Monday, July 16, 2012

From Rural ICU to Inner City LGBTQ

Posted by Janis Rood at Monday, July 16, 2012

To cap up my first rotation, Inpatient Clinical - Internal Medicine:
I ended my rotation in Monroe, MI with a week in the ICU.  I really enjoyed this because I had previously no exposure to emergency medicine.  It was a challenge to take 10 to 13 patients on a daily basis, each with at least 10 complexities and go through them thoroughly.  I was able to optimize therapies for a few, uncover an adverse drug reaction in another, and even help out during a "Code Black" and "Code Brown."  On the one hand I miss that rotation because there was really very little extracurricular work, which was nice for a change.  On the other hand, I missed out on being extra stretched, which promotes person growth and development.  To be determined where the proper balance lies in this regard.

My newest rotation: Community practice with Walgreens in Chicago, IL.  Specifically, Mondays, Wednesdays and Thursdays we spend our days at the Howard Brown Clinic which specializes in serving Lesbians, Gays, Bisexual, Transgendered and Questioning (LGBTQ) patients.  On Tuesdays and Fridays we spend our afternoons at the Mercy Hospital Care Program, which serves only HIV/AIDS patients.  The one word that best describes this rotation is intense.  It's intense for many reasons:

1. The learning curve is steep.  Our preceptor grills us on everything from mechanism of actions, medicinal chemistry, pharmacokinetics, metabolism, drug interactions, first, second and third line medications for ANY given drug state, the ins and outs of all laboratory monitoring parameters, and the list goes on.  He doesn't mind if you don't know an answer...once.  However, you better go home and look it up so everyone can talk about it tomorrow.  The first two weeks are spent looking up anything and everything.

2. The range of topics is wide.  We talk about hormones for transgendered patients, antibiotics for opportunistic infections and STDs, OTC topics, etc.  While the focus of this rotation is HIV/AIDS treatment, we cover every part of inner city medical care, in addition to standard care patients.

3. The range of activities is wide.  We counsel on SubQ injections, perform blood pressure screenings, write SOAP notes, do medication histories, count pills, cashier and counsel, follow-up with new patients, create pill boxes, organize public aid deliveries, etc.  Every day we do something different that builds upon what we did the day before.  I feel that all of my brain is being used at all times.  I go home exhausted, but as stated above, I spend the evenings brushing up on old topics and preparing for new ones.

4. We still have projects and presentations.  We have weekly modules to read over, each with special cases to work up.  We've created a slide show and giving a presentation, "HIV 101," to new psych residents.  We're publishing annotated reviews of literature relative to HIV care in a newsletter.  We're creating a special project to improve clinic/pharmacy work.  In short, we always have something larger than daily work to complete.

While this rotation is a ton of work, completely exhausting, and keeps me away from my husband, friends and family, I really enjoy every day.  This is the type of work I want to do.  I love the interplay of community practice with patients from a constantly clinical perspective.  I thrive on daily tasks that I gain satisfaction from completing, yet have longitudinal projects that keep me motivated.  I like the daily variety, the breadth of topics, and the depth of impact we have on each patient.  I have two weeks left, and I am already sad thinking of leaving.  Here's to an amazing rotation that continues to surprise me, expose me, grow me, and prepare me for what's ahead.

No comments: