September 20, 2017

Inpatient Medicine

By Lucinda Gruber

Well, I'm sure you've all been eagerly anticipating my updates and thoughts from the first part of the month. Sorry. I was covering the inpatient medicine teaching service (shout out to Med 3!) for the last 2 weeks. It's been one of the highlights of my chief year so far! We had a great time - a lot of good learning, interesting cases, and moderately irresponsible caffeine intake. But, with the patient care, teaching, and dictations, I didn't have much time to keep things updated. Here's the run down.

Our inpatient medicine service consists of 4 teams of residents. Each team has 3 interns, 1 senior...and usually a few students, a pharmacist, and a clinical assistant. Oh, and me - the consultant, who says the least and somehow gets all the credit since my name is on the discharge summary. So, we can be a bit of an intimidating presence when we first enter a patient's room. #AcademicTeachingHospital But, once our team would start talking, patients were put at ease and often went on to say how much they appreciated our team-oriented approach to their care. In fact, our team worked so well that I swear there was a day when my only job was to deliver the Caribou coffee.

We helped care for many sick patients over the last few weeks. Between Hannah's team and mine, we treated everything from shingles, DVT/PE, and osteomyelitis to a complicated parapneumonic effusion, inflammatory bowel disease, and a non-operative pelvic fracture. Plus a sprinkling of hospital-associated delirium. One of our patient's was in a difficult position with multiple consult teams helping with her care. It was clear that we were not making much progress as individual teams, so we held a meeting for all her care teams. We talked about things we could each do to help out the other teams, big-picture goals, and specific plans for the next few days. It reminded me of what surprised me when I first started at Mayo 3 years ago. Mayo is the kind of place where doctors still call a referring physician to share their thoughts and people talk face-to-face in the hospital hallway to collaborate on a patient's care. Quite frankly, it's efficient, and it's what is best for our patients.

The most surprising thing about being a new, just-graduated consultant?? It wasn't very different from being a senior resident and running the team. I was surprised at how comfortable I felt in the role...despite being a newbie. Of course, my new priority pager still terrifies me when it goes off...but that may just be the shrill, earth-shattering beeping...

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