Internship dairies: Finding a vein

So here's a quick post in support of Internship Diaries. I would like to give you advice on how to do blood draws and insert IV lines.

First of all, learn properly before you try it on another human being. Watch YouTube videos, learn by observing.

Second, the tourniquet is your friend. If you don't have a tourniquet, use a glove instead. It will make the veins more plump.

Third. Feel the vein before you attempt to insert the needle or cannula. FEEL IT.

Be patient and take your time. It's better to spend 30 seconds extra than to poke somebody and spend five minutes more trying to find a vein.

I know that this is phlebotomy and nursing advice and it may not be needed in hospitals where the ancillary staff does it.

But hey, hope this helps! :)

PS: I just realized I've written a longer post before here: https://www.medicowesome.com/2015/10/tips-on-how-to-find-vein-or-phlebotomy.html

-IkaN

Burnout Advice.... Jay's 2 cents s/p reading Ikan's post

Burnout is a very common thing among us medicos. That spans from being a medical student upto a resident or even a consultant sometimes!

We feel stupid most of the times and some of our seniors have that bad habit of making the juniors feel bad.

But trust me, you WILL become as good as them, and even better! Medical field needs experience and alot of reading. Med school teaches us maybe 1/10th of what we should know as a doctor. And the remaining we learn on the job.

There is always more to learn more to read and more to understand but medicine is not a lonely game. Always refer, and ask! In Medicine, 2 brains are always better than 1 brain. Don't feel shy or bad to ask for help.

Use your head! If they belittle you, tell yourself you will learn it. Smile and move on.

For me each time I lose motivation, I watch an episode of a Medical TV series. It could be HouseMD, The Resident, New Amsterdam, Good Doctor, Chicago Meds, or any random episode I find in Youtube.
Watching them gives me the feeling of impact I can have in others' lives.

I also go through Youtube videos from famous Medical youtubers, few of my favorites are Jane and Jady, TheStriveToFit, Ali Abdal, DoctAura etc. They have amazing study tips and other medical related things that can give you the motivation to read and learn.

Sometimes I go through #Studygram handle in Instagram. There are many colourful notebooks and workspaces, it really inspires me and gives me a free mind to study.

I also like to read the study tips written by my fellow authors. They have eye opening and motivational tips that really makes me go sit and get that one chapter done.

If all these don't work, just listen to your favorite songs and move your body a little bit when your room mates are not watching! 😂 It definitely gives some positivity to shrug off that sad burnout feels.

Yes! I find most of my inspiration and motivation by online activities rather than going out and resting under the trees. One reason being Im not a very outgoing person and another being I have very little time as a Junior Intern.

And also it helps to clean your room. And cooking a meal for you and/or your family/partner. It would leave you with a clutter free environment and a tasty meal to eat. And if things go well, a lot of praising for your yummy food by others with make your self esteem get better too.

Then get a yummy dessert or make one. Sometimes I just eat a slice of custard cake on my way home, or cook a simple bread pudding and share with my roomies. Although they jump into finish it
and finally leaving me a little piece. ( Those two a-holes!!! 😂😂)

You don't need a trip to beach or hike to mountain, but sometimes sleep on a cozy bed with newly washed sheets, after a warm bath, applying your favorite night lotion, a drop of nice smelling essential oil behind your ears and wearing relaxing clothes will refresh you too.

These are few of my techniques to feel good after a toxic day with disastrous rounds.

Confession : I have had my fair share of bad days. I was punished for silly mistakes. I was sanctioned with extension of duty and forced to work extra hours to compensate for it. But we gotta accept our short comings, learn from our mistakes and move on. We at Medicowesome are not saints or gods to dictate how you should live and everyone of us had made errors, said wrong things in rounds, got shouted at, failed exams, and some of us even went through psychiatric help to get over any of the depressive periods we had

But what is most important is, NONE of us gave up! I take this time to thank my Medicowesome family for helping each other and even helping me rise up in such times when I was so low. Behind the groups and the blog, we are an amazing group of friends although many of us have never met each other. Medicowesome is my support group, and we all need one including you. Find your supportive group, and for the records don't forget we at Medicowesome as also on your back, ready to hold you up.

