Wednesday, June 29, 2011

The July Effect

July First is Friday. That means I will be responsible for the health of children other than my own in two days. Good thing I've had eight months of practice with my own son.

There is always a lot of talk about how it is most dangerous to go into the hospital in July. You can find a lot of articles like this one from USA Today or this one from Newsweek that talk about patient deaths attributed to new residents in July. The basic idea is that July 1st is the start of a new academic year. All of the medical students are new, all the interns are new, the second year residents are really just interns +1 additional day, the attendings just graduated from their own programs, etc etc. [The attending doctor is the fully trained, supervising physician/professor in charge of the residents & students.] When you're new (and nervous) you make more mistakes, and theoretically that translates into worse medical care.

Should you really be scared to go to a training hospital in July?

One thing to remember is that the supervision is assuredly stricter in teaching hospitals in July. From what I hear from those that have trained before me, supervision in medicine, in general, is more strict now than it was years ago. There are more regulations - like duty hour regulations, and documentation regulations - than ever before. I have had attendings and preceptors tell me that they moonlighted [were paid to be work overnight] in their training ... as medical students! Interns are just not thrown in the way they once were.

The nurses are also not new in July. Some nurses have been working the same unit for many years, and frequently know more than the doctors that are taking care of the same patients.

If you go to a teaching hospital, you have multiple health care professionals evaluating you. If you go to a private hospital, you have the nurse calling your doctor, who comes in to see you at some point. (Or a hospitalist sees you instead.) That's about it.

I also looked up the study that the above mentioned USA Today article cites. There are multiple flaws with the study. The study only can show correlation of patient deaths in July, not causation by residents; the data is based on previous years where reporting may not have been as strict; only one type of error is evaluated, etc etc.

I don't think that overall medical care is worse in July, but I am going to guess it's slower. A lot slower.

Bottom line: all of the new pediatricians are going to be awesome. But you may want to avoid all those new surgeons ...

Sad News ...

My calculation of days left until the end of residency is off by a hundred. So much for triple digits - we're still well into the quads. Oh well ... I need everyday of practice that I can get!

I also found a more accurate countdown ticker (posted on the right side of my blog) - but it only goes into the triple digits, so just add 1,000 to the number.

Monday, June 27, 2011

Today's a Great Day!

Why? Two reasons:

1. My husband and I celebrated our two year anniversary today! We had a nice dinner out, followed by a nice jog together. (Had to burn off all those calories we consumed.) Baby came along too. He was exceptionally well behaved.

2. 999 days until July 1st, 2014 - the end of residency! Triple digits!

I hope everyone else had a great day today too.

Also, if you read my husband's blog, you will find that it is amusingly ironic that I had a suturing review course today.

Sunday, June 26, 2011

The Name Game

Yawn, it’s late. The baby hasn’t been sleeping well this week, and I’ve been trying to do EMR (electronic medical record) training modules and study neonatal resuscitation after he goes to bed. It’s been quite challenging so far to find time at home to study. I’m hoping that the amount of things I need to do at home lessens, or that I get better at it. It must be very difficult to be a work-from-home parent!
Time is going to be hard to come by. My goal is to write a post twice a week on lighter rotations, and once a week on more difficult rotations. Writing is a valuable activity, and it’s definitely a good outlet for me.
This week was exhausting, but I think it went well overall. The husband and baby had a cold, but we all made it happily through the week. Going back to work is a difficult transition, but I knew that it would be long before it was here. Though challenging, it’s going as smoothly as possible. I’m very thankful for that!
I feel like writing about something light-hearted tonight.
Today I was thinking about how ridiculous I sound when I communicate with my son. Why do adults speak baby talk when communicating with infants? I don’t even realize that I’m doing it half of the time; I’ll catch myself (or a stranger will stare at me) talking nonsense and jumping up and down in the aisles of Target while shopping with my son.
Even the nicknames we have for our son are embarrassing. Our boy has acquired a disproportionate amount of nicknames in his short life, including (but not limited to)
babymon (it started as babyman - I frequently call my husband “dadmon”) the mons (also used to talk to my husband and son collectively), monsies (currently our fave), babes, bug, bean, bear, dude, the dude-ist, munch-munch, munchies, chubs, chubski;
There are also some nicknames we use only in certain situations: snoozy McSnoozerson (snoozy for short), crab crab, crab cakes, sneezy McGee, nude dude, splashy … the list goes on.   
Most of the inanimate objects in our house have names too, but I’ve already over shared enough for today.

