12/15（金）
◆今日の気持ち
（外科 2ヶ月3週）
・集中しすぎる癖のある自分を、うまくコントロールしないといけない。視野は広く、トラブルにはすぐに対処できるようにならないと…。
・すばやく動くようになるためには経験が必要。焦らずゆっくり対応する
・上司に考えたことを伝えることがうまくできていない。カルテ記入で上級医に報告したとする、自分が主治医である患者を持っていた内科での癖をいまだに引きずっていたことを自覚。…治療を指示するなら必ず電話、電話できなくて時間がないことであれば夕方そのことを報告。検査はコストとリスクが低ければ基本的には相談なしでやっておき、データからその先を考え相談。治療指示はすべて相談しOKが出れば書く。説得できなければ文献を見せる。…基本的な方針だができていなかったので、言葉にまとめておく。
…ちがう。仕事はどうやるかのかがよくわかっていなかったことと、仕事できていなかったから焦って仕事をするように切り替えたら、焦ってたせいで報告することを見逃していた。上の先生たちは病棟以外の場所でもかなり情報共有しているようだが、それが見えていなくて変な真似の仕方をしていた。悪い癖は早めにとる
・そもそも、外科での主治医、というあり方がよくわかっていなかったことに気づいた。きちんと意識しよう。
・「研修医は馬鹿な基本的なことを質問できるししなければならない」「思いつきで質問しない」の二つを両立できずにいて中途半端でいたことに気づいた。基本と応用とが入り乱れすぎていた。自分は基本的なことを質問すると怒られる性質を持っているし、きっちり調べ先を考えた上で質問する、調べ方がわからなければその調べ方を質問する、という方針に統一することに決める。基本的なことは、自分ですべて調べるつもりでいく。
●目指す医師像
総合内科医 問診を極めたい
西洋医学的には１～２剤のみつかう医師
症状には漢方を使用する医師
●今日の新患・診断
●今日の病院滞在時間
当直～18時
●今日行ったこと・見たこと・知ったこと
・顔面瘢痕除去形成ope
・大腿骨頚部骨折ope
・亜急性硬膜下血腫除去術
●今日うまくいかなかったこと・失敗
・患者さんを手術台から移動させるときにカテーテルを引っ掛けていた…。上の先生に指摘されなければ危なかった。まだまだまだ視野が狭すぎる。
●今後学びたいこと
●明日の予定
・電解質異常患者の状況をチェック
コメント
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