Feeling very lost

[JustSomePreMed]

I'm sure this isn't a unique problem, but after starting my pediatrics rotation (inpatient) for just the first two days, I already feel like I'm way in over my head. Just trying to keep things straight, figure out the flow of the day, figure out what I'm supposed to be doing and when. It doesn't help that my H&P skills pretty much suck right now, which then sort of extends to my presentation skills.

Also, while I meant to get all my books and such way before I started, Step I studying I guess got in the way and I forgot to, so now I've got stuff ordered on Amazon that's on its way but probably won't be here until the end of this week or Monday. I would've just gone to my school's bookstore, but it has terrible hours and is never open during a time when I can make it there with my current schedule.

Anyway, I'm feeling pretty lost and scatterbrained these first few days. I know it's party my fault, but anyone have any suggestions (specific or in general)? I feel like I should have all kinds of little pocket references with me and such. I've got epocrates on my iphone at least. But are there any good online resources to read up on patients and such? We have uptodate on the hospital computers, but I don't have an account to access from home.

---

Members don't see this ad.

 

[dragonark]

I'm sure this isn't a unique problem, but after starting my pediatrics rotation (inpatient) for just the first two days, I already feel like I'm way in over my head. Just trying to keep things straight, figure out the flow of the day, figure out what I'm supposed to be doing and when. It doesn't help that my H&P skills pretty much suck right now, which then sort of extends to my presentation skills.

Also, while I meant to get all my books and such way before I started, Step I studying I guess got in the way and I forgot to, so now I've got stuff ordered on Amazon that's on its way but probably won't be here until the end of this week or Monday. I would've just gone to my school's bookstore, but it has terrible hours and is never open during a time when I can make it there with my current schedule.

Anyway, I'm feeling pretty lost and scatterbrained these first few days. I know it's party my fault, but anyone have any suggestions (specific or in general)? I feel like I should have all kinds of little pocket references with me and such. I've got epocrates on my iphone at least. But are there any good online resources to read up on patients and such? We have uptodate on the hospital computers, but I don't have an account to access from home.

Welcome to third year buddy. Maxwell's is good for formatting your note and other quick and dirty lookups. Case files is solid for reading during the day when there's that inevitable medical student downtime but can't quite leave yet ness. Sanford anitbiotics guide is also solid. Peds has that red book of infectious diseases which is more relevant to peds. Rest assured, most people at this point in the game have no idea what they're doing. Interns are new, and the seniors are new seniors. The Harriet Lane handbook is the peds bible...but may be too much for a medical student just going through a rotation.

Just read every day, and you'll get the hang of it soon enough. Then you'll start a new rotation and be lost all over again. Yay for third year!

 

[astrocreep96]

I've started with internal medicine and I feel completely lost. Fortunately, my team is pretty good, and they are taking it relatively easy on us right now. But I echo your sentiments - despite two years of occasional training on how to take an H&P or SOAP notes, I'm horrible at it and I can't present worth a damn.

I'm sure this is all pretty normal so I'm going with the flow and trying to put out what effort I can at this point, even though I feel as if I'm spinning my wheels.

 

[julie29524]

If u don't feel completely lost in the first 48 hrs of 3rd year, then there is something really wrong. So chillax, dude.

To help with your peds rotation or any rotation:
1. Do not buy a lot of books, its such a waste of $$ and dead weight after the rotation, u probably wont use it for Step 2. If you want to do peds and want to gun it up, go to library and get whatever the residents are carrying in their pockets. In my hospital, the resident's bible was :
http://www.amazon.com/Harriet-Lane-...=sr_1_5?ie=UTF8&s=books&qid=1278544718&sr=8-5
This book will have everything u possibly need to know about peds, but its a reference for you, definately not a study book.

2. HOWEVER, if you just want a book to cover pimp questions and study for the NBME, then Blueprints is a great book. Then read the Peds NBME thread to know what other books u need to prepare for the NBME.

3. There is no good pocket books for peds that I know of, I just carry around Blueprints all day, my resident told me that the chapter on newborns and childhood development in the best out of all review books. Dynamed is a great tool to read about diseases, I like it better than Uptodate, but its less complete, but totally sufficient for med students. I was never one of those people thats on their iphone looking up stuff constantly, older attending sometimes dislike that because they think you are not paying attention.