Edit: I thought of some more nicknames we frequently use, based on the baby's hairdo: spikey, flatty, flat-head. I'm sure I'll think of more later.

Tuesday, June 21, 2011

Time is free, but it's priceless

When I was a medical student, I frequently lamented about how little free time I had. (Medical professionals like to complain/brag about how hard they work.)
I now realize exactly how much free time I actually had.
Yes, I had rotations where I worked long hours, but whenever I left the hospital I was completely on my own schedule. I could nap if I was exhausted, I could go to the gym on the way home, I could watch 45 minutes of television if I just wanted to relax.
Now that I have a baby, time has a completely different meaning. Time is a precious commodity that I just can’t get enough of.  Even when I was home with the baby full time I barely had enough time to keep up with the necessities. Babies demand 100% of your time. ALL the time. Having a baby means you’re on baby’s clock. ALL the time. There really is no “spare time” anymore.
One thing that having a baby taught me is time management. I was always an efficient, time-conscious person, but now I am a time efficient machine. I can do laundry, cook, make phone calls, pick-up toys, answer emails, and pay bills in a single 45 minute nap. My study habits are amazing, just because I know it’s now or never; there’s no more “I’ll do it later.” I rarely procrastinate.
One thing that bothers me now is wasting time, especially if I’m away from home. There has been a lot of down time during our orientation – a downright excessive amount. We could have cut out 4 hours of down time yesterday. It kills me! I understand that I have a lot to learn while I’m a resident, and that means I have to be away from my family. I am (mostly) okay with that; now is the time for me to learn how to be a competent physician. I don’t want to sit around though. Making hours of small talk with people I barely recognize is even more painful now - I would much rather be with my husband & son.  My time is just too valuable to me now.
I frequently worry about how I am going to cram a lot of living in a little bit of time over the next few years. But now is not the time for worry; it’s time for bed. My husband always reminds me that time for sleep is important too.

Saturday, June 18, 2011

Pre-Orientation Orientation

It is time to finally post an introduction. Sorry to the 36 visitors that I've had before this first post.

I am starting this blog as I am going through a major transition in my life. I have spent the last eight months at home, raising my son. (He was born 10/10/10 - my husband and I like to think we hit the baby jackpot.) Before I was a stay-at-home mom, I was a medical student. Long story short, I took a year off between medical school and residency to take care of my son full time while my husband continued to work.

It has been the most challenging and rewarding year of my life. More of that story will be told later.

 I start my medical residency in pediatrics days from now. My husband, an attorney, just left his job to become a stay-at-home dad while I complete my medical training. Why? It simply is what works best for our family. Well, we hope it is what will work best for our family.

We started the transition into our new lifestyle this week. I had what I like to call "pre-orientation orientation" at work. I spent half of the week at work, training in pediatric resuscitation. Of course, I started my triumphant return into medicine with a bang. When it was my turn to be code leader, the [fake] patient died. What a start back after 13 months off!

My husband and my son seemed to have a great start this week. My son was his normal, happy self with his dad. That was a huge relief. My husband went above and beyond his instructions to "stay alive until I get home" and had a good time with our kiddo. That was also a relief. I struggled a bit more as 1. I have spent the past 8 months reading "Quack, Quack!" and not studying medicine, and 2. I whole-heartedly missed being with my son.

That brings me to the point of this blog. I hope to use it as a tool to help me balance the many aspects of my life. The next few years will be overwhelming difficult, but they also will be overwhelmingly rich. I am blessed to have the two best jobs in the world - taking care of my child, and taking care of your children. I hope you'll stick around as I try figure out how to best take care of my child, your children, and myself! (And maybe my husband too.)