醫學生日記2016年5月25日 --- 開始婦產科見習

醫學生日記2016年5月25日 --- 開始婦產科見習

阿山 （龐靜譯）

 

12周的手術見習終於結束了，草坪也變得更綠了。婦產科見習開始了。入門介紹之後，我上了第一個夜班。以後的12個星期，我每天工作的最長時間都不會超過12小時，那些沒經曆過手術見習的同學都覺得很長，但對於我們手術見習後的同學，這聽上去就像天堂。

 

入門介紹就是常規性地介紹規章製度和對我們的要求。還有兩個學生帶來兩個箱子，箱子裏裝的都是練習縫合的東西。我們同學讓他們帶來還的。見習主任看了一眼箱子裏的東西，轉向我們，用一種很平靜但又失望的語氣說：“我很恨那些不按規定做事的人，給其他人弄出更多的活。” 前兩個在婦產科見習的學生把針放在箱子裏，針頭沒蓋上（任何人打開箱子都可能被紮到），箱子裏的練習線上到處打著結（任何人要去解開這些結就知道多煩了），他們還箱子的時間晚了，而且場合也不對。見習主任問帶箱子來的同學誰讓他們帶來的。很明顯，她很不高興。倆個同學很為難，他們想保護他們的朋友，嘴裏胡亂答著一些沒用的話。見習主任打斷他們說：“打住！你們沒問題。我並不是跟你們生氣。我是生他們的氣。告訴我他們的名字，我們好繼續。” 名字說出來之後，我們見她拿出學生名單，在那兩人名字旁邊寫了幾句。之前她說過她總是帶著名單，隨時做記錄，寫見習評語時放進去。

 

入門介紹另一件值得一提的是教學助理又來了。我們課堂上學胸檢和腹部檢查時他們來過。這次還是同一批人。他們受過特殊培訓，專門教學生如何進行胸檢和腹部檢查。我們對他們進行檢查，他們一步一步教我們怎麽做，幫助我們找到子宮頸，子宮，和卵巢。在檢查過程中，他們還教我們怎麽說，怎麽站，怎麽動，用多少力，患者感覺如何。我總是覺得這些人很偉大，一般人很難想象人們為了培養一個醫生所付出的長時間的努力。

 

我這星期都是夜班，第一次是星期二夜裏。我下午5:30到達，從白班學生那裏拿到報告。三個學生上白班。他們每人看了一個病人，全天隻有一個孕婦生產。總之，一天很無聊。夜班情形全變了。我和另一個同學上夜班。我們每人都看了三個病人，三個孕婦生產。我同學參加了第一個，還幫著取出胎盤。我遇到第二個孕婦，最後一分鍾她要求產房裏不能有男性，我錯過了這次機會。我同學在她生的過程中接著嬰兒。第三個生產的孕婦要求學生不能在場。第一天值班不能看到生產的過程，我有點失望。但是住院醫告訴我甭擔心，這是極少見的情況。大多數到校醫院來的病人都知道這是教學醫院，有很多學生參加他們的治療。當夜所有事平息之後，住院醫讓我們淩晨三點就回家了，把值班時間縮短了三個小時，讓我們多睡了一點覺。

 

我白天大部分時間都在睡覺。下午有課，我們告訴白班的同學我們夜班的所見所聞。他們很嫉妒，因為他們第二天白班還是很無聊。

 

剛開頭，我覺得我在婦產科很有趣。

 

 

Wednesday May 25 – Starting Ob/Gyn

 

 

Finally, 12 weeks of surgery is over and already the grass is greener on the other side. We had our orientation day to ObGyn and I took my first night shift. For the next 12 weeks, my longest work day will not be longer than 12 hours, which to students who have not rotated through surgery, sounds really long, but for us surgery veterans, sounds like heaven.

 

 

The introduction day was mostly routine reviewing expectations and policies. Of minor note, two students brought in two boxes that contained suture practice kits that our classmates had told them to return for them. The rotation director took one look at the kits, turned her head to the group of us, and said in a very calm and frustrated tone: “I hate when people can’t follow instructions and create more work for other people”. The two previous ObGyn students had left sharp needles unsecured in the box (so anybody opening it could be stabbed), left the practice rope tied up in knots (anybody trying to undo tangled rope will understand that frustration), and had returned the kits late and to the wrong location. Our rotation director stared down the two students who had brought the kits in and asked who were the students that had given them the two kits. It was very obvious that she was extremely displeased with them. The two students very awkwardly sputtered some nonsense jumble, desperately attempting to protect the identity of the two offenders. The director cut them off with: “Stop, you are not in trouble. I am not unhappy with you. I am unhappy with them. Now tell me their names so we can move on”. After the names came out, we watched her pull out her student roster and write comments next to both students. Earlier she had just explained to us that she keeps a roster with her to constantly write comments that she will include in each student’s final evaluation.

 

 

Otherwise noteworthy on orientation day, we had the gynecologic teaching assistants come in again. They had come in once previously for our class to teach us the breast and pelvic exams. This time was the same. They were all trained to teach students how to conduct breast and pelvic exams. We performed the exams on them, with them walking us through the process of learning specific maneuvers that helped us find the cervix, uterus, and ovaries. As we were doing all this, they were teaching us what to say, how to stand and move, and how much pressure to use to help make the patient comfortable. I always think these people are very remarkable and it’s odd to think about the lengths people need to go to train new doctors.

 

 

I start with one week of night shift, and my first shift was Tuesday. I came in at 5:00 pm and got the update from the day shift students. There were 3 students on the day shift. They each got to see 1 triage patient, and there was only 1 birth the entire day. So in summary, it was an exquisitely boring day. That quickly changed for the night shift. I was on with one other student. Throughout the night, we each saw 3 triage patients. There were 3 births over the night. The first one, the other student got to participate in and delivered the placenta. I had met with the second mother, but she requested last minute that there be no males in her room, so I missed that opportunity. The other student got to catch the baby as she was pushed out. The third patient requested no medical students. I was a bit disappointed at not being able to see a birth during my first shift, but the residents reassured me that this was the minority of cases. Most patients coming to University Hospital know that it is a teaching hospital and that there will be students participating in their care. After everything had calmed down for the night, the resident team even sent us home at 3:00 am, cutting our shift short by 3 hours so we could get some extra sleep.

 

 

I spent most of the day sleeping. This afternoon, we had a lecture and we got to tell the day shift students what we saw overnight. They were all so jealous because it was the second day in a row where things were slow.

 

 

With this start, I think I’m going to enjoy ObGyn quite a bit.