4. What you should have in your pocket/clipboard is a copy of Immunization Schedule, Ballard scoring sheets, child development checklist, ADHD screening tool, etc. etc.

I'm sure this isn't a unique problem, but after starting my pediatrics rotation (inpatient) for just the first two days, I already feel like I'm way in over my head. Just trying to keep things straight, figure out the flow of the day, figure out what I'm supposed to be doing and when. It doesn't help that my H&P skills pretty much suck right now, which then sort of extends to my presentation skills.

Also, while I meant to get all my books and such way before I started, Step I studying I guess got in the way and I forgot to, so now I've got stuff ordered on Amazon that's on its way but probably won't be here until the end of this week or Monday. I would've just gone to my school's bookstore, but it has terrible hours and is never open during a time when I can make it there with my current schedule.

Anyway, I'm feeling pretty lost and scatterbrained these first few days. I know it's party my fault, but anyone have any suggestions (specific or in general)? I feel like I should have all kinds of little pocket references with me and such. I've got epocrates on my iphone at least. But are there any good online resources to read up on patients and such? We have uptodate on the hospital computers, but I don't have an account to access from home.

 

[DocDanny]

I've started with internal medicine and I feel completely lost. Fortunately, my team is pretty good, and they are taking it relatively easy on us right now. But I echo your sentiments - despite two years of occasional training on how to take an H&P or SOAP notes, I'm horrible at it and I can't present worth a damn.

Heh. My school doesn't think learning SOAP notes is important. We only spent a day on them.

 

[metallo]

Heh. My school doesn't think learning SOAP notes is important. We only spent a day on them.

How long did you expect to spend on them? I'd say just having one session on learning SOAP notes is pretty standard regardless of where you go to school. They just teach you the format, show a few examples, and you go from there. Look at the residents' or attendings' notes or online if you need more help. This is how 3rd year works... you'll get a brief intro, and you'll be thrown into the fire. Don't expect a series of lectures on how to write SOAP notes or anything else for that matter. Also, don't worry... your skills will improve the more you practice them.

 

[DocDanny]

We did the other formats dozens of times.

Yet our instructors told us that we'd use the SOAP notes the most.

 

[metallo]

We did the other formats dozens of times.

Yet our instructors told us that we'd use the SOAP notes the most.

I suppose if I consider all the times throughout medical school that I was taught how to write a soap note (including 1st and 2nd year), it was probably several, but generally the 3rd year clerkships will cover this type of thing once and expect you pick it up from there. My first clerkship was Peds and I think "chart writing" was covered for maybe 30 mins. on our orientation day, but that was the only teaching we got on the topic. You'll learn even more by writing your own notes and then looking at the residents' and attendings' notes later in the day to see what info you missed. It really doesn't take long to figure out how things work on a particular rotation, so don't worry too much about it. No one expects you to be perfect at the beginning.

 

[cartoondoc]

The beginning is always overwhelming. Blueprints is great for peds and also pre-test. But if you're waiting for your books, you can at least look up stuff for your individual patients on emedicine or something. Learn how the ward works, learn your patients well, and that should get you through this rough patch.

 

[lildave2586]

I think we are all in the same boat. At this point, we know so very little. I wrote my first progress note today and it was pretty sad and pathetic. The only thing going in my favor is my team is absolutely excellent. It's 2:00 in the afternoon and I'm not at the hospital; I have so much to be thankful for, actually. I feel REALLY bad for my friends who started out in the ICU. I would have freaked out.

 

[badasshairday]

I am on Peds this month also. We have subspecialty time as well, and I'm on Peds ENT today. I feel like I am just standing around... well the doctor told me to just shadow her today since it is my first day on ENT. I know NOTHING! Kind of sucks.

I think the worst part is the feeling that she might think I am not interested. But I truely am... it's just that I don't know jack s***t.

 

[ShyRem]

You get used to knowing nothing and you start formulating reasonable questions. Make a list of things you have seen that you know nothing about (or very little). Start by looking up 3 of them at a time and the next day come in with good questions. You'll get better. I still have questions and feel like an idiot at times. You're supposed to have questions and you're not supposed to know everything yet (or probably ever).

As for seeing something once and they expect you to know it, get used to that. But feel free to ask questions to get it right - you're a third year student. If you get used to learning stuff quickly you'll get better at it and start picking things up quicker.