Pre-Match Jitters

Since Monday several of the other physicians from the clinic have gone on vacation so my attending has been slammed with all their hospital admits. Which means I have primarily been in the hospital working with the in-patients while my attending keeps up with clinic. We round first thing in the morning and make a care plan for each patient, then I spend the day doing assessments, writing orders and notes, working with social services, therapy, the nurses, families, consulting physicians, and outside agencies to coordinate patient care.

I was sitting at the nurses station this morning going through a patient’s discharge med list and it suddenly occurred to me how much I really liked what I was doing. I have enjoyed every minute of doing the H&P’s and progress notes, having (actual) input on patient work-ups and treatments, interpreting findings, working with all the different disciplines to assure the best care and placement for patients, and watching patients progress.

Like the patient whose meds I was reviewing. I’ve been following them since their admission so earlier in the week when my attending was totally swamped, they sent me over to talk to the patient’s family and then the patient about nursing home placement along with the social worker. The patient, naturally, was not in favor of going to a nursing home (really, is anyone in favor of going to a nursing home?), so we talked to the family first. The family it turned out had been worried about the patient’s safety at home alone for some time, and had been hoping that someone would step in and help advocate for nursing home placement.

There we all were sitting in the conference room, when the patient was wheeled in unaware of what, exactly, we had all been discussing. (Note: If you are elderly, frail, tend to fall a lot, get hurt, live at home by yourself, and are wheeled into a room full of family members, a social worker, and your doctor – You are probably about to experience A Nursing Home Intervention.) It took a bit of convincing, but eventually the patient conceded that it was probably best they be discharged to a local long-term care facility. I walked away knowing that we had done the right thing and that I had helped ensure at least one person would now be safe and appropriately cared for. It felt like the Hugest Win for the home team and…….High Five!!

No? Okay. Whatevs.

I thought about this as I sat at the desk, looking at the pile of charts I had just tackled, watching the nurses whiz by, and I started to panic (a little). Dear Lord. Have I made the Biggest Mistake Ever????? Am I really supposed to be a Hospitalist??? What have I doooooone???!

I shook my head and thought Nah. It’s probably just Pre-Match Jitters. That’s totally what it is….totally. I mean…right? RIGHT????

I can’t even remember the last time I delivered a baby.

I have got to get in on a delivery, a c-section, or a Pap smear…..anything OB/GYN.

STAT.

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