INTERSHIP IN MEDICINE AND PROCEDURE PERFORMED
I am M. SREEJA an intern in department of General Medicine posted from October 1 to November 30
From October 1 to 15, I was posted in periferals
1st-5 th of October ICU
On the first day of Medicine posting I was posted in the ICU. All I did was monitor the patients who were in a critical state. It was the most important part of patient care and I was making sure everything was as good as can be. In the afternoon at lunch a nurse and an attender came rushing in informing me of a patient in the CKD ward who was unresponsive. Immediately I rushed into fight mode, called for help and shifted her to the ICU, I proceeded with chest compressions with guidance of my PGs, for 30 minutes. We intubated her on time. Sadly we couldn't revive her. She was a day care patient who has completed her dialysis and was about to go back home. One minute the patient was fine and the next minute she was gone. It was an awakening of what my role was for the next two months.
The second day was filled with putting in ng tubes. I experience a complient patient who just let me do as was good for his health and a noncomolient patient who was unresponsive and when responsive would try and remove all manner of tubes and wires attached to her. that was a slow but challenging day.
Third day I was hungry and excited for lunch. But during my final check of vitals for that shift one of the patients charted a bp of 120/80 and after finishing the rest of her patients her monitor indicated her pulse falling. her bp at that moment was around 50/40, pulse was not palpable in the next minute. we fought with her for the next 45 minutes trying to bargain for a bit more life for her. But it was of no vain. I didnt know this then but nephrology cases were the most dangerous ones to buy more time for.
Fourth day was another day of monitoring. two patients were on adrenaline and kept me on my toes by having pulse rate changes which had me changing the doses to keep them stable. Another patient, a girl of 21, came in with diabetic ketoasidosis who was turned into a pin cussion with all the abg samples, serum glucose samples, rft/lft samplesand insulin pump. I learned a lot about proper patient communication and trying to explain to her what all the samples were for and why we needed to take them.
Later it was nephro's turn. its better to sum up in one sentence.
" ITS VERY UNPREDICTABLE"
The moment you see a patient you will never know which way the case might go. they might walk in fine and be fine or they might be a hidden landmine waiting to be stepped on.
Anyway here is the list of things I did during that phase
- bp monitoring ranging from 100/60 to 210/110
-Abg samples
- blog samples
- collecting reports
- arogray Sree/Mitra ( shatru in any interns case)
- central lines assisting
- suturing
- dialysis monitoring
- learning about the dialysis unit.
all in all
" nothing is more hectic than half an hourly monitoring"
Finally the last one in periferals WARD duties
- post lunch samples
- fasting samples
- monitoring of. each patients
- Iv canulas
- IV injections .
In ward duties I came to know about the patients life about their routine . I spent most of the time listening to their regrets ( ABOUT ALCOHOL , SMOKING , USING HERBAL MEDICATION etc ) and how it affect not only them but also their family
Next 15 days was psychiatry . it was one of the most important factor in a patients health care. every single case had an element of psychiatry in order to achieve the best outcome for the patient. it also thought me to take care of my own self which helped me in my further unit duties
Then I came to units I was posted in Unit 2 in General medicine
Case
Case
Case
Case
Assisted in
- central line
- lumbar puncture
Procedures done
- ascitic tapping
YouTube vediolink
- collecting abg samples
- collecting blood samples
- IV Canula
- Foley's catheterization
- dressings
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