Stephanie Burke
at
Saturday, November 07, 2015
I was on the
inpatient hematology/oncology service this past rotation block. The experience
was more than I anticipated! As my first intensive patient care rotation, I was
slightly (i.e. terribly) intimidated by the thought of enduring five weeks on
such a demanding and challenging service. Fast-forward a bit: I survived! It
took quite a bit of adjusting to the therapeutics of the rotation, but by the
end, I felt fairly comfortable managing my patients on the floor. I arrived at
the hospital early each morning and some days stretched pretty long. My daily
routine involved working up patients for the day, rounding with the hematology
and oncology teams, following up on patient needs or physician questions, and
finally topic discussions with my preceptor and PGY1/2 residents in the
afternoon. Overall, it was a well-rounded learning experience.
My favorite
part of the rotation was working with hematology patients. I learned the guidelines
for managing acute myeloid leukemia patients, lymphoma patients, and patients
with neutropenic fever relatively quickly. I always felt on top of the needs of
my patients; monitoring their renal function, need for
continuation/discontinuation of anticoagulation, antibiotics or antifungal agents,
drug levels, etc. I had an impact on the health of my patients, and even if
they only had a week or a month more to live, I was going to do everything I
could to ensure their last days were comfortable. This was the hard part of
heme/onc – many patients did not have much longer to live. I remember my first
week on service standing with the medical team in a patient’s room. The patient
was dying, completely incoherent and unable to communicate effectively with us.
As the attending began the conversation about home hospice care with the
patient’s spouse, the spouse appeared okay, taking in this difficult news.
Then, he was not doing okay and began to cry. As we all stood in silence with
our heads down, the attending comforted the spouse. It was my first dose of
reality in the world of the sick and dying. This aspect of the rotation also
took some adjustment. Many of our patients were sick and dying. But, as my
preceptor reminded me, the patients we saw in the hospital were only a subset
of all the hematology and oncology patients outside of the hospital who were doing
fine.
This rotation
challenged me in many ways. Professionally, it challenged my knowledge and understanding
of therapeutics and pathophysiology. Personally, it challenged me to remember
that each day is a gift, and even in the toughest of circumstances, one can
still find joy and hope. It takes a special person to work on the
hematology/oncology service. Some days it was a lot to handle, but if nothing
else, remember your patients. Some are fighting for their lives, and you need
to do your best to help them in that fight.
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