Stay strong and comment or message us about your methods of tackling a toxic day or a burn out session. So we all can learn from it.

Keep it up! Take care and always....be awesome!

With love,
-Jay

Residency and burn out advice

Here's a conversation I had with a friend of mine. She's a resident in a busy government hospital in Mumbai.

I still feel like Jon Snow (I know nothing). I feel like I'm stuck at the basics. And seniors expect a lot. It is somehow unfathomable to me that someday I will be even one tenth as smart as them. Morning rounds as a massacre. It's like beheading my already non existent self confidence. I feel so stupid everyday. I have no energy to study.

I'm trying so hard to not let it get to me but everyday I get to hear criticisms either from professors or immediate seniors. I wasn't born stupid Nakeya but everyday I feel like I've bitten off more than I can chew and chosen a career that's too difficult for me. I feel thoroughly demotivated these days. Like I'm just working because I have to. I feel like I've lost interest only to improve and be better everyday.

Me:
It's OKAY to feel stupid. I think it's everyone of us. It's a part of learning. Indian culture has not developed a way to give constructive feedback... So you got to modify the words they say and take it in a way that motivates and inspires you. It's... I'm pretty sure it's just the culture that makes you feel more stupid than you should feel. The career is not difficult. The training is. You're not stupid. The way they teach is!

We do this thing every week - We share our humanistic experiences with everyone. It could be as simple as holding grocery bags for an old lady.  It really helps. We tend to think about the things we did wrong and belittle ourselves. But we need to think about the good things we did. The things we did right. Made a baby smile when they were sick. Made a correct medical decision. Got the IV in the first go. We need to celebrate the little things.

Take time off from medicine and rest whenever you get a chance.

-IkaN

Just when you lose hope....

(This is a bit of an off-academic post. So if you are on exam season, avoid reading this.)

Being a doctor!..... we all have dreamt of it. Since we were kids we wanted to wear that stethoscope, walk in long hall ways, go to those people with pain and help them...

You wil watch a TV series and when a surgeon would say "Scalpel please!" you feel goosebumps thinking one day you wanna do it...

But there are somedays you just get home or to hostel from medschool or hospital, and you just don't want to do it anymore. You feel like your passion is lost. You feel like you are no more yourself!

YES! We all have gone through this at least once or even more times in our lives. And when you say this, many other medical students will relate to you too.

Whenever you feel so demotivated, just think WHY YOU STARTED THIS AT THE FIRST PLACE? Did you do it by your will? What made you decide this?

For an example, I always wanted to be a doctor, but my will to become a doctor became so strong when my grandpa passed away in a govt hospital because the doctor in charge didn't diagnose that he was having a heart attack. That day I decided I want to be that doctor who will correctly diagnose and treat people to the best capability I can. I wanted to stop anyone else's family member to pass away because of gross incapacity of a doctor.

You may also have a reason like this if you dig inside your mind. And you will find this reason to fire you up again. To make you push through that one more chapter. Go to that one more ward with a wide smile despite you are sleepless and tired.

Find your reason to stay, not to leave! Because once you are on this voyage, you have decided to work for the betterment of the world and the people, and if you quit midway, it's such a waste, my friend!

Many people dream to be in our shoes. If we give it up, we just are ruining a chance of someone else to be a doctor. So make that medschool seat you owned, be worth it.

Another thing! Going through medschool is not a single man's job. It needs hell load of a support. Find this support system in your family, in your significant other, in your friends, and anyone who would give you strength to carry on, and someone who would motivate you, someone who would be there to say "You can do this! I'm with you!".

