Blog 25

Blog 25: 10/29/08

It was my first day at Hospital ISSSTE, which is a hospital dedicated to serving government employees such as public school teachers, administrators, etc. It's a very nice hospital, located only a few blocks away from Hospital Civil (General Hospital of Oaxaca). My first rotation was in the emergency department/Intensive care.
Unfortunately, by the time we got there, all the patients were stabilized and referred to their relative departments. There wasn't much to do. Rotating through the ER is very different than through the O.R. or primary care units.

ER has a lot more stress associated with it. A lot of patients come in with unknown problems, and need to be stabilized immediately. Because today wasn't such a busy day, the residents were using it to really relax; they looked really worn out, probably because most of them were on a 36 hour rotation. It was a really interesting and valuable rotation for me because I learned a lot about myself, and how I would need to change in order to take what I wanted from the experience.

Unlike in the other departments, it was much harder to learn in emergency care. Everything is fast-paced and people don't have the time or energy to stop and teach. It was really frustrating because I was having a hard time getting what I wanted out of the situation. I was used to having doctors taking the time to really explain the patient's problems, and answer questions that I asked. Many times In surgeries, doctors explained to me what was going on, many times without me even asking questions. Due to time and attention constraints present in the ER, I really had to change my strategy to learn. In order to learn, I realized I would have to be more proactive and persistent. The residents weren't just going to wait for me follow them around and ask questions. I would have to be more aggressive. So, I changed my approach and tagged along with any residents I could find. I didn't wait around for them to notice that I had questions, instead I asked questions as they were working and walking around. Any free time they had, I would swoop in with questions that I needed answered. The residents didn't mind my approach at all, and were really willing to explain things when I took the initiative to ask. Many times they didn't fully answer my questions, so I would just ask the person later, or ask someone else.

I learned a lot from the experience because it forced me to learn adaption skills for that environment. In this particular environment, where there's no time and a lot of stress, the only way to benefit is to be proactive and go after what you want. No one has the time to notice what you want or need. Hopefully, I step it up a notch tommorrow and get even more out of the ER. I want to practice my new found skills. However, I also realize that being this aggressive may not fair well in other contexts, such as in the O.R.; instead it might be interpreted as something else, and serve as a great annoyance to surgeons and surgical residents. The lesson I took away from this experience is that it's important to adapt one's approach to learning, based on the context of their environment. Being proactive takes energy, but I'm really looking foreword to my rotation tomorrow!