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GUEST POST: Acting Internship Week #1: Panic

Monday, February 20, 2012

Medical student Caitlin Pedati writes:

My first “call” shift as an AI was a weekend day shift. I was of course responsible for the patients I had been carrying throughout the week and then also helping the intern with issues as they came up. Overall, I was really surprised how busy I was during the whole entire 14 hour shift with just one of my patients, and it made me worry about how hard it would be to be the only intern on and be responsible for ALL of the patients. I wonder how I could have possibly handled the whole census.

I also had one moment during the day that sort of stuck out as a moment where I realized I am moving up in my training.

Going from my third year psychiatry rotation right into my pediatric AI, it was hard to note big differences or changes or notice that things were moving forward. It was hard to feel like this was "4th year" as a separate entity from "3rd year." Anyway, I was sitting catching up on charting when I got a call from a nurse trying to do some wound care for one of my patients. To say things were going poorly was an understatement. When I walked in there were two nurses and a tech trying to calm down the patient who was hysterically crying, tachypneic, tachycardic, and begging them to stop because of the pain.

And as I took in the scene and checked the monitor from the doorway while I hurried into my gown and gloves, the nurse looked over and said, "So what do you want to do?" In my head I said, "Ummm call a doctor?"

It was strange and scary to think that I was supposed to have the answer.

So I talked with the patient, decided we couldn’t do wound care with all this pain, and ended up calling a pain team consult for recommendations on what to give next. Part of me feels like I passed the buck by "phoning a friend," but on the other hand I think I had to realistically recognize what I could do as an AI. And in that moment I think it was probably just about knowing my resources.

I guess the initial feeling I would say I felt at that doorway was panic. And I could have left the room and gotten the intern or senior immediately or or paged for help right then and there, but I'm glad I did my best to assess the situation and then make a decision. In this first week, I have thought often about the phrase “fake it til you make it” and while that may apply, I just want to be careful that I balance that with being cautious and recognizing my limitations. And know when to phone a friend.

ABOUT OUR GUEST POST CONTRIBUTOR: Caitlin Pedati graduated cum laude from Georgetown and is presently in her final year of medical school at George Washington University. She has made a well informed choice to proceed with a career in... pediatrics. Caitlin is expected to earn both a masters in public health and a medical degree in May 2012. She is well published (see partial list here) and will no doubt go on to make many more contributions to the field. 

And stay tuned for Week #2, #3, and #4...


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