Medical books are boring, but books are not the only way you can learn anymore in this digital world. You have millions of videos and interactive websites you can find. You have blogs like our www.medicowesome.com where we breakdown big medical info into small pieces and clarify.

Get your stuff together, clean up your workspace. Cleaner table will motivate you to study too. Use some motivating words in front of your workspace, On your phone's wall paper, On your notebooks! Simply everywhere you would see. If someone would judge you for that, make them your motivation too. Stick up a motivating note on their forehead too! 😂 Just kidding! Ya just keep that smile on always!

Life is great! Medical life is even greater! With all its failures, late night cries, exam phobhias, senior bullies, colleague dramas, its all worth it.

Finish your degree...! This pain lasts only few years! Once you are a fully fledged doctor, you can go ahead and be that wonderful human being you always wanted to be! Don't kill that wonderful person even before you get there!!

We are all voyagers of this same hard journey wherever we are in this world! So let's do this! And in any case you need someone to guide you through your academic related depression or demotivation, always count on us here in Medicowesome!

Have a great day and go own that damn degree!!! 😍

Good luck! See ya later!

Yours,

Jay.

Standing up & speaking out - 2

Hello people

I am glad for your support. In reality when I first chose to speak up about it , I knew none would support me, I mean why would they.
They all had nothing to gain, but a lot to loose.

I have been with my guide for a long time , there were instances which would seem impossible, I mean how can one do this?
How can someone stoop this low ?

We students were in-charge of her ot slippers. Sketchers worth 2k. As soon as the operation theatre ended we had to keep track of getting it washed and keeping it in her locker.
The ambulance was her personal vehicle, ANC and paediatric patients were made to wait for hours, while the ambulance was used to get her tiffin, drop her students at school.

Whenever she had interviews, we were asked to wear new coats and wait outside her office, and come in one by one , while the camera was rolling and ask her questions and doubts.

The operatives where we would put our hand and leg on the weighing scale to increase the weight of the tumour.

None of this can be proved but it all happened.
Her students passed out years before all have gone through this.
We were like her jewellery to make her look pretty in public , and we were thrown away and stepped on in private.

But I can't take it anymore, and I feel anger and despair that how did I even allow her to treat me like this.
This is a shout out to all those times

Residency in India: Harassment and speaking up against it

Let me be honest with you, when I first heard about the abuse of a resident by Dr. Rajashree Katke madam, I chose to ignore it.

"She's not that bad," I thought. Doesn't the resident know how the system works?

I'm embarrassed that the system has made me feel like it is okay for mentors to treat you like this. Mentors are supposed to guide you, inspire you. Not humiliate you at every chance they get.

I'm ashamed of myself because I'm used to how the government hospitals in India can get and used to not raising my voice against it.

I forgot how deeply I condemned such practices - people like her are one of the reasons why I didn't want to do my residency in India.

I worked as a CMO under Dr. Rajashree Katke and I've seen students, residents, medical officers, nurses, paramedical staff and even peons be verbally abused by her at some point. I'm confident none of them will come forward. (I'm also confident that I'll never get my experience letter after writing this, the one I asked for multiple times but never got signed because I didn't show up with an expensive gift.)

People who are asking for proof: There'll be no proof. I wish I recorded her disrespecting people. There'll be no proof of her refusing to teach if her demands aren't met. I can recall residents waiting for her outside her office. Isn't someone's word proof? Is it not evidence?

I'm glad the resident spoke up. Residency is tough. Isn't there too much work already for doctors? Is it too much to expect humane behavior from our mentor?

To the resident:
Maybe you weren't an unlucky girl.

Maybe it was fate who wanted you to be in that position, so that you can raise your voice against such people. You are the reason that hopefully, this abuse will end.

And no other resident will have to deal with this ever again.

Thanks for raising your voice.

Nakeya

This post is supporting a resident and our dear author, Sakkan. She has been doing her residency with a verbally abusive mentor. 

