The Long Road Ahead

Orientation week 1

Today we continued orientation, which we started on Monday. We started off by learning a few abnormal heart sounds, using our simulation dummy HARVEY. In addition to emitting heart sounds from his chest, HARVEY simulates pulses and I’m sure does some other stuff. The instructor was able to place the stethoscope on HARVEY and we all listened in using wireless headphone “stethoscopes.” Hopefully if I encounter any abnormal heart sounds on the wards, they’ll be that obvious, and I’ll be able to catch them.

Later in the day we went over the history and physical exams (H&P’s) we did yesterday on random patients. Though we were assigned to a ward, most of the patients understandably refused an H&P that would take up 90 minutes of their time and have no impact whatsoever on their medical care. Since it was the neuro floor, the rest of the patients had neurological deficits that would impede a nice history (unconscious, speech difficulties, dementia, etc.). I went to another ward, where four patients understandably turned me away. So then I walked over to the VA, where the patients are almost always willing to be poked and prodded by budding medical students. I’ve also found that the veterans are quite pleasant and friendly. Of course, I hate putting these patients through a completely unnecessary history and physical, though it is a pleasure getting to know them. I think once I start my rotations, I’ll be glad to actually have my H&P’s have an effect on the patients’ care.

The end of the day was interesting. Some of us, including yours truly, had male genitourinary and rectal/prostate exam training. It wasn’t as unsettling as you might imagine. Just like when I first put in a foley catheter (to drain urine), when you have a job to do, you tend to block out the apparent awkwardness of the situation.

posted by Ashish @ 1:56 AM