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12/21(木)

◆今日の気持ち
(外科 3ヶ月目)
・急いでいるときと急いでいないとき、外科的な思考と内科的な思考を使い分けなきゃ
・手術前に手術の内容、手順、調べてもわからんし、きいてみないといけないのか。何を求めて何を待つのか、考えないといけない。
・EPOCのレポートがよくわからない。サマリーではないと言われ、書式も決まっていないといわれ、症例レポートは別に欄があるし、よくわからないと知識をまとめたレポートかいたら、経験した症例をかくようにと。ひとり研修は情報なくて、わけがわからない…。上司と未だに文法が合わないというのは、問題…。
・上の先生の背中から、邪魔者オーラを感じる。事前に決めた術式とかカルテにも書いてないし話でも聞いていないのに揚げ足取られるし…。まあ、仕方ない。ぼちぼち、ぼちぼち。
・ちょっと悔しかったので、書ける範囲でレポートをほぼずべて仕上げてみた

●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
・SAH
・乳房腫瘍

●今日の病院滞在時間
7時〜24時半

●今日行ったこと・見たこと・知ったこと
・SAH救急
・A/C Ca ope
・レポート

●今日うまくいかなかったこと・失敗
・落ち着いていなかったのか? 救急でしっかりした血管を貫いた。しばらくルートをとっていなかったら感覚が鈍ったのか? 眠くて鈍っていたのか?
・病棟で作業(病院運営の上で自分の作業はほとんど意味はないのだろうけれど…)を片付けて手術あとの標本を見に行くのを後回しにしていたら、作業が終ってホルマリンつけられていた。ショウ膜面を見逃した…。時間の流れを考えるのも必要だけれど、手術室で適度に患者から目を話して標本を見ておくことも大切なのだろう。
・手術後、基本的なところを頓珍漢な勘違いをしていたら、上司の機嫌を損ねた。基本の輪郭が、まだつかめていない…。

●明日の予定
・ヘモope
・乳房腫瘍摘出
・胆嚢摘出

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