She decided to speak up against it and without our support, no action will be taken. Read more here:

https://m.facebook.com/story.php?story_fbid=1062008630649068&id=750938228422778

https://www.medicowesome.com/2019/02/standing-up-speaking-out.html

https://www.thehindu.com/news/cities/mumbai/resident-docs-seek-action-against-jj-professor/article26325048.ece

https://www.freepressjournal.in/mumbai/mumbai-mard-puts-forth-demands-to-jj-hospital-administration/1464928

https://www.loksatta.com/mumbai-news/jj-the-hospital-dr-rajshree-katke-again-once-in-controversy-1843259/

https://m.timesofindia.com/city/mumbai/medical-pupil-senior-doctor-treating-me-like-maid/articleshow/68055883.cms

https://m.navbharattimes.indiatimes.com/metro/mumbai/crime/exploitation-allegation-by-resident-doctors-of-jj-hospital/articleshow/68054261.cms

Authors diary: Goodbyes

It's heart breaking when you leave work in the evening and show up 10 hours later only to find that the patient you were taking care of passed away during the night.

You don't get to say goodbyes. But my wish for you is that you get to give your condolences 💔 

-IkaN 

Authors diary: In short

Hello!

I am planning to write short one line posts on things that I learn in the everyday.

Authors' diary: 53 facts about me

Another vlog before my long weekend ends =)

Authors' diary: Residency and life so far (after moving to the US)

Hey!

I am video blogging now :)

Authors' diary: Zebra series

Hello!

I am starting a Zebra Series on Medicowesome.

Authors' diary: CHADSVasc High

*talking about atrial fibrillation*

Assessment and plan: New onset atrial fibrillation with rapid ventricular response

Hello!

Here is case one for the A&P series!

Assessment and plan: 99 yo M with PMH of ... admitted for ... is being evaluated for new onset atrial fibrillation with rapid ventricular response.

Authors' diary: Assessment and plan

Hey everyone!

As a medical student rotating in the US, I would have a tough time "typing" the assessment and plan. I would have it straight in my head but putting it all into words was difficult. I guess because I came from a different medical system where we don't write assessment and plan in our notes.

Lab values Fishbone skeleton / Ishikawa Diagram in text

Hey, 

I was looking for this skeleton to manually put in the outside labs for my patient.

Authors' diary: Ponder

We were discussing a case today and learnt how important it is to take a second to think before we do something when dealing with patients.

Before you get a CT scan on the patient in the ER, stop and think - does the patient really need a CT scan? Will it get me the answers I'm looking for? Or will I need additional testing? Think of the harms of radiation exposure. Unless you don't want to rule out a hemorrhage that requires immediate intervention, do not order it STAT.

Authors' diary: Life support

When it seems out of your reach, should you try?

Here's an email I got from an awesomite who was extremely confused on whether or not to pursue something out of her reach (In this case, post graduate training in the US). Since it was an extremely personal email, I haven't posted the entire email here (just bits and pieces). Her email is in italics.

About me

Hey Medicowesomites :D 

I have been posting here since some time and I would like to introduce myself

I am Murad Almasri from Palestine, I finished my med school in Egypt then did my USMLEs (step 3 left though) and will start my residency in Pediatrics in the US soon  :)

I am a positive person and I always like to know more and more ...it's just like eating information 
I believe in sth called "encyclopedial knowledge"..try to know everything about everything.

 I love making mnemonics and collecting them, I think I've been doing that since high school maybe even before that and this helped me tremendously in the USMLEs.

 I like reading books especially novels - I am a big Harry Potter fan ^_^ .
I also like video games ( I sometimes ask myself who doesn’t :D ?) and of course moviesssss 

 Learning new languages is a passion for me too, I already know a few.

 Good luck Medicowesomites and enjoy this amaaaaaazing website :)

 -Murad

Authors diary: Octopus and tyrosinase

Hey everyone!

Here's another way I study - when I am looking up cool things in other creatures, I compare it to the human body. It's fun!