with athletics. I felt for my P.A. because she is great at her job, but I do agree with the dad in saying the professional should know where the patients are coming from. Presumably, that’s why I love learning and shadowing orthopedics. I grew up playing competitive baseball for thirteen years, ran cross-country, and am still an avid weight-lifter. From now on I am going to make sure I have the right ingredients, no matter what kind of cake I’m making.