5:55 am - alarm goes off. Today I'm rounding on patients at the hospital with my substitute preceptor, so I wake up earlier. My preceptor is on vacation so for the time being, I'm rotating with an attending who also works at my preceptor's practice.
6:15 am - I finally stop hitting snooze and roll out of bed. I clean up and then go to the kitchen for some breakfast. Today it's a cinnamon bagel with honey pecan cream cheese and instant coffee. I eat the rest of my breakfast (usually a banana or a kind breakfast bar) on my way to the hospital so that I can sustain myself until after rounds.
6:35 am- Get ready and grab my lunch and snacks. The last 2 weeks I've been good about meal prepping so I already have a salad packed and ready to go. For snacks I have a greek blueberry yogurt, walnuts, and a protein bar.
7:00 am - Out the door and on the road. I live about 17 mins away from the hospital which is in downtown Nashville. Rush hour traffic is the worst part of my day so I leave a few mins early to make it to rounds on time (which we start at 7:30).
7:32 am - My attending and I both were stuck in traffic that morning so I was a few mins late, otherwise I can get there by 7:25. My attending made it there around 7:55 so I spent my free time people watching and taking pictures for y'all.
8:00 am - we had two patients to round on today. One of them is on the floor and one in the MICU (medical intensive care unit). This week was my first experience in an ICU setting and I learned so much about ventilators, feeding tubes, and coordinating with other providers taking care of the same patient. Although I wish I could tell you more about what was going on medically, I have to respect patient privacy and make sure to not violate HIPPA.
8:45 am - once we round on the patients, we go back and put in any orders we need to, do our notes for the day so the next provider knows what we did, and talk to the nurse taking care of the particular patient to make sure everyone is on the same page. We discharged our patient on the floor and my attending actually had me do the discharge instructions. Even though he basically told me what to do, I felt like such a boss ;) Jokes apart, it felt great to be actually useful and play a small role in the care of one of our patients.
9:00 am - we are done rounding and don't have our first patient till 10 am at the clinic. I take this opportunity to stop by at Starbucks on my way to the clinic and grab a nice hot white chocolate mocha. I was able to get in about half an hour of studying while waiting for our patients to start coming in. Every minute is so precious it seems.
10 - 12:20 pm - we see our morning patients. I get to go in and get the HPI and do a focused PE on a few patients. Then I come out and present to my preceptor, tell him my assessment and plan, and we go back in to see the pt together. Something new I've tried this rotation is to log patients as I go (for my school) so I don't have a lump sum to do when I get home that evening. I've been so grateful for my iPad this month and am definitely glad I made the investment. I use it to study at clinic and or at home and also to log patients. It's so much easier to grab it on the go.
12:20 - 1 pm - Lunch time! Today I had a salad with lettuce, carrots, tomatoes, eggs, chick peas, and balsamic vinaigrette. I try to rest in my car for a while before seeing afternoon patients. We usually have drug reps come and bring us lunch but I try to eat healthy and avoid eating outside food everyday. I have broken that rule twice when they bring us chili's though ;)
1 - 4 pm: more patients, more charts, more of everything. This afternoon was so crazy busy that I didn't get a chance to sit down for a second, except for the time I was getting the HPI from patients. My preceptor and I review the X-rays we took for the day as part of physicals so he can sign off on them.
Side note: the cool thing about this particular practice is all the imaging and testing interpretation I get to do. They have their own X-ray and DEXA scan, do EKGs for physicals and any acute complaints, and have an ultrasound tech come in twice a week to mostly do echos and any other study that needs to be done. I've seen a lot of hearts, carotids, and gallbladders on ultrasound so far. Recently I my preceptor also taught me how to read a thyroid US (hardest one so far for me, I still don't know what I was looking at).
4:15 pm - today I got to go home a little earlier since we got done with patients early. The drive home was not quick though since rush hour traffic likes to suck away all of my free time. At least the view on my drive back was pretty.
5 pm - shower and clean up. I grab some pretzels and hummus and watch an episode of Fixer Upper to wind down before I start studying for the EOR exam coming up in a week (eeeekk).
6 - 7:30 pm - Tonight I am finishing up the critical care section and starting the endocrine section on the PAEA blueprint for EORs. I have been using my lecture notes in addition to PANCE prep pearls to study for this EOR, so I'm interested to see how that turns out.
7:30 - 8 pm - Dinner time. I also take this time to catch up on emails, phone calls, texts, etc. that I haven't had a chance to respond to all day. I finish up logging patients in since the afternoon got crazy and I didn't get a chance to do so.
8 - 9:15 pm: some more studying, interrupted by checking all sorts of social media. I spend some time taking a 20 question quiz on TrueLearn, a requirement by our school during rotations (110 questions per rotation). I try to study a section and take a quiz on that to see what I need to work on more. Thankfully this time around I've been getting better scores than during my family med rotation.
9:15 pm: Tired and brain dead, I walk away from the books and call it a night. I spend the next half an hour or so getting my life together for the next day and get ready for bed.
9:50 pm - lights out! Early morning tomorrow as we still have patients in the hospital to round on.
I hope you all enjoyed reading about a typical day for me on my internal medicine rotation. If there are any questions or you'd like more details about something in specific, please leave a comment or feel free to email me!
Day in Review
Hours worked: 9
Total patients seen: 12
Patients seen on my own: 5
Hours studied: 3
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Love this post! I am looking to try to get into tutoring for A&P and was linked to your blog that way, but I am going to be reapplying to PA school this next cycle!
ReplyDeleteAre there any specific resources you used, or would suggest, for the "critical care" portion of this EOR? I'm currently on my Internal Med rotation at a rural hospital that does not have an ICU and transfers all of their critical care patients to other hospitals. So... I'm pretty nervous about how that portion of the exam will go.
ReplyDeleteI didn’t see any of this on my IM rotation either. I just used Pance prep pearls and my lecture notes to prepare for this portion of the topic list and I felt like I was able to do well on that portion of the exam with just those resources. You can also use case files for internal medicine as that will walk you through cases and then give you practice questions at the end of the chapter. I didn’t use it for IM but I did for some of my other rotations and case files was super helpful!
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