Tuesday, October 1, 2013

It's The Little Things

It's the little things that make the days worthwhile. Medical school can  be tough on the psyche because there is so much pressure and a big push to be perfect, to get everything right. Sometimes you don't get a whole lot of feedback and you are basically clueless how you are doing and what other's think. More than half of your clinical grades are based off of people's opinions and sometimes it is hard to make an impression and even harder to make a good impression. While other students fight this by being very assertive, I have never found that to be my strong suit. So when I'm drowning in stress and worrying about what people think it is the little things I count on. It is the little things that tell me I am doing the right things and on the right track.
Originally when I was thinking about this post I wanted it to be all about 1 simple statement a family made to my attending my last day of inpatient pediatrics, but then sitting down I realized throughout the month there were several times where I felt good about where I am in my education. I think the first statement was made by a nephrologist. During my first week of speciality team, I only saw endocrine patients for several reasons, but when given the opportunity to see a nephrology patient I was hesitant. The renal attending for whatever reason intimidated me. He seemed more formal and I thought it was much more likely I would "fail" seeing one of his patients then seeing one of the endocrine patients. I remember after I saw my first nephrology patient I was nervous about presenting and not knowing the right answers. By this time I was comfortable with my residents who I loved working with so that helped with the confidence level. I felt like I really clicked with the family and had a good rapport with them so that also helped. After I gave my presentation and was able to answer any questions he had I felt better. But it was the quick moment as we walked out of the room where he simply said, "that was very good" that made the difference. It was that moment where I felt very accomplished. A simple statement that made me want to do even better.
I continued to feel good about how I was doing on speciality inpatient rounds and by the end of those 2 weeks I felt confident in my ability to talk to kids, come up with plans, and give presentations. As I mentioned in a previous post, it was hard for me to see those 2 weeks end and part of that was because of the really good residents I worked with. I still feel like I owe a lot of my growth during this month to them making me comfortable and pushing me to progress. It was the last time that I saw my intern that was another one of "those" moments. In her goodbyes, she said "I am very impressed."Another moment where I knew I was doing okay.
Then there is the moment that inspired this post. It was my very last afternoon of inpatient pediatrics. We had a child come in with pneumonia and associated empyema who would need a chest tube for drainage. I went in first to talk with the family, get the history, and see how the little one was. The child was obviously uncomfortable and the family was very concerned. They had lots of questions and requests. It was very touching to see a room full of people who clearly really cared about this child. I answered all the questions I could and assured them I would get the answer to any of their other questions. The first thing I did was ask the attending to put in orders for some of the parents requests to get the ball rolling. After a quick presentation, a couple of phone calls, and entering some orders, the attending and I went in to see the family together. It was a nice moment when she told the family the same kind of thing that I told them. It made me feel like I had given them the right information and was on the same page as the attending. But the big moment for me was as we were leaving, the father said, "I just wanted you to know that your student did really well answering our questions and reassuring us. We felt a lot better after she came in."It was a moment of encouragement. I had given accurate answers, said the right things, and made a difference in the care of my patient. It is moments like this that make me want to work harder, to learn more, to be more. It is moments like that where all the stress, pressure, and exhaustion are worth it.

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