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Shadowing in the NICU: Day 3

August 15th, 2013  |  Published in Pre-Med Tips

NICU room

Source: Flickr/Vsai

Today felt like a very short day because it was. I woke up late and ran around the house frantically with the usual problems: couldn’t find my keys, couldn’t find a hair elastic, put mascara on but somehow it kept smudging off all over my face. Ten doses of makeup remover later, I rushed out of the house, keys in hand. Strategically speeding down the highway, I made it to the hospital in perfect timing and was feeling quite pleased. However, I suddenly was thirsty and when I reached into my purse I realized that I had dumped all of its contents out when searching for my keys. No water bottle. Looking around the faculty lounge there was no water in sight so I realized that I’ll have to suck it up and make it through rounds.

Rounds kicked off with the safety meeting and then talks of our first patient began. I always disliked that in Emergency Medicine you never find out what happens to the patient after discharge or admit. In the NICU since all the patients are inpatient, you see them every day and can see their progress or regression over time. I was happy that I had remembered the patient’s condition, and thanks to the kajillion x-rays I was shown in the ER, could recognize change since yesterday. Debates regarding the appropriate quantity of electrolytes to put in the TPN began and I suddenly felt extremely warm. My tongue felt fat and dry in my mouth. I forced myself to focus on the conversation, but felt really thirsty. My heart beat more quickly and the squeezing feeling in my chest gave me the familiar signal that passing out was inevitable. I slipped away to the staff bathroom, washed my hands, and then drank from the sink because I was super desperate.

Back at rounds, we had moved on to the next patient. This was a new admit so I tried to catch up on the story. But, I felt really horrible. I remembered the day when I near-passed out at work in the ER and was half-forced to be an ER patient (after nearly passing out you’re incredibly pliable and will agree with anything anyone is telling you.) That ER bill was not pretty even though they only charted me as a level 4. I did not want that bill again. Feeling badly, I snuck away again and once the door closed behind me, lunged for the faculty lounge door. Of course today, of all days, the lock on the door was working and I could not get in since no one told me the code. Fortunately I found the on-call room which had a chair and bed. I collapsed into the chair but realized I would probably be better if I could lay down and keep my low blood pressure from worsening. After about 5 minutes of this, I decided I would be okay and went back to rounds. By now they were on the third patient, I tried to focus on rounds. One of the nurse practitioners asked why I wasn’t wearing a badge. While talking to her I felt worse and started to black out a little. I told her I had to go lie down because I felt awful, she said I looked horrible (I’m sure I was all pale.) I asked for the code to the faculty lounge, somehow managed to remember it, and curled up on the small couch.

Couch

Source Flickr/Mandy_Jansen

1 hour later, I was not feeling deathly and returned sheepishly to rounds. Moral of the story: pregnant premeds should remain adequately hydrated while shadowing. Basically the most awkward shadowing experience ever. The nurse practitioner asked how I was, and the physician did as well. I told them I was feeling better and was glad when their attention quickly turned from me to the patients.

There were few patients left to round on, and I was disappointed to miss out on hearing about some patients I was keenly interested in. Yesterday the medical students were “pimped” which is a weird word I think because they were asked to answer questions in a very nice way and I did not sense that there was any stress or pressure to respond perfectly. I amused myself by thinking about what I would say if I were them. Sometimes I got pretty close to the right answer, in my mind!

Some pretty serious clinical issues were brought up in an attempt to find the root cause of a patient’s condition. These were fairly interesting and I enjoyed listening to the different perspective of the med/peds physician versus the peds physician. Plans were made to consult and I was disappointed I wouldn’t get to hear what the consult had to say.

When rounds were complete I got a chance to speak to the attending. He is a really excellent teacher and I’m glad that he was the attending on rounds while I was there. He has an excellent way of explaining difficult topics in the most simple way; he influenced by teaching style in my latest training video for Khan Academy (not yet producing content for them but maybe one day!) Listening to him speak about topics in neonatal medicine, I couldn’t help but feel excited about them just because of his enthusiasm. He began talked about retinopathy in prematurity (basically blindness in premature infants) and I found the subject interesting so I chose it for my presentation tomorrow: the last day of shadowing.

We also discussed my medical school plans. Interestingly his daughter is also applying to medical school so he was very aware of the sort of GPA/MCAT scores/extra-curriculars they medical schools want to see in applicants. He gave me some keen advice on applying and shared his experience watching his daughter apply to medical school. He did recommend I retake my MCAT. I freaked out internally because I really don’t have time to study for the MCAT in addition to doing my postbac and continuing volunteering/shadowing. I discussed this with a friend of mine who did the VCU postbac and she, too, was concerned about her MCAT score because we had the same score (but different sub-section scores). Luckily, when I emailed the adviser to ask her advice on my MCAT score she said firmly that I do not need to retake my MCAT for VCU because I am well within their range. Crisis averted! I am unbelievably relieved I do not need to retake my MCAT for VCU. Of course if I get crazy and apply to Hofstra again, I would. But I am not doing that.

Now I just have to put together a 10-15 minute on retinopathy in prematurity, try to sleep, and try not to stress out about the presentation tomorrow!

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