Thursday, November 1, 2012

Ortho/Musculoskeletal Clinic

This is my last full week of ortho clinic. Because I'm nice and so are my rotation partners I've offered to step in and cover for them on two days when they need to be out of town. Because I've already done the rotation, two extra days in ortho clinic won't be a big deal. But I am looking forward to being done with it every day. It is long, intense, and has been a great learning experience, basically because we have been thrown into the deep end of the pool and told to sink or swim. So we started swimming. I think that's the best way to learn. The attending has laid out his requirements, and you do it. See one. Do one. Teach one. He's very hands off. If he doesn't want you to do it, he won't let you, but other than that it is basically we, the students, who are actually "practicing" medicine in the clinic, and the attending usually approves our choices. Maybe we're learning something??

I've learned how to do knee injections, shoulder injections, and trigger point injections on the back and neck. It's amazing how after doing it a few times, I don't think anything now of sticking a 1.5 inch needle into somebody's knee. The first time I was terrified. Sometimes I still need to stick twice, but I've gotten pretty good at finding the spot, even on tough knees. I've also significantly improved my radiograph reading skills. It's basically a necessity as when I present a patient to my attending he pulls up the radiograph and says ok, show me the problem. After a round or two of "uhhhh, I can't see anything" I started staring at them for a while, and started to see problems. Sometimes I still don't quite make out where the fracture is, or what the problem is, as on occasion they appear invisible to my eye, but I feel much more confident.

This has probably been my first no-holes-barred introduction into insanity medicine. We have easily seen 100+ patients some days. There are anywhere between 4 and 6 people handling patients in the clinic, so do the math.

Yesterday was quite hectic and frustrating because for whatever reason (cough cough lazy, overly-socializing receptionists cough cough) patients scheduled for 1pm, who had checked in at 1230, weren't brought back to the clinic until after 1:45. All the while we are literally sitting around twiddling our thumbs wondering where in the world our patients are, and having to accept the reality that we will not be leaving before 6:30. Oh goody. Throw on top of that the usual dose of hospital politics and drama from that person (and every group has one) and it was just a frenetic afternoon. Sometimes you just gotta dance. 

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