12/20(水)
◆今日の気持ち
(外科 3ヶ月目)
・必要以上に受け止めすぎない柳の心。きちんと学ぶためにこそ、重要。
・外科ope後の特有の病気がある。それの問診時の、頭に入れている検査前確率がまだまだ狂っている。外科の患者を頭に叩き込みきれていないということ。研ぎ澄まさないといけない。
・一人回診は、しっかり患者と話せじっくり患者を診ることもできて、嬉しい。でも、みたぶんきちんと報告しないと。
・自分の患者・領域に手を出すな、という雰囲気を上の先生から感じる。仕方がないことだし、ちょこちょこと周辺を攻めていこう
・糸結び、落ち着いてすばやくできるようになっていた。自分に自信なくやっていると、緩んじゃう気がした。でも、ope後こそ、練習しておかないとな…
●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
・胆石症
・胆嚢摘出後胆管炎
・A/C Ca → 腸重積
・腹腔鏡下に子宮筋腫
●今日の病院滞在時間
4時半〜20時
●今日行ったこと・見たこと・知ったこと
・一人回診
・ラパコロン …かがみもち&糸結び&ステイプラー
・EPOCレポート症候編提出
・救急症例検討会議
●今日うまくいかなかったこと・失敗
・外科カンファ。現病歴を覚えてられない。入院時の原疾患を覚えてられない。…次から原疾患はメモ。現病歴が必要な1週以内の入院患者のカルテは手元に。…棚に入れておくと、やっぱり届かない。
・カンファでしゃべるべきこと。突込みが甘い。opeの適応、opeの術式のためのstage、回復期の経過、など、opeに集中して思考を組み立てるべし。
・ステイプラーがまっすぐできない。こんどこそ!! …平行におけているかどうか、一息つく。
・気腹したあと切開いれると創が曲がる。まずラインを引いておく
●明日の予定
・ヘモope
・胆嚢摘出
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