Saturday, September 29, 2012

This Is Why I Am Here

Sometimes with the long lectures, complicated topics, and the late nights in the library I forget why I came to medical school. Today I was reminded the reason why I am here. I woke up this morning at 7am, which is early for a Saturday morning. (I am sure in 2 years during surgical rotations, were you have to be dressed and ready at 5:45am, I will relish the days when I can sleep in until 7am.) I dragged my feet out of bed, down the stairs, and to my car to head over to Camden Clinic.

Camden Clinic is a UMDNJ-SOM medical student run non-profit clinic. Camden is open every Saturday from 9am until 12pm. We primarily do physicals but from 11am until 12pm we do acute care, were we see minor illnesses and injuries. We have one attending physician, two or three upper class students and two or three first and second years. The first and second year students pair off with third and forth year students to do a primary evaluation. 

Camden Clinic
Today I was so excited to go in, other than waking up early, this opportunity reminded me of volunteering at the Suitcase Clinic at Berkeley. I had such a great time volunteering in Berkeley that I was excited to be able to give back to the community in New Jersey too. 

Due to HIPAA regulations, which I just re-read just so I don't get in trouble, I cant disclose any patient information that can reveal the persons identity. So I will vaguely talk about what I did, how I felt during my first day volunteering. 

First off it was amazing. My first patient spoke little English, so I was able to practice my medical Spanish. I was so excited that I was able to use my skills to help the patient verbalize her concerns to the doctor. The patient was so grateful that we formed a very strong patient- care-provider relationship. She was nervous at first due to the language barrier but being able to translate for her made her feel more comfortable in the doctors office. 

Other than speaking Spanish, I was able to perform a physical examination on various patients. The third year I was with was very knowledgeable and she gave me the opportunity to perform many of the tasks on my own. She said "If your comfortable, go ahead."

I was able to take temperatures, blood pressure, respiration rate, and heart rate. Listen for heart sound, lung sound, and bowel sounds. Perform cranial nerve tests, ear exam, throat exam, lymphatic exam, eye exam, scoliosis exam, reflex testing, testicular and groin hernia exam. Some of the exams that I did were for the very first time. Many of the tests we learn in lecture but its when the attending doctor asks you to listen to the lungs at the second intercostal space and feel the sub-mandibular lymph nodes, and you think, yes I know how to do this, that feeling of understanding at a higher level excites you. 
I know I look very Scary

The third year I was shadowing was writing the SOAP(subjective, objective, assessment and plan) notes, because you know us doctors we love acronyms, while I was dictating to her. She would say can you check for scoliosis? Which I have seen done, but never done before, and if you know me I am up for anything. I had the patient lean over ran my fingers down his spine. "Looks good to me, want to double check?" She looked up for an instant. "Yup looks good." she replied in an instant. I am so excited that in two years I will be ask quick as her. 

Other than working on my clinical diagnosis skills, I also was able to work on my people skills, which I find very important in medicine. I am sure everyone has experienced White Coat Nervousness, now that I have the white coat means that its my turn to make people nervous, but its the personable attitude of the doctor that helps relax the patients. Volunteering for a place like Camden Clinic give me the opportunity to use the knowledge I learned in class and help people feel better. 

Monday, September 24, 2012

Knock, knock who's there?

Today I had my first standardized patient exam. This is when you walk into a mock doctors examination room with a real person and you have to treat them. Today we just found landmarks on them which was not too bad. (I am not looking forward to rectal exams next year.) But it was very nerve racking going into a room where you are watched through a one way mirror and recorded.



From inside the space station aka SPL
When I arrived at the Standardized patient lab (SPL) we were briefed on our mission, to palpate anatomical landmarks and then send into this space-station like room. It was a dark long room with desks facing windows into an exam room. In front of each window is a doctor or nurse wearing headphones typing at a computer. Inside every room was a real person.

Door 10 they told me, I made my way over to door 10. They woman at the station gave me and sanitizer and told me "Whenever your read." I looking into the window to see my first standardized patient. Male, mid thirties, fairly in shape, tall. I thought, ok this wont be so bad, but I was still nervous and my hands were shaking.

I looked down at my shoes and took a couple deep breaths. Knock, knock. Its the first thing you must always do when your entering an exam room. I heard the mans voice from within the room. "Come in." My heart was racing, well its now or never, I opened the door to my very first patient.

All in all it went well. I didn't get any questions I did not know, and I was well prepared. When I was palpating him my hands were shaking still, I wonder if he noticed. It was not as bad as I was expecting. Although I didn't forget that the widow was there, I did grow in confidence the longer I was in the room. I left the room feeling satisfied about my first patient encounter. I wont know for at lease another week how I scored, but at least I didn't faint.